Psychotropic medicine use without current or prior medical advice, storage at home and association with perceived stress in a primary health care setting in Greece / Uso de medicamentos psicotrópicos sin consejo médico actual o previo, almacenamiento en el hogar y asociación con estrés percibido en un entorno de atención primaria en Grecia

Objective: Psychotropic medicines use alters according to socio-economic factors and perceived stress. The study aimed to assess the prevalence of use of psychotropic medicines and supplements (PMS) without medical advice, including storage at home, and its relationship with socio-demographic characteristics and perceived stress in primary care patients. Materials and methods: A cross-sectional sample of adult attendees in an urban primary care unit in Crete, Greece, were surveyed during regularly scheduled appointments during a three-week period in October 2020. A questionnaire was distributed to investigate PMS use during the last 12 months. The validated Greek version of Perceived Stress Scale (PSS-14) was adopted to measure perceived stress. Results: Of 263 respondents (mean age 46.3±14.5 years; 66.5% females), 101 (38.4%; 95%CI 33.1–43.7%) recalled having psychotropic medicines stored at home cabinets and 72 (27.4%; 95%CI 22.4–32.3%) reported using PMS without medical advice in the last 12 months. Conclusions: This study revealed a high prevalence of PMS use without medical advice, including storage at home. People>59 years of age, experiencing irregular sleep and scoring high in PSS, displayed increased prevalence of storing PMS at home or using them without medical advice. The findings could potentially inform primary care providers to focus on patients most likely to be users of PMS without medical advice.(AU)

Objetivo: El uso de medicamentos psicotrópicos cambia según los factores socioeconómicos y el estrés percibido. El estudio tuvo como objetivo evaluar la prevalencia de uso de medicamentos y suplementos psicotrópicos (MSP) sin consejo médico, incluido el almacenamiento en el hogar y su relación con las características sociodemográficas y el estrés inferido en pacientes de atención primaria. Materiales y métodos: Se encuestó a una muestra transversal de asistentes adultos en una Unidad de Atención Primaria Urbana en Crete, Grecia, durante citas programadas regularmente durante un periodo de tres semanas en Octubre de 2020. Se distribuyó un cuestionario para investigar el uso de MSP durante los últimos 12 meses. Se adoptó la versión griega validada de la Escala de Estrés Percibido (Perceived Stress Scale 14, PSS-14) para medir el estrés percibido. Resultado: De 263 encuestados (edad media 46,3 ± 14,5 años; 66,5% mujeres), 101 (38,4%; IC 95%; 33,1-43,7%) recordaban tener medicamentos psicotrópicos almacenados en los armarios de sus casas y 72 (27,4%; IC 95%; 22,4-32,3%) informó haber usado MSP sin consejo médico en los últimos 12 meses. Conclusiones: Este estudio reveló una alta prevalencia de uso de MSP sin consejo médico, incluido el almacenamiento en el hogar. Las personas mayores de 59 años, que experimentaron sueño irregular y puntuaron alto en PSS, mostraron una mayor prevalencia de almacenar MSP en casa o usarlos sin consejo médico. Los hallazgos podrían informar potencialmente a los proveedores de atención primaria para que se centren en los pacientes con mayor probabilidad de usar MSP sin consejo médico.(AU)

Leachability of hexavalent chromium from fly ash-marl mixtures in Sarigiol basin, Western Macedonia, Greece: environmental hazard and potential human health risk.

Hexavalent chromium (Cr (VI)) is an environmental contaminant brining high concerns due to its higher toxicity and mobility in comparison with trivalent chromium Cr(III). Cr (VI) has been linked with several adverse health effects, including respiratory diseases, lung cancer, and skin irritation. The primary sources of it in the environment are industrial activities.Most of the time, fly ash made of lignite can release Cr(VI) when it comes into contact with water in an aquatic environment. The objective of this study is the investigation of Cr (VI) concentration in leachates of fly ash and marl mixtures and the determination of its solubility under different pH conditions. Samples of fly ash were collected from the Power Plant of Agios Dimitrios. Additionally, samples of marl were collected from the mine of South Field, and both samples were mixed and prepared in in different proportions (% w.t.). The leaching experiments were carried out according to the EN-12457/1-4 (2003) standard under different pH conditions and chemical analysis of the leachates were performed by spectrophotometry with diphenylcarbazide (DPC). The environmental footprint of Cr (VI) in the study area was significant, especially in mixtures containing higher concentrations of fly ash. A critical pH range between 6 to 12 is observed. At acidic pH values, a high release of Cr (VI) was observed, while at the mentioned critical values (pH 10-12), a gradual decrease in its leachability was noticed. The high concentrations of Cr (VI) in the industrial area studied require immediate actions in terms of managing and limiting the potential hazardous impacts on the environment and by extension on the public health by developing appropriate prevention strategies.

