Sexualized Drug Use and Chemsex: Their Association with Sexual Health Among Men who have Sex with Men Living in Greece.

Objectives: The study aims to investigate rates of sexualized drug use (SDU) and chemsex, a type of SDU involving specifically the use of crystal methamphetamine, mephedrone, or GHB/GBL and their association with the rates of negative sexual health outcomes among men who have sex with men (MSM) in Greece. Methods: Survey of 485 MSM in internal disease departments and community testing centers. Results: Twenty-eight percent of participants were involved in SDU and 20.4% in chemsex. HIV positive status and recent STI diagnoses were associated with SDU involvement. Conclusion: SDU and chemsex rates and their impact on health reveal the need for informed community-based services.

Neonatal End-of-Life Decision Making: The Possible Behavior of Greek Physicians, Midwives, and Nurses in Clinical Scenarios.

BACKGROUND: This study investigates the acceptability, bioethical justification, and determinants of the provision of intensive care to extremely preterm or ill neonates among healthcare professionals serving in NICUs in Greek hospitals. METHODS: Healthcare professionals (71 physicians, 98 midwives, and 82 nurses) employed full-time at all public Neonatal Intensive Care Units (NICUs) (n = 17) in Greece were asked to report their potential behavior in three clinical scenarios. RESULTS: The majority of healthcare professionals would start and continue intensive care to (a) an extremely preterm neonate, (b) a full-term neonate with an unfavorable prognosis, and (c) a neonate with complete phocomelia. In cases (a) and (b), midwives and nurses compared to physicians (p = 0.009 and p = 0.004 in scenarios (a) and (b), respectively) and health professionals ascribing to the quality-of-life principle compared to those ascribing to the intrinsic value of life (p = 0.001 and p = 0.01 scenarios (a) and (b) respectively), tend towards withholding or withdrawing care. Religion plays an important role in all three scenarios (p = 0.005, p = 0.017 and p = 0.043, respectively). CONCLUSIONS: Understanding healthcare professionals' therapeutic intensiveness in the face of NICU ethical dilemmas can improve NICU policies, support strategies, and, consequently, the quality of neonatal intensive care.

The relationship between dimensions of mental health and alexithymia in multiple sclerosis patients.

OBJECTIVES: The emotional correlates of multiple sclerosis have been the source of empirical interest in recent years. Studies have indicated that alexithymia as well as anxiety and depression are of central importance in this regard. The purpose of the present study was to continue this line of investigation regarding the relationships between alexithymia and mental health problems in patients with multiple sclerosis. More specifically, this study examined whether, and if so to what extent alexithymia significantly accounts for mental health problems in multiple sclerosis patients over and above the effect of the disease itself. The possible role of alexithymia as a moderating variable between multiple sclerosis and mental health difficulties was also investigated. In addition, the current study investigated mental health problems and alexithymia in greater depth by focusing on specific mental health problems that is, somatic complaints, anxiety, social dysfunction and depression as well as each of the component dimensions of alexithymia, that is, difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. METHODS: Forty patients with multiple sclerosis were compared to forty healthy individuals on the General Health Questionnaire-28 and the Toronto Alexithymia Scale-20. RESULTS: Alexithymia, especially difficulties identifying feelings, contributed to a substantial extent over and above multiple sclerosis per se in predicting all forms of psychopathology. The alexithymia dimension of difficulty describing feelings was found to moderate the relationship of multiple sclerosis with anxiety, so that the relationship between anxiety levels and difficulty describing feelings is different in multiple sclerosis patients than in healthy individuals. Finally, the alexithymia dimension externally oriented thinking was related to social dysfunction for all participants but to greater degree for multiple sclerosis patients. CONCLUSION: These to date unprecedented results have important implications regarding psychological treatment of patients with MS.

Bioethical Decisions in Neonatal Intensive Care: Neonatologists' Self-Reported Practices in Greek NICUs.

This study presents, for the first time, empirical data on practices regarding bioethical decision-making in treatment of preterm and ill newborns in Greece. The aim of the study was to: a) record self-reported practices and involvement of Greek physicians in decisions of withholding and withdrawing neonatal intensive care, and b) explore the implication of cultural, ethical, and professional parameters in decision-making. Methods: 71 physicians, employed fulltime in all public Neonatal Intensive Care Units (NICUs) (n = 17) in Greece, completed an anonymous questionnaire between May 2009 and May 2011. Results: One-third of the physicians in our sample admitted that they have, at least once in the past, decided the limitation of intensive care of a newborn close to death (37.7%) and/or a newborn with unfavorable neurological prognosis (30.8%). The higher the physicians' support towards the value of quality of human life, the more probable it was that they had taken a decision to withhold or withdraw neonatal intensive care (p <0.05). Conclusions: Our research shows that Greek NICU physicians report considerably lower levels of ethical decision-making regarding preterm and ill newborns compared to their counterparts in other European countries. Clinical practices and attitudes towards ethical decision-making appear to be influenced mainly by the Greek physicians' values.

