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Puchner KP, Giannakou V, Veizis A, Bougioukas K, Hargreaves S, Benos A, Kondilis E. COVID-19 vaccination roll-out and uptake among refugees and migrants in Greece: a retrospective analysis of national vaccination routine data. Public Health 2024; 229:84-87. [PMID: 38412698 DOI: 10.1016/j.puhe.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/01/2024] [Accepted: 01/13/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Refugees and migrants (R&Ms) exhibited higher risk of COVID-19 infection, and higher mortality rates during the pandemic. Acknowledging these risks, R&Ms early in the pandemic were identified by WHO as a priority vaccination group in need of protection. The aim of this study was to assess the vaccination roll-out and uptake among R&Ms residing in Reception Identification Centers (RICs) and Reception Sites (RSs) in Greece, relative to the general population. STUDY DESIGN Nationwide observational study. METHODS Retrospective analysis of national vaccination routine data and population census data, collected and triangulated from multiple official/governmental sources. Weekly vaccine roll-out and uptake were calculated for the general Greek population and the R&M population, through the first year of the vaccination programme in Greece (December 2020-December 2021). RESULTS Vaccine roll-out among migrants in RICs/RSs started with a 22-week delay, compared to the general population. By the end of the first year of the vaccination programme in Greece in December 2021, the national vaccination uptake among registered R&Ms residing in official reception facilities was 27.3 % for 1st dose and 4.7 % for booster dose; considerably lower compared to the general population (69.5 % uptake for 1st dose, 64.7 % for 2nd dose, and 32.0 % for 3rd dose). CONCLUSION Delayed vaccine roll-out and low vaccine uptake among R&Ms in Greece are signs of low prioritisation and implementation failures in the R&M vaccination strategy. In face of future public health threats, lessons should be learned, and vaccine equity should be insured for all socially vulnerable and high-risk population groups.
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Affiliation(s)
- K P Puchner
- Laboratory of Primary Health Care, General Medicine and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - V Giannakou
- MSc Program in Public Health and Health Policy, School of Medicine, Aristotle University of Thessaloniki, Greece
| | | | - K Bougioukas
- Laboratory of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - S Hargreaves
- Infection and Immunity Research Institute, St George's, University of London, UK
| | - A Benos
- Laboratory of Primary Health Care, General Medicine and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - E Kondilis
- Laboratory of Primary Health Care, General Medicine and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Greece.
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Kondilis E, Benos A. The COVID-19 Pandemic and the Private Health Sector: Profiting without Socially Contributing. Int J Soc Determinants Health Health Serv 2023; 53:466-477. [PMID: 37680140 DOI: 10.1177/27551938231201070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
The COVID-19 pandemic necessitated the mobilization of all available health care resources, including private, for-profit ones. The aim of this multiple methods study (combination of document and secondary data analysis) was to assess government regulations facilitating the private health sector's participation in the COVID-19 response in Greece. During the pandemic, the government made three successive increases in private providers' reimbursement fees, provided additional financial incentives to private providers, and allocated €280 million of emergency funding for the private sector's involvement in the national COVID-19 response. In response, private hospitals made available on average 2.2% of their total bed capacity per epidemic wave for the treatment of COVID-19 patients and 1.7% of their total bed capacity for the treatment of non-COVID-19 patients transferred from National Health System (NHS) hospitals. In 2020 the five largest health care corporate groups maintained their revenues, while in 2021 they increased them by 18.7%-a striking comparison with the 9% recession experienced by the Greek economy in 2020 and its 8.4% recovery in 2021. In a time of an acute public health crisis, private health care providers responded to society's pressing health care needs by insulating their facilities from COVID-19 patients and NHS patient transfers, minimizing their social contribution and safeguarding their revenues and profits.
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Affiliation(s)
- Elias Kondilis
- School of Medicine, Aristotles University of Thessaloniki, Thessaloniki, Greece
| | - Alexis Benos
- School of Medicine, Aristotles University of Thessaloniki, Thessaloniki, Greece
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Benos A. Pandemic's Experience Questioning Capitalistic Dominance Comment on "Ensuring Global Health Equity in a Post-pandemic Economy". Int J Health Policy Manag 2023; 12:7764. [PMID: 37579490 PMCID: PMC10125069 DOI: 10.34172/ijhpm.2022.7764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/04/2022] [Indexed: 08/16/2023] Open
Abstract
Reflecting on the up-to-date global experience of the coronavirus disease 2019 (COVID-19) pandemic is of crucial importance in order to draw conclusions needed for the design of policies aiming the prevention of new epidemics and the effective protection, preparedness and response of any new emerging. Ongoing environmental destruction, excess mortality by COVID-19 and non-COVID diseases reflecting the dismantlement and commodification of both public health services and healthcare services, deep economic crisis, increasing and deepening social inequalities are the main characteristics raised by the pandemic. The causes of the causes of all these are the dominant rules of the capitalistic system, driven mainly by the unlimited greed for profit on the expenses of the majority of the society. The effectiveness of any proposed correction of this system is discussed and the need for another society responding to the needs of the population is argued.