Emigration of Greek Knowledge to the Arab World.

The period described in this chapter reflects activity prior to the establishment of surgical centers in Europe in the twelfth century. It is a kind of prologue to the reintroduction of high-quality surgical practice. Religious squabbles within Christianity led to European medicine and surgery, the principles of which were written in Greek, being transported eastwards into the region newly dominated by Islam. There the works were translated into Arabic and during three to four hundred years, the works were not only retained but were enriched by contributions from within Arab culture. This evolution naturally enough came to affect what happened next. However, one thing is clear and was even commented on as early as by Albucasis. The surgeon's respect and distinction within society had depreciated during the sojourn of medical science in the Islamic world, with physicians being regarded as distinctly superior beings. With regard to specific details related to opening the head there was broad consistency between the various authors all of whom seem to have been greatly influenced by Paul of Ægina. Thus, there is no mention of the crown trepan. Opening the skull was performed with the non-perforating trepans making small holes which were connected with chisels or lenticulars. The indication to do this was separation of the dura from the bone. Whether or not the sutures should be avoided when trepanning is not a topic mentioned in these writings. There was also no recommendation for prophylactic trepanation.

The Plegma dataset: Domestic appliance-level and aggregate electricity demand with metadata from Greece.

The growing availability of smart meter data has facilitated the development of energy-saving services like demand response, personalized energy feedback, and non-intrusive-load-monitoring applications, all of which heavily rely on advanced machine learning algorithms trained on energy consumption datasets. To ensure the accuracy and reliability of these services, real-world smart meter data collection is crucial. The Plegma dataset described in this paper addresses this need bfy providing whole- house aggregate loads and appliance-level consumption measurements at 10-second intervals from 13 different households over a period of one year. It also includes environmental data such as humidity and temperature, building characteristics, demographic information, and user practice routines to enable quantitative as well as qualitative analysis. Plegma is the first high-frequency electricity measurements dataset in Greece, capturing the consumption behavior of people in the Mediterranean area who use devices not commonly included in other datasets, such as AC and electric-water boilers. The dataset comprises 218 million readings from 88 installed meters and sensors. The collected data are available in CSV format.

Discovery of the novel HLA-B*47:01:01:07 allele in a Greek volunteer bone marrow donor.

HLA-B*47:01:01:07 differs from the HLA-B*47:01:01:03 allele by one nucleotide deletion in the 3'UTR.

Discovery of the novel HLA-A*01:01:01:112 allele in a Greek volunteer bone marrow donor.

HLA-A*01:01:01:112 differs from the HLA-A*01:01:01:01 allele by one nucleotide substitution in the 5'UTR.

NMR Analysis of Extra Virgin Olive Oil of the Epirus Region of Greece with Emphasis on Selected Phenolic Compounds.

Extra virgin olive oil (EVOO) is recognized for its numerous health benefits, attributed to its rich phenolic components. NMR has emerged as a prevalent technique for precisely identifying these compounds. Among Mediterranean countries, Greece stands as the third-largest producer of olives, with the Epirus region notably advancing in olive cultivation, contributing significantly to the dynamic growth of the region. In this study, an NMR method was employed based on the acquisition of a 1H NMR spectrum along with multiple resonant suppression in order to increase the sensitivity. Using the above method, 198 samples of extra virgin olive oil, primarily sourced from the Epirus region, were analyzed, and both the qualitative and quantitative aspects of the phenolic compounds were obtained. In addition, we examined the effects of various factors such as variety, harvest month, and region origin on the phenolic compounds' concentration. The results revealed an average total phenolic content of 246 mg/kg, closely approaching the EU health claim limit of 250 mg/kg. Approximately 15% of the samples were confidently characterized as high-phenolic olive oil. The highest concentrations were observed in the Thesprotia samples, with several Lianolia varieties exceeding the total phenolic content of 400 mg/kg. Statistical tests demonstrated a significant influence of the olive variety and the month of fruit harvest on phenolic component concentration, followed by the region of origin. A very strong correlation was noted between the total phenolics content and the levels of oleocanthal and oleacein, with a correlation coefficient (r) of 0.924. Upon optimization of all factors affecting olive oil quality, the majority of the EVOOs from the Epirus region have the potential to be characterized as high in phenolic content.

