Predicting VO2max in Children and Adolescents Aged between 6 and 17 Using Physiological Characteristics and Participation in Sport Activities: A Cross-Sectional Study Comparing Different Regression Models Stratified by Gender.

Background: The aim of this study is to use different regression models to capture the association between cardiorespiratory fitness VO2max (measured in mL/kg/min) and somatometric characteristics and sports activities and making better predictions. Methods: multiple linear regression (MLR), quantile regression (QR), ridge regression (RR), support vector regression (SVR) with three different kernels, artificial neural networks (ANNs), and boosted regression trees (RTs) were compared to explain and predict VO2max and to choose the best performance model. The sample consisted of 4908 children (2314 males and 2594 females) aged between 6 and 17. Cardiorespiratory fitness was assessed by the 20 m maximal multistage shuttle run test and maximal oxygen uptake (VO2max) was calculated. Welch t-tests, Mann−Whitney-U tests, X2 tests, and ANOVA tests were performed. The performance measures were root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2). All analyses were stratified by gender. Results: A comparison of the statistical indices for both the predicted and actual data indicated that in boys, the MLR model outperformed all other models in all indices, followed by the linear SVR model. In girls, the MLR model performed better than the other models in R2 but was outperformed by SVR-RBF in terms of RMSE and MAE. The overweight and obesity categories in both sexes (p < 0.001) and maternal prepregnancy obesity in girls had a significant negative effect on VO2max. Age, weekly football training, track and field, basketball, and swimming had different positive effects based on gender. Conclusion: The MLR model showed remarkable performance against all other models and was competitive with the SVR models. In addition, this study's data showed that changes in cardiorespiratory fitness were dependent, to a different extent based on gender, on BMI category, weight, height, age, and participation in some organized sports activities. Predictors that are not considered modifiable, such as gender, can be used to guide targeted interventions and policies.

Anthropometric, Lifestyle Characteristics, Adherence to the Mediterranean Diet, and COVID-19 Have a High Impact on the Greek Adolescents' Health-Related Quality of Life.

OBJECTIVE: The study aimed at analyzing the relationship between anthropometric characteristics, lifestyle, and dietary habits, as well as the burden of the pandemic on the health-related quality of life among Greek pupils. RESEARCH METHODS AND PROCEDURES: On the whole, 2088 adolescents aged 12-18 years from Attica, Greece, were enlisted in this school-based cross-sectional study that took place in May-December 2021. Health-related quality of life was estimated through the KIDSCREEN-27 questionnaire, adherence to the Mediterranean diet-through the KIDMED test. For the empirical and econometric analyses, the Mann-Whitney U and Kruskal-Wallis means comparison tests were utilized; multiple linear regression was used accordingly. RESULTS: The present study provides evidence to the fact that boys, younger adolescents, adolescents living with both parents and with highly educated mothers had a better health-related quality of life. Concerning their eating practices, positive predictors were consuming a better-quality breakfast, having all five meals daily, consuming lunch and dinner with parents, and higher adherence to the Mediterranean diet. Moreover, sufficient night sleep time, fewer hours spent on screen viewing, more frequent walks, and having hobbies were linked to the health-related quality of life with a positive sign. In contrast, negative predictors were higher body mass index and everyday life difficulties due to the COVID-19 pandemic crisis. CONCLUSIONS: Greek adolescents' anthropometric characteristics, BMI, lifestyle and sedentary habits, eating habits, and adherence to the Mediterranean diet were significantly related to their perceived health-related quality of life during the pandemic.

Effects of Nutrition, and Physical Activity Habits and Perceptions on Body Mass Index (BMI) in Children Aged 12-15 Years: A Cross-Sectional Study Comparing Boys and Girls.

Background: The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index (BMI) in children aged 12-15 years in Greece. Furthermore, to compare the difference between the two sexes. Methods: This is a cross-sectional study conducted on a representative secondary school cohort that included 5144 subjects, aged 12 to 15 years. Students and their parents filled in validated questionnaires evaluating socioeconomic status, nutrition and physical activity. International Obesity Task Force cut offs were used to classify the children. Factor analysis of mixed data and partial proportional ordered logistic models were used to analyze ΒMΙ distributions. All analyses were stratified by gender. Results: Boys were 2.9 (95%CI: 2.592-3.328) times more likely to be overweight/obese than girls. Partial proportional ordinal models indicate significant associations between nutritional and physical habits and perceptions variables but also significant gender differences in socio-demographic, nutritional risk factors as well as physical activity habits and perceptions. Conclusions: A clear understanding of the factors that contribute to the sex differences in nutrition and physical activity habits and perceptions may guide intervention efforts.