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Affiliation(s)
- Alexis Benos
- Lab of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University, Thessaloniki, Greece
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Papapostolou A, Petridou EJ, Papageorgiou K, Stournara A, Benos A, Lafi S, Giadinis N. Seroprevalence and risk factors assessment of Brucella spp. in dairy buffaloes in mainland Greece. J HELL VET MED SOC 2022. [DOI: 10.12681/jhvms.28038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Brucellosis is an infectious bacterial disease caused by members of genus Brucella, affecting both animals and humans, and resulting in both serious economic losses in animal production sector and deterioration of public health. A cross-sectional study was conducted from January to August of 2018 to determine the seroprevalence and associated risk factors of bovine brucellosis, in Central Macedonia and East Macedonia and Thrace, in mainland Greece. A total of 1,255 blood samples were collected using a simple random sampling technique from dairy buffaloes older than12 months. All serum samples were analyzed with Rose Bengal Test for screening and Complement Fixation Test for confirmation of the positive samples. Accordingly, the overall individual-level seroprevalence of dairy buffaloes in the study area was 0.72% (9/1,255, 95% CI:0.32-1.36%) while the overall herd-level seroprevalence was 15.38% (4/26, 95% CI:6.15-33.53%). Moreover, information was gathered on demographic characteristics of the owners, individual animals and herd level risk factors and other farm characteristics using a questionnaire. Higher prevalence of Brucella spp. was observed in buffaloes bred under intensive and semi-intensive feeding systems, compared to those bred under extensive ones. High seroprevalence of brucellosis was also observed in medium size herds. Two of the herds had recorded history of the disease, the last five years while, in these two herds delays in the implementation of brucellosis eradication programs were revealed. The present study indicated that the occurrence of brucellosis in Greece dairy buffalo farms is at a low magnitude. Even though the seroprevalence is low, it can still be potential hazard for both susceptible animals and humans
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Tsantaki E, Smyrnakis E, Constantinidis TC, Benos A. Indoor air quality and sick building syndrome in a university setting: a case study in Greece. Int J Environ Health Res 2022; 32:595-615. [PMID: 32633551 DOI: 10.1080/09603123.2020.1789567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
The perceived Indoor Air Quality (IAQ), the prevalence of Sick Building Syndrome (SBS) symptoms and its contributing risk factors were assessed in a university during the period of the economic crisis in Greece. Data was collected from 613 employees via questionnaires. Hierarchical linear regression analysis was performed. The most prevalent perceived IAQ complaints were 'Dust and dirt' (63.2%), 'Room temperature too low' (24.9%) and 'Varying room temperature' (24.4%). The most frequently reported SBS symptom was 'Fatigue' (34.1%). The prevalence of General, Mucosal and Dermal symptoms was 40.8%, 19.8% and 8.1%, respectively. Several contributing risk factors were identified, such as IAQ Discomfort Scale, atopy, sleep problems, female, exposure to biological and chemical agents, PC-use, Psychosocial Work Scale and job satisfaction. Poor perceived IAQ and high prevalence of SBS symptoms were reported from the university staff in a temperate climate country. SBS seemed to be multifactorial.