The Fagerström Test for Nicotine Dependence, as a prognostic factor, in current smokers with and without COPD: A cross-sectional study in northern Greece.

BACKGROUND: Smoking poses the most common risk factor for chronic obstructive pulmonary disease (COPD) and aggravates disease progression. Tobacco dependence inhibits smoking cessation and may affect smoking patterns that increase tobacco exposure and predispose to lung function decline. AIMS AND OBJECTIVES: We aimed to assess tobacco dependence in current smokers with and without COPD and evaluate its role in disease development. METHOD: This cross-sectional study was conducted in Greek rural areas. Current smokers completed the Fagerström Test for Nicotine Dependence and were classified into COPD and non-COPD groups based on spirometry parameters. RESULTS: Among current smokers, 288 participants comprised the non-COPD and 71 the COPD group. Both presented moderate tobacco dependence, but smokers with COPD started to smoke earlier in the morning. Multiple logistic regression analysis revealed higher COPD prevalence in smokers with higher scores in the Fagerström test (odds ratio OR = 1.12, 95% confidence interval [1.01 - 1.24]) and older age (OR = 1.06 [1.03 - 1.09]), independently of pack-years smoking index. Multiple linear regression analysis in smokers with COPD showed that the forced expiratory volume in the 1st second decreased by 2.3% of the predicted value for each point increase in the Fagerström Test and 0.59% for each year of age, independently of participants' sex and pack-years smoking index. CONCLUSION: The Fagerström score appears to indicate a higher probability for COPD and lung function deterioration when assessed along with age in current smokers. Smoking cessation support programs are fundamental to COPD prevention and management.

A novel HLA-C*17 variant, HLA-C*17:01:01:29, identified in a healthy individual from Greece.

HLA-C*17:01:01:29 differs from the HLA-C*17:01:01:05 allele by one nucleotide substitution in the 3'UTR.

A novel HLA-C*04 variant, HLA-C*04:01:01:174, identified in a healthy individual from Greece.

HLA-C*04:01:01:174 differs from the HLA-C*04:01:01:06 allele by one nucleotide substitution in the intron 5.

A novel HLA-C*01 variant, HLA-C*01:02:01:70, identified in a healthy individual from Greece.

HLA-C*01:02:01:70 differs from the HLA-C*01:02:01:01 allele by one nucleotide substitution in the intron 4.

Empathy, self-compassion, and depression correlations among health professionals in Northern Greece.

OBJECTIVE: Aim: To study and record the level of empathy and self-compassion of the medical and nursing staff of a general hospital in North Greece, and to investigate their connection to depression levels.. PATIENTS AND METHODS: Materials and Methods: The study sample consists of 88 people (66 women and 22 men), medical and nursing staff of the General Hospital of Kavala (northern Greece) who filled out a questionnaire. The questionnaire consists of 4 parts: 1) socio-demographic data; 2) the Toronto Empathy Questionnaire (TEQ); 3) Self- Compassion Scale (SCS), and 4) the Beck Depression Inventory (BDI). For the statistical processing of the data, SPSS v.25 software was used. RESULTS: Results: The mean total value for TEQ indicates moderate high level of empathy (M = 40.5). For self-compassion the mean total value for SCS was moderate (M = 82.6) and the BDI shows a low level of depression (M = 28.7). A high level of empathy corresponds to a high level of self-compassion (ρ(88) = 0.263, p = 0013). Older ages correspond to a lower level of depression (ρ(88) = -0.218, p = .042). CONCLUSION: Conclusions: Empathy is a key factor for the creation of the therapeutic relationship between the patient and the healthcare provider, while increasing the level of the health provider's self-compassion. Increased levels of self-compassion and older age among providers may correspond to lower levels of depression.

