Evaluation of food photographs assessing the dietary intake of children up to 10 years old

OBJECTIVE: Young children lack basic skills related to recognizing the types of foods they consume and dietary surveys often rely on parents' response. The present study aimed to evaluate how well parents of children aged from 3 months to 10 years perceive images of portions of foods commonly consumed by young children. DESIGN: Pre-weighed, actual food portions (n 2314) were shown to the study participants who were asked to indicate the picture that corresponded to the food in view. Mean differences between picture numbers selected and shown were estimated and compared using unpaired t tests or Tukey-Cramer pairwise comparisons. SETTING: Real-time testing of parents' perception of food images presenting portion sizes consumed by children up to 10 years old. SUBJECTS: A convenience sample of 138 parents/caregivers of young children (69 % females). RESULTS: Individuals selected the correct or adjacent image in about 97 % of the assessments. Images presenting amorphous solids (i.e. pies and pastries with a filling), liquid or semi-liquid dishes (i.e. soups, porridges, fruit and vegetable purées) were more prone to bias. There was no indication that personal characteristics (gender, age, educational background, age, number of offspring) were associated with differences in the way parents/caregivers perceived the food pictures. CONCLUSIONS: Food pictures may not be appropriate to quantify the intake of liquid, semi-liquid or amorphous solid foods in surveys addressing young children and studies evaluating their performance as food portion anchors should ensure the inclusion of several and various amorphous foods in the assessment

Evaluation of a digital food photography atlas used as portion size measurement aid in dietary surveys in Greece

Objective To evaluate how well respondents perceive digital images of food portions commonly consumed in Greece. Design The picture series was defined on the basis of usual dietary intakes assessed in earlier large-scale studies in Greece. The evaluation included 2218 pre-weighed actual portions shown to participants, who were subsequently asked to link each portion to a food picture. Mean differences between picture numbers selected and portions actually shown were compared using the Wilcoxon paired signed-rank test. The effect of personal characteristics on participants' selections was evaluated through unpaired t tests (sex and school years) or through Tukey-Kramer pairwise comparisons (age and food groups). Setting Testing of participants' perception of digital food images used in the Greek national nutrition survey. Subjects Individuals (n 103, 61 % females) aged 12 years and over, selected on the basis of the target population of the Greek nutrition survey using convenience sampling. Results Individuals selected the correct or adjacent image in about 90 % of the assessments and tended to overestimate small and underestimate large quantities. Photographs of Greek traditional pies and meat-based pastry dishes led participants to perceive the amounts in the photos larger than they actually were. Adolescents were more prone to underestimating food quantities through the pictures. Conclusions The digital food atlas appears generally suitable to be used for the estimation of average food intakes in large-scale dietary surveys in Greece. However, individuals who consistently consume only small or only large food portions may have biased perceptions in relation to others. © The Authors 2016

Group patient education: effectiveness of a brief intervention in people with type 2 diabetes mellitus in primary health care in Greece: a clinically controlled trial

This study aims to assess the impact of a brief patient group education intervention in people with type 2 diabetes mellitus. The sample, 193 people with type 2 diabetes mellitus who were patients at the diabetic clinic of a primary health care setting in Attica, was assigned to two groups, intervention (138 individuals) and control group (55 individuals). The intervention group, instead of receiving standard care, attended a structured group educational programme using Conversation Maps while the control group had standard care. The main outcome measures were HbA1c, body mass index (BMI), triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), measured at baseline and 6 months after the intervention. After 6 months, significant differences in changes of the studied parameters were observed between the groups in HbA1c, 1.4 (95% CI: 1.1, 1.7), (P < 0.001) and HDL -4.4 (95% CI: -8.1, -0.8), (P < 0.001) in favour of group education. Within the groups, the intervention group presented a significant reduction in HbA1c, -0.6 (95% CI: -0.8, -0.3), (P < 0.001), in BMI, -0.7 (95% CI: -0.9, -0.1), (P = 0.007), in triglycerides, -21.1 (95% CI: -47.1, -9.9), (P = 0.003) and LDL, -10.0 (95% CI: -22.5, -5.7), (P < 0.001), while in the control group significant reductions were observed in HbA1c, -0.5 (95% CI: -0.5, -0.3), (P = 0.003), in HLD, -4.1 (95% CI: -7.7, -2.3), (P = 0.001) and in LDL, -9.4 (95% CI: -19.9, -3.9), (P = 0.018). Group-based patient education using Conversation Maps for people with type 2 diabetes is more effective, compared with individual education, in diabetes self-management