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Affiliation(s)
- Efthymia Tsantaki
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexis Benos
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kondilis E, Papamichail D, Gallo V, Benos A. COVID-19 data gaps and lack of transparency undermine pandemic response. J Public Health (Oxf) 2021; 43:e307-e308. [PMID: 33559684 PMCID: PMC7928702 DOI: 10.1093/pubmed/fdab016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Elias Kondilis
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki Greece
| | - Dimitris Papamichail
- Department of Public Health Policy, University of West Attica, 11521 Athens Greece
| | - Valentina Gallo
- Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands
| | - Alexis Benos
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki Greece
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Affiliation(s)
- Elias Kondilis
- Department of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Karl Puchner
- Department of Medicine, National Kapodistrian University of Athens, Athens, Greece
| | - Apostolos Veizis
- Medical Operational Support Unit, Médecins sans Frontières, Athens, Greece
| | - Christos Papatheodorou
- Department of Social Policy, Panteion University of Social and Political Sciences, Athens, Greece
| | - Alexis Benos
- Department of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Touloumi G, Karakatsani A, Karakosta A, Sofianopoulou E, Koustenis P, Gavana M, Alamanos Y, Kantzanou M, Konstantakopoulos G, Chryssochoou X, Benos A, Vantarakis A, Hadjichristodoulou C, Chlouverakis G, Trypsianis G, Voulgari PV, Makrilakis K, Liatis S, Stergiou G. National Survey of Morbidity and Risk Factors (EMENO): Protocol for a Health Examination Survey Representative of the Adult Greek Population. JMIR Res Protoc 2019; 8:e10997. [PMID: 30714576 PMCID: PMC6378546 DOI: 10.2196/10997] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/27/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background Main causes of death in Greece are cardiovascular diseases (CVDs), malignant neoplasms, respiratory diseases, and road traffic crashes. To assess the population health status, monitor health systems, and adjust policies, national population-based health surveys are recommended. The previous health surveys that were conducted in Greece were restricted to specific regions or high-risk groups. Objective This paper presents the design and methods of the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors). The primary objectives are to describe morbidity (focusing on CVD, respiratory diseases, and diabetes), related risk factors, as well as health care and preventive measures utility patterns in a random sample of adults living in Greece. Methods The sample was selected by applying multistage stratified random sampling on 2011 Census. Trained interviewers and physicians made home visits. Standardized questionnaires were administered; physical examination, anthropometric and blood pressure measurements, and spirometry were performed. Blood samples were collected for lipid profile, glucose, glycated hemoglobin, and transaminases measurements. The survey was conducted from May 2013 until June 2016. Results In total, 6006 individuals were recruited (response rate 72%). Of these, 4827 participated in at least one physical examination, 4446 had blood tests, and 3622 spirometry, whereas 3580 provided consent for using stored samples for future research (3528 including DNA studies). Statistical analysis has started, and first results are expected to be submitted for publication by the end of 2018. Conclusions EMENO comprises a unique health data resource and a bio-resource in a Mediterranean population. Its results will provide valid estimates of morbidity and risk factors’ prevalence (overall and in specific subdomains) and health care and preventive measures usage in Greece, necessary for an evidence-based strategy planning of health policies and preventive activities. International Registered Report Identifier (IRRID) DERR1-10.2196/10997
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Affiliation(s)
- Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Karakatsani
- Second Pulmonary Department, "Attikon" University Hospital, Medical School, University of Athens, Athens, Greece
| | - Argiro Karakosta
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Sofianopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Panagiotis Koustenis
- Department of Political Science and History, School of Political Science, Panteion University of Social and Political Science, Athens, Greece
| | - Magda Gavana
- Department of Primary Health Care, General Practice and Health Services Research, Medical School, Aristotle University, Thessaloniki, Greece
| | - Yannis Alamanos
- Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece
| | - Maria Kantzanou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Konstantakopoulos
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Xenia Chryssochoou
- Department of Psychology, Panteion University of Political and Social Sciences, Athens, Greece
| | - Alexis Benos
- Department of Primary Health Care, General Practice and Health Services Research, Medical School, Aristotle University, Thessaloniki, Greece
| | - Apostolos Vantarakis
- Environmental Microbiology Unit, Department of Public Health, Medical School, University of Patras, Patra, Greece
| | | | - Gregory Chlouverakis
- Laboratory of Biostatistics, School of Medicine, University of Crete, Crete, Greece
| | - Gregory Trypsianis
- Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Thrace, Greece
| | - Paraskevi V Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Konstantinos Makrilakis
- Hellenic Diabetes Association, Athens, Greece.,First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- Hellenic Diabetes Association, Athens, Greece.,First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Stergiou
- Hypertension Center STRIDE-7, Third Department of Medicine, Sotiria Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Mastrokostas A, Gavana M, Gkrizioti M, Smyrnakis E, Cholongitas E, Benos A, Haidich AB. Discrepancies and misconceptions of perceived colorectal cancer screening barriers between primary health professionals and unscreened population. A comparative study in Greece. J BUON 2018; 23:67-76. [PMID: 30722114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Our study aimed to compare the views of healthy eligible unscreened adults, to those of primary care providers in Greece, about colorectal cancer (CRC) screening perceived barriers. METHODS A sample of 791 unscreened adults (50-75 years) from a recent nationwide health survey in Greece were interviewed about CRC screening barriers, and the main reason for not adhering to colonoscopy and fecal occult blood test (FOBT) was assessed. Results were compared to a concurrent survey of 161 primary care professionals (PCPs) from the same region and the agreement with the general population was assessed with odds ratios (OR) and 95% confidence intervals (CI). RESULTS General population stated as a primary barrier for colonoscopy, at a significant higher frequency than the PCPs (p<0.001), lack of symptoms (44.5 vs 5.7%), negligence (14.2 vs 3.8%) and lack of PCP recommendation (9.2 vs 2.5%). PCPs were more likely to agree for fear of pain of colonoscopy (OR:19.6, 95%CI 9.3-41.4), fear of cancer diagnosis (OR:17.7, 95%CI 10.8-29.1), and embarrassment (OR:13.8, 95%CI 8.1-23.6). Regarding FOBT, the most frequent barrier for the unscreened population compared to PCPs (p<0.001), was lack of symptoms (38.2 vs 3.9%), followed by unawareness of the test (22.9 vs 55.2%) and lack of PCP recommendation (13% vs 12.3%). The only barrier that PCPs agreed at significantly lower frequency was the lack of physician recommendation (OR:0.3; 95%CI 0.2-0.4). CONCLUSIONS PCPs do not share the same views as the general population about CRC screening barriers in Greece. PCPs should focus counseling on patient perceived barriers in order to promote adherence.
