Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece.

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages.

Diet-Related Behaviors and Diet Quality among School-Aged Adolescents Living in Greece.

Prevalence of diet-related behaviors (i.e., breakfast consumption, eating with the family) and their association with a 17-point diet quality score, constructed on the basis of reported frequency (in days/week) of vegetable, fruit, sweets and sugar-sweetened beverages consumption, was investigated among 3525 adolescents (51.5% girls) aged 11, 13 and 15 years, who were participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) cross-sectional study, during 2018. Almost one-third (32.9%) of the sample had breakfast ≤1 day/weekdays, 20.2% rarely ate with the family, 26.1% had a meal while watching TV ≥5 days/week, 31.7% had a snack in front of a screen ≥5 days/week and 24.1% ate in fast-food restaurants at least once/week. Multivariable ordinal logistic regression revealed that eating breakfast ≤1 day/weekdays compared to 4-5 days/weekdays (Odds ratio (OR): 1.56, 95% con-fidence interval (CI): 1.34-1.82), eating rarely with the family compared to almost every day (OR: 1.35, 95% CI: 1.13-1.60) and eating in fast-food restaurants ≥2 times/week vs. rarely (OR: 4.59, 95% CI: 3.14-6.70) were associated with higher odds of having poor diet quality. High frequency of having meals/snacks in front of a screen/TV was also associated with poor diet quality. Efforts to prevent or modify these behaviors during adolescence may contribute to healthier diet.

Real-World Data on Health-Related Quality of Life Assessment in Patients With Breast Cancer Receiving Subcutaneous Trastuzumab.

PURPOSE: Trastuzumab, a humanized anti-human epidermal growth factor receptor 2 (anti-HER2) antibody delivered intravenously, has revolutionized the treatment of patients with breast cancer overexpressing HER2 protein. Recently, a newer subcutaneous formulation was shown to have comparable efficacy to the initial intravenous trastuzumab. In this study, we aimed to evaluate the impact of subcutaneous trastuzumab on the health-related quality of life (HRQoL) of patients diagnosed with early or metastatic HER2-overexpressing breast cancer. METHODS: Patients were provided with the EORTC QLQ-C30 (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) and the BR-23 questionnaires. The scoring of questionnaires and patient's sociodemographic and clinicopathologic characteristics were recorded and analyzed by descriptive and correlation statistics employing t test and 2-way analysis of variance. RESULTS: A total of 163 patients agreed to participate in the study. About 90 of 163 patients (55.21%) received subcutaneous trastuzumab and 21 patients intravenous trastuzumab (12.88%). A control group of 52 HER2+ patients received chemotherapy without trastuzumab (31.90%). Patients receiving subcutaneous trastuzumab were older and of more advanced disease stage compared with those receiving chemotherapy (58.5 vs 51 years, 39.8% vs 28.8% advanced disease). In univariate analysis, subcutaneous trastuzumab was associated with less nausea and vomiting (P = .002) but worse cognitive function (P = .013) and dyspnea (P = .042). Patients who have received >8 cycles of subcutaneous trastuzumab reported less diarrhea (P = .049) and systemic therapy side effects (P = .015). Multivariate analysis showed that patients without comorbidity receiving subcutaneous trastuzumab had less treatment side effects, less upset by hair loss, and higher emotional functioning. Of note, mastectomy and subcutaneous trastuzumab were associated with improved role functioning (P = .021). In metastatic disease, no negative impact of subcutaneous trastuzumab on HRQoL was found. CONCLUSIONS: The administration of subcutaneous trastuzumab improved certain symptoms and did not adversely affect most of the assessed functional scales. Particularly, in the metastatic setting, subcutaneous trastuzumab had no negative impact on HRQoL.

HCV/HIV coinfection among people who inject drugs and enter opioid substitution treatment in Greece: prevalence and correlates.