Evaluation of food photographs assessing the dietary intake of children up to 10 years old

Objective Young children lack basic skills related to recognizing the types of foods they consume and dietary surveys often rely on parents' response. The present study aimed to evaluate how well parents of children aged from 3 months to 10 years perceive images of portions of foods commonly consumed by young children. Design Pre-weighed, actual food portions (n 2314) were shown to the study participants who were asked to indicate the picture that corresponded to the food in view. Mean differences between picture numbers selected and shown were estimated and compared using unpaired t tests or Tukey-Cramer pairwise comparisons. Setting Real-time testing of parents' perception of food images presenting portion sizes consumed by children up to 10 years old. Subjects A convenience sample of 138 parents/caregivers of young children (69 % females). Results Individuals selected the correct or adjacent image in about 97 % of the assessments. Images presenting amorphous solids (i.e. pies and pastries with a filling), liquid or semi-liquid dishes (i.e. soups, porridges, fruit and vegetable purées) were more prone to bias. There was no indication that personal characteristics (gender, age, educational background, age, number of offspring) were associated with differences in the way parents/caregivers perceived the food pictures. Conclusions Food pictures may not be appropriate to quantify the intake of liquid, semi-liquid or amorphous solid foods in surveys addressing young children and studies evaluating their performance as food portion anchors should ensure the inclusion of several and various amorphous foods in the assessment. Copyright © The Authors 2017

Nicotine dependence and loss of autonomy among Greek adolescent smokers: A countrywide cross-sectional study

Nicotine dependence is one of the main reasons for the continuation of smoking among adolescents. Loss of autonomy (LOA) is a measure of dependence. This study is the first to investigate LOA and its determinants among Greek adolescents. In 2013, 13-to-15-year-old middle-school students were selected by multi-stage clustered sampling. LOA was evaluated with the Hooked-on-Nicotine Checklist (HONC). Multiple univariate analysis was used to assess the association between adolescent demographics, smoking habits, and loss of autonomy. Three-hundred thirty-nine current smokers responded to the questionnaire (response rate: 82.3%). Of these respondents, 51.2% were male and 88.8% reported at least one LOA symptom. The mean HONC score was 4.13/10 (95% CI: 3.82–4.45). Higher scores were negatively associated with lower smoking frequency (cumulative odds ratio (cOR): 0.240, 95% CI: 0.144–0.400) and positively associated with lower age at first cigarette (cOR: 2.29, 95% CI: 1.38–3.82). Female gender was significantly associated with the prevalence but not the degree of LOA. Overall, the prevalence and the degree of nicotine dependence among adolescent smokers in Greece is similar to other countries. Frequent smoking and initiation of smoking at a younger age are linked to nicotine dependence, although it was not possible to make causal inferences. The relationship between nicotine dependence and gender remains unclear. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Smoking prevalence among hospitalized COVID-19 patients and its association with disease severity and mortality: an expanded re-analysis of a recent publication