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Affiliation(s)
- Athanasios Mastrokostas
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Benos A, Bodini C, Cowan H, McCoy D, Milsom P, Sanders D. Defending academic and medical independence in Turkey. Lancet 2017; 390:645. [PMID: 28756903 DOI: 10.1016/s0140-6736(17)32093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/24/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Alexis Benos
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chiara Bodini
- Centre for International and Intercultural Health, University of Bologna, 40126 Bologna, Italy.
| | - Hannah Cowan
- London School of Hygiene & Tropical Medicine, London, UK
| | - David McCoy
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | | | - David Sanders
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Papamichail D, Petraki I, Arkoudis C, Terzidis A, Smyrnakis E, Benos A, Panagiotopoulos T. Low vaccination coverage of Greek Roma children amid economic crisis: national survey using stratified cluster sampling. Eur J Public Health 2017; 27:318-324. [PMID: 27694159 PMCID: PMC5439213 DOI: 10.1093/eurpub/ckw179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background Research on Roma health is fragmentary as major methodological obstacles often exist. Reliable estimates on vaccination coverage of Roma children at a national level and identification of risk factors for low coverage could play an instrumental role in developing evidence-based policies to promote vaccination in this marginalized population group. Methods We carried out a national vaccination coverage survey of Roma children. Thirty Roma settlements, stratified by geographical region and settlement type, were included; 7-10 children aged 24-77 months were selected from each settlement using systematic sampling. Information on children's vaccination coverage was collected from multiple sources. In the analysis we applied weights for each stratum, identified through a consensus process. Results A total of 251 Roma children participated in the study. A vaccination document was presented for the large majority (86%). We found very low vaccination coverage for all vaccines. In 35-39% of children 'minimum vaccination' (DTP3 and IPV2 and MMR1) was administered, while 34-38% had received HepB3 and 31-35% Hib3; no child was vaccinated against tuberculosis in the first year of life. Better living conditions and primary care services close to Roma settlements were associated with higher vaccination indices. Conclusions Our study showed inadequate vaccination coverage of Roma children in Greece, much lower than that of the non-minority child population. This serious public health challenge should be systematically addressed, or, amid continuing economic recession, the gap may widen. Valid national estimates on important characteristics of the Roma population can contribute to planning inclusion policies.