Robotic Arm-Assisted Total Knee Arthroplasty: Anatomical Alignment and Mid-Term Outcomes from the First Cohort Originating in Greece.

Robotic arm-assisted total knee arthroplasty (RATKA) represents a haptic assistive robotic arm used for bone preparation. The purpose of this study was to present implant survivorship, complications and evaluate patients' satisfaction, clinical and functional outcome of RATKA with a minimum of 1-year follow-up. The Oxford Knee Score was recorded preoperatively and at last follow-up. Patients' satisfaction rates, as well as complications and re-operations were studied. Anatomical alignment including varus, valgus deformities and flexion, extension, pre-and postoperatively were evaluated. A total of 156 patients with mean age = 71.9 years were included in the study. The mean follow-up was 35.7 months, while one revision was performed due to infection. Statistically significant improvement of the Oxford Knee Score, as well as of the knee alignment deformities were recorded, while 99.4% of patients reported to be "very satisfied" or "satisfied" with the procedure. RATKA seems to be a safe, as well as reproductible procedure at short-and mid-term follow-up, while the accurate implant positioning may lead to favorable long-term outcomes.

Sterile Insect Technique (SIT) field trial targeting the suppression of Aedes albopictus in Greece.

The sterile insect technique (SIT) involves releasing large numbers of sterile males to outcompete wild males in mating with females, leading to a decline in pest populations. In the current study, we conducted a suppression trial in Greece against the invasive dengue vector mosquito Aedes albopictus (Skuse) through the weekly release of sterile males for 22 weeks from June to September 2019. Our approach included the long-distance transport of sterile mosquitoes, and their release at a density of 2,547 ± 159 sterile males per hectare per week as part of an area-wide integrated pest management strategy (AW-IPM). The repeated releases of sterile males resulted in a gradual reduction in egg density, reaching 78% from mid-June to early September. This reduction remained between 70% and 78% for four weeks after the end of the releases. Additionally, in the SIT intervention area, the ovitrap index, representing the percentage of traps containing eggs, remained lower throughout the trial than in the control area. This trial represents a significant advance in the field of mosquito control, as it explores the viability and efficacy of producing and transporting sterile males from a distant facility to the release area. Our results provide valuable insights for future SIT programmes targeting Ae. Albopictus, and the methodology we employed can serve as a starting point for developing more refined and effective release protocols, including the transportation of sterile males over long distances from production units to intervention areas.

Title: Essai sur le terrain de la Technique de l'Insecte Stérile (TIS) ciblant la suppression d'Aedes albopictus en Grèce. Abstract: La technique de l'insecte stérile (TIS) consiste à libérer un grand nombre de mâles stériles pour supplanter les mâles sauvages lors de l'accouplement avec les femelles, entraînant ainsi un déclin des populations de nuisibles. Dans la présente étude, nous avons mené un essai de suppression en Grèce contre le moustique vecteur invasif de la dengue, Aedes albopictus (Skuse), par le biais de la libération hebdomadaire de mâles stériles pendant 22 semaines de juin à septembre 2019. Notre approche comprenait le transport sur de longues distances de moustiques stériles, et leur lâcher à une densité de 2 547 ± 159 mâles stériles par hectare et par semaine dans le cadre d'une stratégie de lutte intégrée contre les nuisibles à l'échelle de la zone (AW-IPM). Les lâchers répétés de mâles stériles ont entraîné une réduction progressive de la densité des œufs, atteignant 78 % de la mi-juin au début septembre. Cette réduction est restée entre 70 % et 78 % pendant quatre semaines après la fin des lâchers. De plus, dans la zone d'intervention de la TIS, l'indice d'oviposition, représentant le pourcentage de pièges contenant des œufs, est resté plus faible que dans la zone témoin tout au long de l'essai. Cet essai représente une avancée significative dans le domaine de la lutte contre les moustiques, car il explore la viabilité et l'efficacité de la production et du transport de mâles stériles depuis une installation éloignée vers la zone de lâcher. Nos résultats fournissent des informations précieuses pour les futurs programmes de TIS ciblant Ae. albopictus et la méthodologie que nous avons utilisée pourra servir de point de départ pour développer des protocoles de libération plus raffinés et plus efficaces, y compris le transport de mâles stériles sur de longues distances depuis les unités de production jusqu'aux zones d'intervention.

