Purpose This study investigated the prevalence of Internet addiction (IA) and cyberbullying and examined profiles of adolescents with increased risk to develop pathological behaviors. Methods In this cross-sectional, school-based study, 8053 students of 30 middle and 21 high schools (12-18 years old) were invited to participate, based on a multistage stratified random sampling technique. The Internet aiddiction test (IAT) was used along with information on socio-demographics, Internet activities and cyberbullying experience. Results Five thousand five hundred and ninety students participated (response rate 69.4%). Pathological Internet use (IAT ≥50) was found in 526 (10.1%), while 403 (7.3%) experienced cyberbullying as victims and 367 (6.6%) as perpetrators during the last year. In multivariable models, the odds of IA increased with online hours on mobile phones and Internet use during weekends, Internet café visits, chatrooms usage and engagement in cyberbullying. Cyberbullying victims were more likely to be older, female, Facebook and chatrooms users, while perpetrators were more likely to be male, older Internet users and fans of pornographic sites. A perpetrator was significantly more likely to have also been a victim [odds ratio (OR) = 5.51, confidence interval (CI): 3.92-7.74]. Hours of daily Internet use on a mobile phone was independently associated with IA and cyberbullying (OR) 1.41, 95% CI 1.30, 1.53 and OR 1.11, 95% CI 1.01, 1.21, respectively. Conclusions Cyberbullying is associated with IA and the hours spent online on a mobile phone affected both conditions. The increasing Internet access through mobile phones or other devices should be accompanied by the appropriate education of both parents and adolescents on safe Internet use.
Background: Accreditation of primary care organizations within Greece is still in its infancy. Our task in Greece was to attempt to introduce a patient safety initiative in a local area, focusing on developing minimum standards for accreditation, assess whether a pragmatic approach would engage physicians, and provide evidence of improvement. Objective: To use monitoring of clinical performance as the basis for the launch of an accreditation system for primary care in Greece and to report on the process and lessons learnt. Methods: An established set of clinical indicators for patient safety was introduced in five Greek primary health centres. A web-based platform, for reporting practitioners’ scores on the selected indicators, was used to record the activity of the practitioners. Results: There was considerable variation in the use of clinical indicators by individual GPs. Following the intervention, the reporting on the indicators had increased while the scores on indicators only increased slightly. However, GPs engaged with the process and recognized its relevance to improving patient safety. Conclusion: We successfully piloted a means of engaging with GPs to improve patient safety using established indicators even where there was limited infrastructure to support such initiatives.
Purpose Although safe Internet use is an emerging public health issue, there is a scarcity of published work describing relevant school-based interventions. The objective of this study was to explore the impact of a health professional-led, school-based intervention in raising awareness on cyber-safety in adolescents, Therefore, the aim of this study was to investigate adolescents' evaluation of this school-based intervention, 6 months after its implementation, as well as the impact of adolescents' school class and gender on their evaluation. Methods A student sample was selected using a multistage stratified random sampling technique, according to the location and school grade level (middle, high school). The students - aged from 12 to 18 years old experienced an interactive presentation in their classrooms on the amount of time spent online, the use of social networks and the available support services. An evaluation tool was completed anonymously and voluntarily 6 months after the intervention. Results Four hundred and sixty-two students (response rate 90.7%, 246 middle, 216 high school) completed the evaluation tool. Younger students, especially the ones in the first year of middle school, scored significantly higher in all six parameters used in the evaluation of this intervention compared with all the older participants: (a) they had kept the presented information on Safeline and Saferinternet websites and the helpline Ypostirizo (70.2% vs. 33.7%, p < 0.001) (b) they had already used it (32.5% vs. 12.3%, p < 0.001), (c) they had learned new information on cyber safety (66.4% vs. 34%, p < 0.001), (d) they rated the intervention as more interesting (median 8 vs. 7, p < 0.05), (e) they had reconsidered the way they use Internet (median 7 vs. 6, p < 0.05) and (f) they had changed their cyber behavior (median 7 vs. 5, p < 0.05). Conclusion The active involvement of students in a discussion on cyber-safety based on their experiences was highly evaluated. The impact of the intervention on the youngest students underlines the need for raising awareness on cyber-safety and support services, earlier in the students' life.
Background: Little is known regarding the Internet activities of children, although Internet habits and pathological usage have been previously described in adolescents. Objectives: This study aimed in describing Internet use in both primary and secondary school children in order to early detect habits with high risks of developing pathological Internet use. Patients and Methods: 2,473 children from 26 primary (aged from 6 to 12) and 16 secondary schools (12 -15 years old) from seven different regions in Greece participated. Participants answered questions regarding their Internet activities and demographics. Results: 367 (40.9 %) children from primary and 707 (44.9 %) from secondary schools played online games daily, while 115 (12.8 %) and 965 (61.2 %) respectively had a Facebook profile. The boys played games and used Facebook more than girls [primary: OR = 1.2, 95% CI (1.0, 1.9), secondary school: OR = 2.3, 95% CI (1.9, 2.9), and [OR = 2.1, 95% CI (1.3, 3.2), OR = 1.3, 95% (1.1, 1.6), accordingly]. Students with home Internet access were more likely to use online games and go on Facebook. Conclusions:The male gender and home Internet access are both associated with the higher usage of online games and Facebook, while profiles in Facebook are illegally created at the first years of primary school. Since both Internet activities have been repetitively associated with pathological Internet usage, educators and social services should work on increasing awareness in young children and their parents.
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