Depressive symptoms among adolescents in Georgia: the role of ethnicity, low self-control, parents, and peers.

OBJECTIVES: The present study tested the role of low self-control, positive parental and peer relationships, and ethnic minority status (Armenian or Azeri), in explaining variability in depressive symptoms in Georgian youth. METHODS: Self-report data were collected from N = 8254 adolescents in Georgia (55.5% female, M age = 15.57, SD 1.03). Hypotheses were tested using structural equation modeling (SEM) with latent constructs. RESULTS: Low self-control significantly and positively predicted depressive symptoms, while perceived parental warmth did so negatively; peer friendship quality was unrelated. Ethnic minority status explained a very small amount of unique variance in depressive symptoms for Azeri youth only, not for Armenian adolescents. Multi-group SEM moderation tests provided evidence that the links between constructs were invariant across ethnic groups. The model explained 15.6% of variance in depressive symptoms. CONCLUSIONS: Findings support the salience of the tested depressive symptom correlates among Georgian adolescents, consistent with previous evidence from other countries. Adolescent ethnic minority status did not increase risk of depressive symptoms. Self-control emerged as the strongest correlate.

The antibiotic knowledge, attitudes and behaviors of patients, doctors and pharmacists in the WHO Eastern European region - a qualitative, comparative analysis of the culture of antibiotic use in Armenia, Georgia, Kazakhstan, Moldova, Russia and Tajikistan.

BACKGROUND: To reduce antimicrobial resistance (AMR), initiatives such as surveillance activities and activities to increase knowledge about how and why antibiotics (ABs) are (mis)used are needed. More surveillance systems are in place in the WHO Western European region than in the Eastern region, and only sparse knowledge exists about the current culture of AB use in the Eastern European countries. OBJECTIVE: To investigate AB knowledge, attitudes and behaviors in countries in the WHO Eastern European region in order to identify overall similarities and differences across the region and how AB knowledge, attitudes and behavior patterns may be influenced by the national health care system. METHODS: Semi-structured interviews were conducted in Armenia, Georgia, Kazakhstan, Moldova, Russia and Tajikistan with patients, doctors and pharmacists. In total, 80 interviews were carried out. A directed content analysis was applied, followed by a comparative analysis, identifying the similarities and differences in AB attitudes, knowledge and behaviors between the countries and discussing how the national health care systems might influence these patterns. RESULTS: Cross-national patterns were identified regarding patients seeking ABs over-the-counter (OTC), patient variations in their requests for ABs when consulting doctors, and, finally, doctors and pharmacists appearing knowledgeable about ABs and their uses, with doctors displaying careful attitudes towards AMR. Indications of national differences between the countries included the ability of patients to afford ABs, prescribing practices of doctors and pharmacist attitudes towards selling ABs without prescriptions. Multiple aspects involved in patient and pharmacist AB decision making were detected, such as various rationales involved in buying/selling ABs OTC, implying that these processes are more complex than previously reported in the literature. CONCLUSIONS: Similarities across the Eastern European region could be seen in patient needs and uses of antibiotics obtained OTC at community pharmacies, whereas doctors appeared more influenced by specific structures of the national healthcare system.

The Georgian version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR).

The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the Georgian language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity). A total of 100 JIA patients (26% systemic, 57% oligoarticular, 16% RF negative polyarthritis, and 1% RF positive polyarthritis) and 100 healthy children, were enrolled at two paediatric rheumatology centre. Notably, none of the enrolled JIA patients is affected with psoriatic arthritis or with enthesitis-related arthritis or with undifferentiated arthritis. The JAMAR components discriminated healthy subjects from JIA patients, except for the school-related problems variable. All JAMAR components revealed good psychometric performances. In conclusion, the Georgian version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.

Parallel mediation effects by sleep on the parental warmth-problem behavior links: evidence from national probability samples of Georgian and Swiss adolescents.

Previous research has documented the importance of parenting on adolescent health and well-being; however, some of the underlying mechanisms that link the quality of parent-child relationship to health, adjustment, and well-being are not clearly understood. The current study seeks to address this gap by examining the extent to which sleep functioning mediates the effects by parental warmth on different measures of adolescent problem behaviors. Specifically, we test whether sleep functioning, operationalized by sleep quality and sleep quantity, mediates the relationship between the parental warmth and three measures of problem behaviors, namely alcohol use, illegal drug use, and deviance, in two nationally representative samples of Georgian (N = 6,992; M = 15.83, 60% females, and Swiss (N = 5,575; M = 17.17, 50% females) adolescents. Based on tests for parallel mediating effects by sleep functioning of parental warmth on problem behaviors in the MEDIATE macro in SPSS, the findings provided evidence that both sleep quality and sleep quantity independently and cumulatively mediated the effects of parental warmth on each of the three problem behaviors in both samples, with one exception. These results highlight the salience of positive parenting on sleep functioning among teens in two different cultural contexts, and, in turn, on measures of problem behaviors.