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Affiliation(s)
- Dimitris Papamichail
- Department of Child Health, National School of Public Health, Athens, Greece
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki
| | - Ioanna Petraki
- Programme “Education of Roma children”, Centre for Intercultural Studies, Faculty of Philosophy, Pedagogy and Psychology, University of Athens
- Programme of Postgraduate Education “International Medicine - Health Crisis Management”, Medical School, University of Athens
| | - Chrisoula Arkoudis
- Programme “Education of Roma children”, Centre for Intercultural Studies, Faculty of Philosophy, Pedagogy and Psychology, University of Athens
| | - Agis Terzidis
- Programme of Postgraduate Education “International Medicine - Health Crisis Management”, Medical School, University of Athens
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki
| | - Alexis Benos
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki
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Chourdakis M, Smyrnakis E, Doundoulakis I, Leedham-Green K, Wylie A, Benos A, Stephenson A. MON-P203: Degree of Motivation and Perception of Targeted Weight Loss Among Overweightand Obese Patients in Primary Care During a Novel Behavioral Change Consultation. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30837-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leedham-Green KE, Smyrnakis E, Wylie A, Chourdakis M, Stephenson A, Benos A. Breaking down the barriers to international collaboration through technology. Education for Primary Care 2016; 27:431. [DOI: 10.1080/14739879.2016.1203269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Nella D, Panagopoulou E, Galanis N, Montgomery A, Benos A. Consequences of Job Insecurity on the Psychological and Physical Health of Greek Civil Servants. Biomed Res Int 2015; 2015:673623. [PMID: 26557687 PMCID: PMC4628735 DOI: 10.1155/2015/673623] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 11/18/2022]
Abstract
The aim of this study was to estimate the short term consequences of job insecurity associated with a newly introduced mobility framework in Greece. In specific, the study examined the impact of job insecurity on anxiety, depression, and psychosomatic and musculoskeletal symptoms, two months after the announcement of the mobility framework. In addition the study also examined the "spill over" effects of job insecurity on employees not directly affected by the mobility framework. Personal interviews using a structured questionnaire were conducted for 36 university administrative employees awaiting repositioning, 36 coworkers not at risk, and 28 administrative employees of a local hospital not at risk. Compared to both control groups the employees in the anticipation phase of labor mobility had significantly worse scores for perceived stress, anxiety, depression, positive affect, negative affect, social support, marital discord, common somatic symptoms, and frequency of musculoskeletal pain. This study highlights the immediate detrimental effects of job insecurity on the physical, psychological, and social functioning of employees. There is a need for the development of front line interventions to prevent these effects from developing into chronic conditions with considerable cost for the individual and society in general.
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Affiliation(s)
- Dimitra Nella
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 55131 Thessaloniki, Greece
| | - Efharis Panagopoulou
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 55131 Thessaloniki, Greece
| | - Nikiforos Galanis
- Department of Orthopaedics, “Papageorgiou” General Hospital, Medical School, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
| | - Anthony Montgomery
- Department of Educational and Social Policy, University of Macedonia, Egnatia Street 156, 54636 Thessaloniki, Greece
| | - Alexis Benos
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 55131 Thessaloniki, Greece
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Ladbury GAF, Gavana M, Danis K, Papa A, Papamichail D, Mourelatos S, Gewehr S, Theocharopoulos G, Bonovas S, Benos A, Panagiotopoulos T. Population seroprevalence study after a West Nile virus lineage 2 epidemic, Greece, 2010. PLoS One 2013; 8:e80432. [PMID: 24260390 PMCID: PMC3832368 DOI: 10.1371/journal.pone.0080432] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022] Open
Abstract
Introduction During summer 2010, 262 human cases including 35 deaths from West Nile virus (WNV) infection were reported from Central Macedonia, Greece. Evidence from mosquitoes, birds and blood donors demonstrated that the epidemic was caused by WNV lineage 2, which until recently was considered of low virulence. We conducted a household seroprevalence study to estimate the spread of infection in the population during the epidemic, ascertain the relationship of infection to clinical disease, and identify risk factors for infection. Methods We used a two-stage cluster design to select a random sample of residents aged ≥18 years in the outbreak epicentre. We collected demographic, medical, and risk factor data using standard questionnaires and environmental checklists, and tested serum samples for presence of WNV IgG and IgM antibodies using ELISA. Results Overall, 723 individuals participated in the study, and 644 blood samples were available. Weighted seropositivity for IgG antibodies was 5.8% (95% CI: 3.8–8.6; n=41). We estimated that about 1 in 130 (1:141 to 1:124) infected individuals developed WNV neuroinvasive disease, and approximately 18% had clinical manifestations attributable to their infection. Risk factors for infection reflected high exposure to mosquitoes; rural residents were particularly at risk (prevalence ratio: 8.2, 95% CI: 1.1–58.7). Discussion This study adds to the evidence that WNV lineage 2 strains can cause significant illness, demonstrating ratios of infection to clinical disease similar to those found previously for WNV lineage 1.
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Affiliation(s)
- Georgia A. F. Ladbury
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Magda Gavana
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kostas Danis
- Hellenic Centre for Disease Control and Prevention (KEELPNO), Athens, Greece
- National School of Public Health, Athens, Greece
- * E-mail:
| | - Anna Papa
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Stefanos Bonovas
- Hellenic Centre for Disease Control and Prevention (KEELPNO), Athens, Greece
| | - Alexis Benos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
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Smyrnakis E, Gavana M, Kondilis E, Giannakopoulos S, Benos A. Reply: Cost and returns related to medical education in rural and remote locations. Rural Remote Health 2013. [DOI: 10.22605/rrh2641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kondilis E, Giannakopoulos S, Gavana M, Ierodiakonou I, Waitzkin H, Benos A. Economic crisis, restrictive policies, and the population's health and health care: the Greek case. Am J Public Health 2013; 103:973-9. [PMID: 23597358 DOI: 10.2105/ajph.2012.301126] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The global economic crisis has affected the Greek economy with unprecedented severity, making Greece an important test of the relationship between socioeconomic determinants and a population's well-being. Suicide and homicide mortality rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009, and mental disorders, substance abuse, and infectious disease morbidity showed deteriorating trends during 2010 and 2011. Utilization of public inpatient and primary care services rose by 6.2% and 21.9%, respectively, between 2010 and 2011, while the Ministry of Health's total expenditures fell by 23.7% between 2009 and 2011. In a time of economic turmoil, rising health care needs and increasing demand for public services collide with austerity and privatization policies, exposing Greece's population health to further risks.