Novel Pathogenic Variants Leading to Sporadic Amyotrophic Lateral Sclerosis in Greek Patients.

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive disease that affects motor neurons, leading to paralysis and death usually 3-5 years after the onset of symptoms. The investigation of both sporadic and familial ALS highlighted four main genes that contribute to the pathogenesis of the disease: SOD1, FUS, TARDBP and C9orf72. This study aims to provide a comprehensive investigation of genetic variants found in SOD1, FUS and TARDBP genes in Greek sporadic ALS (sALS) cases. Our sequencing analysis of the coding regions of the abovementioned genes that include the majority of the variants that lead to ALS in 32 sALS patients and 3 healthy relatives revealed 6 variants in SOD1, 19 variants in FUS and 37 variants in TARDBP, of which the SOD1 p.D90A and the FUS c.*356G>A (rs886051940) variants have been previously associated with ALS, while two novel nonsense pathogenic variants were also identified, namely FUS p.R241* and TDP-43 p.Y214*. Our study contributes to the worldwide effort toward clarifying the genetic basis of sALS to better understand the disease's molecular pathology.

A Chronic Obstructive Pulmonary Disease Self-Management Intervention for Improving Patient-Reported Outcomes in Primary Care in Greece.

Background and Objectives: Self-management programs are essential for increasing COPD patient participation and autonomy in making appropriate decisions about their chronic condition. The present study aimed to assess the impact of COPD self-management interventions on quality of life, functional status, patient education, depression, and anxiety in primary care. Materials and Methods: We conducted a randomized controlled trial recruiting patients with COPD (GOLD A and B) from four primary care centers in Crete, Greece, with one intervention group (n = 40) receiving self-management educational support and one control group (n = 80) receiving usual care. To measure quality of life, functional status, patient education, depression, and anxiety, we used patient-reported outcome measures (PROMs) at baseline and 6 months post-intervention, including the Short-Form Health survey (SF-12), Clinical COPD Questionnaire (CCQ), mMRC, Beck Anxiety Inventory (BAI), Beck Depression Inventory, Health Education Impact Questionnaire (HeiQ), and Health Literacy Questionnaire (HLQ). Results: At the end of the 6-month intervention, most PROMs improved significantly in the intervention group (p < 0.05) but did not show significant changes in the control group. The greatest improvements at follow-up compared to baseline measurements were observed for dyspnea (mMRC-38.6%), anxiety (BAI-35%), depression (BDI-20.2%), COPD health status (CCQ-34.1%), and the actively managing my health subscale of HLQ (23.5%). Conclusions: Our results suggest that a self-management intervention could be an effective strategy for improving PROMs in primary care. Although more research is needed to identify the long-term effects of such interventional programs, policymakers could implement similar programs to improve the overall health of these patients.

Evaluation of Lower Urinary Tract Symptoms in Males and Urinary Incontinence in Females in Primary Health Care in Greece.

Background and Objectives: The significant prevalence of Lower Urinary Tract Symptoms (LUTS), erectile dysfunction (ED), and associated adverse effects calls for increased attention in primary care settings. In Greece, there is a lack of sufficient data for LUTS and ED screening in primary care. Therefore, the aim of our study was to estimate the prevalence of LUTS and ED, identify associated risk factors, and evaluate their impact on quality of life among adult primary healthcare users aged 40 years and older in Crete, Greece. Materials and Methods: A cross-sectional study was conducted to explore the prevalence of LUTS and ED in 1746 primary health care users visiting rural primary health care practices in Crete, Greece. Participants underwent a comprehensive evaluation including demographic parameters, screening for LUTS utilizing the validated International Prostate Symptoms Score (IPSS) questionnaire and for ED using the International Index of Erectile Function (IIEF-5), in males, and for urinary incontinence in women with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Participants with a prior diagnosis of LUTS or ED were excluded (n = 183). Results: Out of 536 participants finally included (n = 1746 screened), 32% of males and 36% of females exhibited moderate to severe LUTS. Following adjustments, we identified advanced age, retirement, and the presence of diabetes type 2 as factors associated with the occurrence of LUTS in men. Patients with LUTS also had a substantially increased likelihood of experiencing ED. Moreover, it was observed that women with hypertension or diabetes type 2 and lower education levels face an increased likelihood of developing LUTS, which adversely affects their quality of life. Conclusions: In conclusion, the findings of this study reveal a high occurrence of LUTS and ED in adults aged 40 years and older who utilize primary healthcare services, with a negative impact on their quality of life.