Background: There is a lot of debate about the effects of smoking on COVID-19. A recent fixed-effects meta-analysis found smoking to be associated with disease severity among hospitalized patients, but other studies report an unusually low prevalence of smoking among hospitalized patients. The purpose of this study was to expand the analysis by calculating the prevalence odds ratio (POR) of smoking among hospitalized COVID-19 patients, while the association between smoking and disease severity and mortality was examined by random-effects meta-analyses considering the highly heterogeneous study populations. Methods: The same studies as examined in the previous meta-analysis were analyzed (N = 22, 20 studies from China and 2 from USA). The POR relative to the expected smoking prevalence was calculated using gender and age-adjusted population smoking rates. Random-effects meta-analyses were used for all other associations. Results: A total of 7162 patients were included, with 482 being smokers. The POR was 0.24 (95%CI 0.19–0.30). Unlike the original study, the association between smoking and disease severity was not statistically significant using random-effects meta-analysis (OR 1.40, 95%CI 0.98–1.98). In agreement with the original study, no statistically significant association was found between smoking and mortality (OR 1.86, 95%CI 0.88–3.94). Conclusion: An unusually low prevalence of smoking, approximately 1/4th the expected prevalence, was observed among hospitalized COVID-19 patients. Any association between smoking and COVID-19 severity cannot be generalized but should refer to the seemingly low proportion of smokers who develop severe COVID-19 that requires hospitalization. Smokers should be advised to quit due to long-term health risks, but pharmaceutical nicotine or other nicotinic cholinergic agonists should be explored as potential therapeutic options, based on a recently presented hypothesis. © 2021, The Author(s)

The Toronto Empathy Questionnaire: Reliability and validity in a Nationwide sample of Greek teachers

The present study examined the Toronto Empathy Questionnaire's (TEQ) validity and reliability in a sample of 3955 Greek teachers. In order to test the internal consistency reliability, the Cronbach's alpha coefficient was used and was found satisfactory at 0.72. The sample was randomly split and an exploratory factor analysis (EFA) was conducted in the even subsample, justifying the one-factor solution, with the only discrepancy of the low loading of an item. In the odd subsample a confirmatory factor analysis (CFA) was performed to confirm the one-factor model identified by the EFA. The chi square test (χ2) of the model was significant (p < 0.05), while the root mean square error of approximation (RMSEA), the comparative fit index (CFI) and the goodness of fit index (GFI) values were 0.078, 0.969 and 0.960, respectively, further supporting the model's fit. Student's t-tests and analysis of variance (ANOVA) showed that women, teachers with children of their own, those working full-time in public schools, those with students who needed special education, and those who had received mental health promotion training, scored higher. Additionally, multiple linear regression analysis revealed that sex, working status, having students who needed special education, and having attended mental health training courses were independently associated with TEQ score. The analyses confirmed that the Greek version of TEQ could be used for researches in Greek educators as a valid and reliable measure of teachers' empathy. © 2017 by the authors

Health-related quality of life of a very special population: monks of Holy Mountain Athos, Greece

The investigation of Health-Related Quality of Life (HRQOL) of Orthodox Christian monks who live at the Holy Mount Athos in Greece, and its correlation with demographic characteristics and Sense of Coherence (SOC-13). A cross-sectional study was designed. The seven monasteries and five scetes with the largest number of monk population were invited to participate. Two monasteries and 1 scete gave their permission for the study. The final monks sample was formed by 166 monks from 215 who participated to the study. HRQOL was assessed using the SF-12 and Sense of Coherence the SOC-13 scales that were completed by monks from May to August 2012. Ieultiple linear regression analyses were conducted to explore the association of the HRQOL subscales with the demographics and SOC-13. The mean age was 45.5 +/- 13.0 years; 83.7% lived in communal monasteries, and the mean number of years in monasticism was 18.4 +/- 12.1. The mean value of their Physical Component Summary (PCS) score was 47.3 +/- 5.3, which is lower than in the general Greek men population, while their Mental Component Summary (MCS) score was 56.4 +/- 5.8, which is higher than in the general Greek men population. The mean value of SOC-13 was 65.7 +/- 6.5. Positive association for PCS appeared for place of living (beta = 5.43, SE = 1.27, p < 0.001) and negative association for age (beta = -0.16, SE = 0.03, p < 0.001) while for MCS for number of years in monasticism (beta = 0.07, SE = 0.06, p = 0.023) and sense of coherence (beta = 0.47, SE = 0.06, p < 0.001). The results indicated that monks had better mental health but worse physical health compared to the general Greek male population. More studies are required to validate the above findings