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Affiliation(s)
- Elias Kondilis
- Laboratory of Hygiene and Social Medicine-Medical School, Aristotle University, Thessaloniki, Greece
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Smyrnakis E, Gavana M, Kondilis E, Giannakopoulos S, Benos A. Reply: Cost and returns related to medical education in rural and remote locations. Rural Remote Health 2013; 13:2641. [PMID: 23731199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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Stefanidou S, Gerodimos C, Benos A, Galanopoulou V, Chatziyannis I, Kanakoudi F, Aslanidis S, Boura P, Sfetsios T, Settas L, Katsounaros M, Papadopoulou D, Giamalis P, Dombros N, Chatzistilianou M, Garyfallos A. Clinical expression and course in patients with late onset systemic lupus erythematosus. Hippokratia 2013; 17:153-156. [PMID: 24376322 PMCID: PMC3743621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND To analyze the pattern of clinical expression and the 5-year disease course in Caucasian patients with late onset of systemic lupus erythematosus (SLE) and to compare the findings with an early onset SLE group. METHODS Medical records of 551 patients who presented with SLE at hospitals of the region of Thessaloniki between 1989 and 2007 were studied. Patients who developed SLE at or after the age of 50 years were classified as the late onset group, while younger patients served as the early onset group. Data on clinical manifestations and damage accrual at disease onset and at 5 years was obtained and compared between the two groups. RESULTS In 121 patients, the disease started after the age of 50 years. Elderly patients showed less pronounced female predominance and less often presented with malar rash, nephropathy, fever and lymphadenopathy, while lung involvement, pericarditis and sicca syndrome were more frequent. Damage accrual was similar in both groups. The main causes of damage at 5 years differed, with the elderly exhibiting more cardiovascular damage. They also had a higher incidence of hypertension and osteoporosis at 5 years. CONCLUSIONS Caucasian SLE patients with late onset of the disease present with different clinical manifestations, suggesting that age affects the expression of SLE. Damage accrual at 5 years is similar in the elderly and the younger patients. However, the causes of this damage and the occurrence of other comorbidities follow a different pattern, possibly reflecting the disease process and the effects of aging.
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Affiliation(s)
- S Stefanidou
- 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital
| | - C Gerodimos
- 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital
| | - A Benos
- Department of Hygiene, Aristotle University
| | | | | | - F Kanakoudi
- 1 Department of Pediatrics, Aristotle University, Hippokration Hospital
| | - S Aslanidis
- 2 Propedeutic Department of Internal Medicine, Hippokration Hospital
| | - P Boura
- 2 Department of Internal Medicine, Aristotle University, Hippokration Hospital
| | - T Sfetsios
- Department of Rheumatology, Inter-Balkan Hospital
| | - L Settas
- 1 Department of Internal Medicine, Aristotle University, AHEPA Hospital
| | - M Katsounaros
- 2 Department of Internal Medicine, Papanikolaou Hospital
| | | | - P Giamalis
- Department of Nephrology, Hippokration Hospital
| | - N Dombros
- Department of Nephrology, AHEPA Hospital
| | - M Chatzistilianou
- 2 Department of Pediatrics, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - A Garyfallos
- 4 Department of Internal Medicine, Aristotle University, Hippokration Hospital
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Kondilis E, Ierodiakonou I, Gavana M, Giannakopoulos S, Benos A. Suicide mortality and economic crisis in Greece: men's Achilles’ heel: Table 1. J Epidemiol Community Health 2013; 67:e1. [DOI: 10.1136/jech-2013-202499] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Smyrnakis E, Gavana M, Kondilis E, Giannakopoulos S, Panos A, Chainoglou A, Stardeli T, Kavaka N, Benos A. Primary health care and general practice attachment: establishing an undergraduate teaching network in rural Greek health centers. Rural Remote Health 2013. [DOI: 10.22605/rrh1946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Smyrnakis E, Gavana M, Kondilis E, Giannakopoulos S, Panos A, Chainoglou A, Stardeli T, Kavaka N, Benos A. Primary health care and general practice attachment: establishing an undergraduate teaching network in rural Greek health centers. Rural Remote Health 2013; 13:1946. [PMID: 23480820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