Objectified body consciousness and mental health in female adolescents: cross-cultural evidence from Georgian and Swiss national samples.

PURPOSE: The current study tested both descriptive and explanatory similarities and differences in a latent objectified body consciousness (OBC) construct and its relationship to three mental health indicators among Georgian and Swiss adolescents. Few studies have been conducted on adolescents; similarly, most work has been completed on U.S. college-age women. METHODS: School-based questionnaire data were collected from a total of 18,239 adolescents in Georgia (n = 9,499) and Switzerland (n = 8,740), following the same protocol. Participants rated three measures of OBC (body shame, body surveillance, and appearance control beliefs) and three mental health indicators (depressive symptoms, somatic complaints, and suicidal ideation). Final study samples included 2,657 (mean age = 16.4 years) and 3,803 female youth (mean age = 17.8 years), respectively. Data analyses included mean level comparisons, confirmatory factor analysis, path analysis, and multigroup invariance tests. RESULTS: Findings provide support for a latent OBC construct across cultures, with partial evidence of cultural differences (one of two manifest indicators). By contrast, multigroup invariance tests provide consistent evidence of no differences in the relationships between the OBC latent construct and three mental health indicators between Georgian and Swiss samples. CONCLUSION: Despite mean level differences, findings support a latent OBC construct in both cultures, perhaps slightly more so among Swiss youth. The links between OBC and mental health indicators were also invariant across the two cultures, providing greater support for a global or universal (vs. "cultured") framework of adolescent development related to the constructs and relationships studied.

EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria.

OBJECTIVES: To validate the previously proposed classification criteria for Henoch-Schönlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA). METHODS: Step 1: retrospective/prospective web-data collection for children with HSP, c-PAN, c-WG and c-TA with age at diagnosis

A test of Jessor's problem behavior theory in a Eurasian and a Western European developmental context.

PURPOSE: The current study tested the applicability of Jessor's problem behavior theory (PBT) in national probability samples from Georgia and Switzerland. Comparisons focused on (1) the applicability of the problem behavior syndrome (PBS) in both developmental contexts, and (2) on the applicability of employing a set of theory-driven risk and protective factors in the prediction of problem behaviors. METHODS: School-based questionnaire data were collected from n = 18,239 adolescents in Georgia (n = 9499) and Switzerland (n = 8740) following the same protocol. Participants rated five measures of problem behaviors (alcohol and drug use, problems because of alcohol and drug use, and deviance), three risk factors (future uncertainty, depression, and stress), and three protective factors (family, peer, and school attachment). Final study samples included n = 9043 Georgian youth (mean age = 15.57; 58.8% females) and n = 8348 Swiss youth (mean age = 17.95; 48.5% females). Data analyses were completed using structural equation modeling, path analyses, and post hoc z-tests for comparisons of regression coefficients. RESULTS: Findings indicated that the PBS replicated in both samples, and that theory-driven risk and protective factors accounted for 13% and 10% in Georgian and Swiss samples, respectively in the PBS, net the effects by demographic variables. Follow-up z-tests provided evidence of some differences in the magnitude, but not direction, in five of six individual paths by country. CONCLUSION: PBT and the PBS find empirical support in these Eurasian and Western European samples; thus, Jessor's theory holds value and promise in understanding the etiology of adolescent problem behaviors outside of the United States.

The Georgian adolescent health survey: methodological and strategic issues.

OBJECTIVES: To conduct a national survey on adolescent health and lifestyles in Georgia and to thus set up a database on adolescent. METHODS: A two-stage cluster sample of around 8000-10000 in-school 15-18 years adolescents are being reached through a random selection of classes in Georgia. The sample has been stratified by age, region, type of school and language. A self-administered questionnaire of 87 questions has been developed and translated into the four main languages used in Georgia. RESULTS: Up to June 2004, the researchers have reached 511 classes (9306 pupils). In total, 8039 questionnaires have been considered valid. The main concerns encountered for this survey are linked with acceptance of the survey, cross-cultural issues, political and strategic problems as well as inadequate physical environmental support. CONCLUSION: Despite Georgia's unfavourable economical and political situation, it has been possible to run a national survey on the health of adolescents, according to the usual standards used in the field. This survey should allow for 1) the identification of priorities in the field of health care and health promotion 2) the monitoring of adolescent health in the future.