Worldwide actions against plastic pollution from microbeads and microplastics in cosmetics focusing on European policies. Has the issue been handled effectively?

Microbeads are solid primary microplastics < 5 mm in diameter that are added to cosmetic products for cleansing and/or exfoliation of the skin. After use, they are discharged into the drain and end up in Wastewater Treatment Plants (WWTPs), from which they can escape into waters. Once disposed, there is no efficient method of recovery and the environmental conditions do not allow full biodegradation. Focusing mainly on the possible effect of microbeads on the environment and the human health, and taking into account that there have always been alternatives with similar cost, scientists suggested banning microbeads from cosmetic products. Despite the increasing knowledge on the microplastics' effects, the pressure from non-governmental organizations (NGO's) and the increasing public concern, few European and other countries worldwide have taken legislative steps against microbeads, and even fewer against other microplastics used in cosmetic products, mainly because it is a common belief that cosmetic industries responded massively to the call for a phase-out. Although EU acted soon after scientists focused on microbeads' effects by restricting cosmetics with microbeads to bare the EU Ecolabel in 2014, there is still no European-wide ban, which will probably take place as of 2022. Present study offers a thorough literature review on the presence of microbeads in cosmetics up to date, focusing primarily on the actions against their use, and questioning whether future pollution from microbeads or/and microplastics in cosmetics has been successfully handled.

Effects of Body Mass Index (BMI), demographic and socioeconomic factors on organized physical activity (OPA) participation in children aged 6-15 years: a cross-sectional study comparing primary and secondary school children in Greece.

BACKGROUND: The aim of the present study was to examine the influence of body mass index category, as well as of demographic and socioeconomic factors on the participation in organized physical activity (OPA) of schoolchildren attending primary and secondary school in Greece. Furthermore, to compare the difference between the two levels. METHODS: This is a cross-sectional study conducted on a representative elementary and secondary school cohort, derived using stratification and probability proportional to size (PPS) methodology. The final sample included 18,264 subjects, aged 6 to 15 years. Parents of all students and students of secondary schools fulfilled validated questionnaires evaluating socioeconomic status, and participation to OPA. International Obesity Task Force (IOTF) cut offs were used to classify the children. Univariate and multivariate logistic models examined factors associated with OPA. All analyses were stratified by school level. RESULTS: Sport participation was not reported in 37.7 and 54.4% of primary and secondary schoolchildren respectively. Having BMI within normal range, being male, having parents participating in an organized activity and a high socio-economic status seem to encourage participation in OPA in both school levels. CONCLUSIONS: Children with normal BMI are more likely to participate in OPA. Parents as role model as well as higher socioeconomic status of the family emerge as important influencers. Participation in OPA declines as students enter secondary school. Interventions focusing on increasing physical education and activity into school daily program should be tailored to the specific needs of different weight categories and can possibly eliminate the impact of SES inequalities.

Utility and applicability of the "Childhood Obesity Risk Evaluation" (CORE)-index in predicting obesity in childhood and adolescence in Greece from early life: the "National Action Plan for Public Health".