CONTEXT Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both the scope and the setting of this training procedure. Regarding the latter, the quality of teaching is often questioned in settings such as rural primary health centers, where health professionals have neither incentives nor accredited training skills. Therefore, the success of community based medical education depends substantially on the procedures implemented to involve non-academic staff as clinical teachers. ISSUE This report describes the steps taken by the Aristotle University of Thessaloniki (AUTH) Medical School to establish and maintain a Rural Primary Health Care (PHC) Teaching Network in order to implement community oriented PHC and GP undergraduate medical education. A multi-professional teachers' network of healthcare staff, working in Rural Primary Health Centers, has been chosen, in order to expose students to the holistic approach of PHC. The enrollment of teachers to the Teaching Network was solely on a voluntary basis. The novelty of this procedure is that each professional is approached personally, instead through the Health Center (HC) that usually offers this service as a package in similar activities. In an attempt to attract health professionals committed to medical education, a self-selection procedure was adopted. Collaboration with the medical school was established but it was characterized by the School's inability to compensate teachers. A series of 'Training the Trainers' seminars were completed during the first implementation period in order to enhance the awareness of health professionals regarding undergraduate teaching in PHC; to present the educational needs of medical students; to expose them to the principles of medical teaching; and to strengthen their communication skills. LESSONS LEARNED Setting up sustainable community oriented medical education activities in a more or less unfriendly environment is a difficult task that calls for wisely selected functional steps. Pilot educational activities determine the quality of the implemented programs by evaluating difficulties and constraints. Recruiting teachers on a voluntary basis proved to be critical in enhancing the quality of this educational activity, and overcoming distance constraints. The educational activities which were offered created a homogenous group of PHC teachers with explicit educational aims and objectives.
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Affiliation(s)
- Emmanouil Smyrnakis
- Laboratory of Hygiene and Social Medicine, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Abusalah A, Gavana M, Haidich AB, Smyrnakis E, Papadakis N, Papanikolaou A, Benos A. Low birth weight and prenatal exposure to indoor pollution from tobacco smoke and wood fuel smoke: a matched case-control study in Gaza Strip. Matern Child Health J 2012; 16:1718-27. [PMID: 21842400 DOI: 10.1007/s10995-011-0851-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Maternal exposure to environmental tobacco smoke (ETS) is a major health hazard as it contains lower doses of the toxins that smokers' inhale. Prenatal exposure to wood fuel smoke has been linked to delivering low birth weight (LBW) infants. The study aims to assess the association between prenatal exposure to ETS and wood fuel smoke and LBW. A case-control study in ratio 1:1 was conducted in two hospitals with obstetric services in Gaza Strip. Subjects were selected during May-June and July-August 2007 from attenders of Mbarak Hospital and Shifa Medical Centre, respectively. 184 (41.2%), and 79 (17.7%) out of 446 participants were exposed to environmental tobacco smoke and wood fuel smoke, respectively. Adjusted maternal exposure to ETS (especially the number of cigarettes smoked, water pipe and wood fuel smoke) was associated with LBW infants. Cigarette smoke exhibits an independent dose-response risk of LBW after adjusting for confounders. Prenatal exposure to cigarette smoke indoors is related to a reduction in birth weight of infants of -237 g (95% CI: -415, -58) for pregnant women exposed to 1-20 cigarettes per day and -391 g (95% CI: -642, -140) for exposure to more than 20 cigarettes per day. Exposure to wood fuel smoke exhibits a reduction of infants' adjusted mean birth weight by -186 g (95% CI: -354, -19). Prenatal exposure to passive smoking and wood fuel smoke are independently associated with LBW. Both these factors are modifiable exposures that could possibly lead to a reduction of delivering LBW infants.