Cross-country variations in the caregiver role: evidence from the ENTWINE-iCohort study.

BACKGROUND: Globally, economically developed countries face similar ageing demographics and the challenge of a 'care gap', yet they vary due to different care and formal support systems, and different cultural and societal norms around illness and care. The aim of this exploratory study was to examine cross-country variations in caregiver motivations, willingness, values, meaning in life, illness beliefs, and experiences of wellbeing, gain, health-related quality of life, burden and depression, across 6 European countries and Israel. Cross-country differences in the above-mentioned informal caregiver experiences are rarely described. METHODS: An online survey (ENTWINE-iCohort) was conducted using validated measures wherever possible. This paper utilises data from 879 caregivers and seven countries (Greece, Italy, the Netherlands, Poland, Sweden, the UK, and Israel). RESULTS: No consistent finding supporting the concurrent relationship between caregiver support policies/country culture and caregiver motivations/willingness was found. Caregivers in countries typically characterised by individualist cultures reported lower familism, higher self-enhancement values, and greater perceived illness threat compared to more collectivist countries. Search for meaning was higher in poorer countries than in wealthier countries. Higher negative caregiver experiences (e.g., burden) and lower positive experiences (e.g., wellbeing) were generally observed in countries with underdeveloped caregiver support as compared to countries with more developed formal support systems. CONCLUSIONS: Cross-country variations can be explained to varying degrees by national policies around care (or their absence) and country cultural contexts. The results emphasise the importance of formal support services for achieving positive caregiver experiences, and help inform the development of policies and measures to support caregivers in Europe and Israel.

Editorial: Oral Health: luxury or a fundamental human right? The necessity of introducing a dedicated oral health budget and Proportionate Universalism in Greece.

Oral health is an integral part of overall health and critically affects quality of life as well as personal and social well-being. Poor oral health negatively influences general health and creates medical, financial and social burdens for individuals, families and health systems. The US Office of Disease Prevention and Health Promotion (2021) sees use of the oral health care system as a leading health indicator. Oral health improvement is an important step to reduce socioeconomic inequalities and promote the UN Sustainable Development Strategy (Wang et al., 2020, Huang and Chang 2022). Moreover, "achieving the highest attainable standard of oral health is a fundamental human right of every human being" (WHO 2022a).

Healthy diets positively associated with health-related quality of life in children and adolescents from low socioeconomic areas: Findings from the Greek Food Aid Program, DIATROFI.

OBJECTIVES: To assess the relationship of diet with health-related quality of life (HRQoL) in vulnerable children and adolescents. METHODS: Data included 6583 children and adolescents (aged 3-18 years old) from the Greek Food-Aid DIATROFI Program in the 2015 to 2016 and 2017 to 2018 school years. HRQoL was measured with the Pediatric Quality of Life Inventory questionnaire and diet with food frequency questionnaires. The healthy plant-based diet index (hPDI), animal score, and dietary patterns were investigated. RESULTS: The hPDI and animal score were associated with good HRQoL (odds ratio [OR] [95% confidence interval], 10-unit increase: ORhPDI = 1.28 [1.05, 1.57], ORanimal = 1.51 [1.14, 2.00]) and physical (ORanimal = 1.62 [1.23, 2.13]), emotional (ORhPDI = 1.30 [1.07, 1.58], ORanimal = 1.41 [1.08, 1.85]) and school function (ORhPDI = 1.32 [1.09, 1.59], ORanimal = 1.46 [1.12, 1.89]). Dietary patterns of fruits, raw vegetables, and cheese were associated with good HRQoL (OR of 1-unit increase: 1.22 [1.13, 1.32]), and physical OR = 1.18 [1.09, 1.27]) and emotional function (OR = 1.09 [1.02, 1.18]). Starchy foods and sweetened beverages were associated with poor HRQoL (OR = 0.75 [0.63, 0.90]), and emotional (OR = 0.80 [0.68, 0.95]) and school function (OR = 0.72 [0.61, 0.85]). CONCLUSION: Healthy diets and dietary patterns were positively associated with the HRQoL of vulnerable children and adolescents, which may offer opportunities for prevention.