Early identification of infants being at high risk to become obese at their later childhood or adolescence can be of vital importance in any obesity prevention initiative. The aim of the present study was to examine the utility and applicability of the "Childhood Obesity Risk Evaluation (CORE)" index as a screening tool for the early prediction of obesity in childhood and adolescence. Anthropometric, socio-demographic data were collected cross-sectionally and retrospectively from a representative sample of 5946 children, and adolescents and were combined for calculating the CORE-index score. Logistic regression analyses were performed to examine the associations of the CORE-index score with obesity by gender and age group, and cut-off point analysis was also applied to identify the optimal value of the CORE-index score that differentiates obese from non-obese children. Mean CORE-index score in the total sample was 3.06 (sd 1.92) units (range 0-11 units). Each unit increase in the CORE-index score was found to be associated with a 30 % (95 % C.I. 1.24-1.36) increased likelihood for obesity in childhood or adolescence, while the optimal cut-off value of the CORE-index score that predicted obesity with the highest possible sensitivity and specificity was found to be 3.5. CONCLUSION: The present study supports the utility and applicability of the CORE-index as a screening tool for the early identification of infants that are potentially at a higher risk for becoming obese at their childhood and adolescence. This tool could be routinely used by health professionals to identify infants at high risk and provide appropriate counselling to their parents and caregivers so as to maximize the effectiveness of early obesity prevention initiatives. What is known? • Childhood obesity has reached epidemic proportions worldwide. • Certain perinatal and socio-demographic indices that were previously identified as correlates of childhood obesity in children were combined to develop the CORE-index, a screening tool that estimates obesity risk in 9-13 year-old children. What is new? • The utility and applicability of the CORE-index as screening tool can be extended to the age range of 6-15 years. • The CORE-index is a cost-effective screening tool that can assist health professionals in initiating obesity preventive measures from early life.

Sex differences in depression among older adults: are older women more vulnerable than men in social risk factors? The case of open care centers for older people in Greece.

This study examined depression, which, research has indicated, is the most common mental health problem affecting older people, especially women. Our objective was to estimate the prevalence of depression among older people in an urban Greek population and to investigate the covariates of depression symptoms prevalence by gender. The sample consisted of 360 individuals, 218 women and 142 men, aged 60 years or older, members of four open care centers for older people in Greece. A questionnaire for socio-demographic and medical data was used. Depression was probed by use of the geriatric depression scale short form. One-hundred and nine persons (30.3%), 32 men (22.53%) and 77 women (35.12%) were found to have depressive symptoms. The results indicated that women have more depression symptoms than men. Being currently unmarried and suffering from multimorbidity were associated with depression symptoms in both gender groups. Meetings with friends were found to be protective factors for both sexes; care of grandchildren and participating in outings and excursions seemed to be protective factors for women only. Unfavorable economic situations, and being childless, were associated with prevalence of depression symptoms among women only. This study confirmed the relationship between depression symptoms and gender and the importance of social and medical factors in the prevalence of depression symptoms, in both gender groups. It also indicated the greater vulnerability of women to some social factors.

Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation.

BACKGROUND: The local treatment of burn wounds has long been a subject of debate. The objective of this study was to compare the cost and the effectiveness of Moist Exposed Burn Ointment -MEBO versus a combination of povidone iodine plus bepanthenol cream for partial thickness burns. METHODS: The study was carried out in the Burn Center of a state hospital in Athens, Greece. 211 patients needing conservative therapy were prospectively selected according to the depth of the burn wound. The treatment was allocated according to the Stratified Randomization Design. The outcomes measured were mean cost of in-hospital stay, rate of complications, time of 50% wound healing, pain scores, in hospital stay diminution. We have adopted a societal perspective. RESULTS: In the total groups MEBO presented lower cost, (although not significantly different: p = 0.10) and better effectiveness. The data suggest that MEBO is the dominant therapy for superficial partial burn wound with significantly lower costs and significantly higher effectiveness due to a lesser time of recovery and consequently lower time of hospitalization and follow-up. MEBO presented similar percentages of complications with the comparator, lower pain levels and smaller time of no healthy appearance of the burn limits for superficial partial thickness burns. CONCLUSIONS: The data suggested that topical application of MEBO may be considered for further investigation as a potential first-line treatment modality for superficial partial thickness burns. TRIAL REGISTRATION: The trial has been registered on the International Standard Randomised Controlled Trial Number Register (ISRCTN) and given the registration number ISRCTN74058791.

Explanatory versus pragmatic trial-based economic evaluations: application to alternative therapies for burns.

The debate concerning the adoption of a pragmatic or explanatory attitude to clinical trials as well as the exact points of distinction between the two attitudes, has lasted for more than 40 years. Recently, new methodological proposals have been given as a pragmatic-explanatory continuum indicator summary tool and mechanistic-practical framework to distinguish the two attitudes. In this review, we provide a guide to the literature concerning the debate regarding the choice between explanatory and pragmatic attitudes in trial-based economic evaluations, focusing on the therapies for burns.