Comparative study of hostility in depressive patients with and without a suicide attempt history.

Hostility in association with depression seems to be connected to suicidal behavior. This study aimed to evaluate hostility and its dimensions in relation to depression in patients who suffered from diagnosed depression with and without a suicide attempt history. The study included 168 participants; 58 patients with depression and suicide attempt history, 55 patients with depression without a suicide attempt history and 55 healthy controls. Hostility was assessed with the Hostility and Direction of Hostility Questionnaire, while depression with the Beck Depression Inventory (BDI). Patients with depression and a suicide attempt history compared with the patients without attempt history presented statistically significantly higher total hostility (28.71 ± 6.43 vs 24.20 ± 7.66), extroverted hostility (17.16 ± 4.37 vs 14.15 ± 4.63), acting out hostility (6.03 ± 2.09 vs 4.73 ± 1.93), and self criticism (6.95 ± 2.12 vs 5.89 ± 2.32). No statistically significant differences were found between the two clinical groups in depression according to the BDI. Moreover depressive patients with suicide attempt history scored higher in all the hostility dimensions than the controls. Therefore, it could be suggested that hostility and especially its extrapunitive dimensions are associated with suicidal behavior, since no differences in depression were recorded between the two clinical groups.

Preterm birth and maternal psychological health.

Studies have shown that preterm birth significantly influences mothers' psychological health. This study aimed to identify factors associated with preterm birth and assess postnatal depression and anxiety symptoms in mothers of preterm infants (n = 75) compared to mothers who delivered at term (n = 125) in a Greek sample. Multiple pregnancies, assisted reproduction technology, caesarean section, non-Greek ethnicity and smoking during pregnancy were associated with preterm delivery. Moreover, preterm infants' mothers had higher depression, state anxiety and trait anxiety scores. These findings suggest that addressing preventable causes of preterm delivery is crucial, while mothers of preterm infants should receive postnatal support.

Validity and reliability of the Greek version of the Modified Fatigue Impact Scale in multiple sclerosis patients.

Fatigue in multiple sclerosis (MS) may be attributed to a variety of biological and psychological factors. Scales addressing the multidimensionality of fatigue are used in MS evaluation, although adequacy of data on their reliability and validity is questionable. The aim of the present study was to provide evidence for the validity and reliability of the Greek version of the Modified Fatigue Impact Scale (MFIS). The MFIS was translated into Greek and administered to 99 MS patients and 75 controls. Exploratory factor analysis was carried out and reliability measures were calculated. Discriminant validity was also assessed. The mean MFIS score was 33.8 (SD 17.8). Two factors (physical and cognitive) were extracted through factor analysis; a psychosocial factor was not identified. Reliability measures (intraclass correlation coefficient, Cronbach's α, Pearson's correlation) yielded high values. Patients and nonpatients differed statistically significantly in the MFIS scores; no statistically significant differences in MFIS score according to the type of MS were observed. It can be concluded that the Greek version of MFIS is valid and reliable, although questions about the scale dimensions remain. Further modifications and cultural adaptation of the scale may help create a useful tool for screening and assessment of fatigue in MS patients.

Mothers' expectations and other factors affecting breastfeeding at six months in Greece.

The objective of this study is to determine the factors influencing breastfeeding duration in Greece. A total of 145 women were interviewed, on the third day post-partum. Women were followed up by telephone interviews at three and six months post-partum. Chi-square test and binomial sequential logistic regression analysis were used for statistical analysis. Results from this study show that baby-friendly hospital, antenatal courses, mother's perception of her capability to successfully breastfeed her infant, mother's intention to breastfeed for a duration of six months or more, mother's and father's education level, introduction of complementary foods or fluids, caesarean delivery, smoking and ethnicity were significantly associated with the duration of breastfeeding. In conclusion, additional antenatal and postnatal framework is necessary. Mothers' prediction of the duration of breastfeeding is an additional tool for identification of women with a high probability for early weaning.