BACKGROUND: HCV/HIV coinfection in people who inject drugs is a public health issue, which presents a variety of challenges to healthcare providers. The determinants of HCV/HIV coinfection in this population are nonetheless not well known. The aim of the present study is to identify the factors associated with HCV/HIV coinfection in people who inject drugs and enter drug-related treatment. METHODS: Linked serological and behavioral data were collected from people who entered 38 opioid substitution treatment clinics in central and southern Greece between January and December 2013. Three mutually exclusive groups were defined based on the presence of HCV and HIV antibodies. Group 1 clients had neither infection, Group 2 had HCV but not HIV, and Group 3 had HCV/HIV coinfection. Multinomial logistic regression analyses identified differences between groups according to socio-demographic, drug use and higher-risk behavioral characteristics. RESULTS: Our study population consisted of 580 people who injected drugs in the past 12 months (79.8 % males, with median age 36 years).79.4 % were HCV and 15.7 % HIV infected. Of those with complete serological data in both HCV and HIV indicators, 20.4 % were uninfected, 64.0 % HCV monoinfected, and 14.9 % HCV/HIV coinfected. HCV infection with or without HIV coinfection was positively associated with living alone or with a spouse/partner without children, prior incarceration, drug injecting histories of ≥10 years, and syringe sharing in the past 12 months, and negatively associated with never having previously been tested for HCV. HCV/HIV coinfection, but not HCV infection alone, was positively associated with residence in urban areas (relative risk ratio [RRR] = 4.8, 95 % confidence interval [CI]: 1.7-13.7, p = 0.004) and averaging >3 injections a day in the past 30 days (RRR = 4.5, 95 % CI: 1.6-12.8, p = 0.005), and negatively associated with using a condom in the last sexual intercourse. CONCLUSIONS: People who inject drugs and live in urban areas and inject frequently have higher risk of coinfection. Findings highlight the need for scaling-up needle and syringe programs in inner city areas and promoting access of this population to screening and treatment, especially in prisons. The protective role of living with parents and children could inform the implementation of indicated interventions.

Prevalence and correlates of electronic cigarette use among adolescents in Greece: a preliminary cross-sectional analysis of nationwide survey data.

INTRODUCTION: This study reports the prevalence of electronic cigarette (e-cigarette) use among adolescents in Greece and explores how dual smokers of e-cigarettes and combustible (conventional) cigarettes differ from smokers of only combustible cigarettes across socio-demographic, familial, psychosomatic health and substance use characteristics. METHODS: Self-reports on smoking were collected from a nationally representative sample of 1320 15-year-old Greek students in the 2014 Health Behaviour in School-aged Children study. Bivariate and multivariable logistic regression analyses were carried out with dependent variables a) lifetime smoking conventional cigarettes and b) lifetime e-cigarette use among lifetime smokers. RESULTS: About 36.9% of 15-year-olds reported lifetime smoking of conventional cigarettes, and 16.6% lifetime use of e-cigarettes, mostly experimenting (0.5% reported current e-cigarette use). Six in 7 ever e-cigarette smokers had smoked conventional cigarettes. Peers who smoke and lifetime cannabis use were significant correlates of both lifetime conventional cigarette and e-cigarette smoking, but more strongly for smoking conventional cigarettes. Alcohol use and low parental monitoring correlated with tobacco smoking but not e-cigarette use. Girls were more likely than boys to report lifetime use of tobacco, but, among lifetime smokers, boys had almost seven times the odds of girls of e-cigarette use. In lifetime smokers, low life satisfaction in females and current smoking of conventional tobacco were independently associated with the experimentation with e-cigarettes. CONCLUSIONS: Experimental use of e-cigarettes is relatively widespread among adolescents in Greece. Targeted interventions should focus on male smokers and the role of peer processes and cannabis use in the risk of experimenting with e-cigarettes.

National income inequality and declining GDP growth rates are associated with increases in HIV diagnoses among people who inject drugs in Europe: a panel data analysis.

BACKGROUND: There is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA). METHODS: We used panel data (2003-2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated. FINDINGS: In multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested. INTERPRETATION: Given the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable groups.