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Affiliation(s)
- Akram Abusalah
- Department of Hygiene and Social Medicine, Medical School, Aristotle University of Thessaloniki, PO box: 1689, 54006, Thessaloniki, Greece
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Panagopoulou E, Giata O, Montgomery A, Dinas K, Benos A. Human papillomavirus and cervical screening: misconceptions undermine adherence. Am J Health Promot 2012; 26:6-9. [PMID: 21879936 DOI: 10.4278/ajhp.09113-arb-364] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Prophylactic vaccination programs in conjunction with cervical screening can significantly reduce the incidence of cervical cancer worldwide. This study tested the hypothesis that human papillomavirus (HPV) vaccination can adversely affect adherence to cervical screening if the public develops the misconception that the HPV vaccination has removed the need for screening. DESIGN A postal survey using a stratified random sample was employed. PARTICIPANTS Overall, 500 medical students and 500 nonmedical students of the Aristotle University of Thessaloniki were invited to participate. The response rate was 82%. MEASURES A questionnaire was developed assessing demographic characteristics, adherence to cervical screening, and awareness and attitudes toward HPV. ANALYSIS Logistic regression was used to assess the impact of HPV awareness and attitudes towards HPV vaccination on adherence to Papanicolaou screening, controlling for place of origin and mother's screening behavior. RESULTS Students who believed that vaccination against HPV obviated the need for a Papanicolaou test were two times less likely to adhere to cervical screening (adjusted odds ratio, 1.89; 95% confidence interval, 1.37-2.57; p = .0004). The effect was stronger in the nonmedical subgroup (adjusted odds ratio, 3.05; 95% confidence interval, 1.85-5.160; p = .0003). CONCLUSION Findings highlight that misconceptions can adversely affect preventive behaviors and reduce the probability of an early diagnosis of cervical cancer.
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Affiliation(s)
- Efharis Panagopoulou
- Department of Biological Sciences and Preventive Medicine, Medical School, Aristotle University Thessaloniki, Macedonia, Greece.
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Vakfari A, Gavana M, Giannakopoulos S, Smyrnakis E, Benos A. Participation rates in cervical cancer screening: experience in rural Northern Greece. Hippokratia 2011; 15:346-352. [PMID: 24391418 PMCID: PMC3876852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND AIM Cervical cancer is one of the most common causes of cancer mortality among women worldwide but it is one of the most preventable cancers due to the Pap smear test. The aim of this study was to estimate the participation rate of females in screening of cervical cancer with Pap smear test. METHODS The study took place in a hospital in Rural Northern Greece during April and May 2007. Convenience sampling was performed and questionnaires were completed by 214 eligible females aged 20-64 years. RESULTS One hundred and twenty four (57.9%) of the participants had had a Pap-test at some point in their lifetime. 72 of them (33.65%) had the test performed for the first time according to current guidelines. 13.6% were unaware about the recommended onset age of the test, 16.4% did not know the proper intervals, while 22.4% did not know the recommended upper age limit. 32.6% were informed by mass media, family members and friends. The take-up rates, the source of information and the setting where the examination was performed were related to age, origin, income, educational status, type of occupation and place of residence. Disparities in participation rates were detected. CONCLUSIONS Special efforts should be made by National Health Services towards enhancing secondary prevention of cervical cancer by increasing participation rates of older women, those with lower educational background, females with low income, Roma, retired or unemployed and residents of rural areas.
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Affiliation(s)
- A Vakfari
- Laboratory of Hygiene and Social Medicine, Aristotle University of Thessaloniki, Greece
| | - M Gavana
- Laboratory of Hygiene and Social Medicine, Aristotle University of Thessaloniki, Greece
| | - S Giannakopoulos
- Laboratory of Hygiene and Social Medicine, Aristotle University of Thessaloniki, Greece
| | - E Smyrnakis
- Laboratory of Hygiene and Social Medicine, Aristotle University of Thessaloniki, Greece
| | - A Benos
- Laboratory of Hygiene and Social Medicine, Aristotle University of Thessaloniki, Greece
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Kondilis E, Gavana M, Giannakopoulos S, Smyrnakis E, Dombros N, Benos A. Payments and quality of care in private for-profit and public hospitals in Greece. BMC Health Serv Res 2011; 11:234. [PMID: 21943020 PMCID: PMC3199237 DOI: 10.1186/1472-6963-11-234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 09/23/2011] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. METHODS Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. RESULTS PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. CONCLUSIONS In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.
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Affiliation(s)
- Elias Kondilis
- Greek Observatory on the Privatization of Health Care, Aristotle University, 54124 Thessaloniki, Greece
- Laboratory of Hygiene, Medical School, Aristotle University, 54124 Thessaloniki, Greece
| | - Magda Gavana
- Laboratory of Hygiene, Medical School, Aristotle University, 54124 Thessaloniki, Greece
| | | | - Emmanouil Smyrnakis
- Laboratory of Hygiene, Medical School, Aristotle University, 54124 Thessaloniki, Greece
| | - Nikolaos Dombros
- Medical School, Aristotle University, 54124 Thessaloniki, Greece
| | - Alexis Benos
- Greek Observatory on the Privatization of Health Care, Aristotle University, 54124 Thessaloniki, Greece
- Laboratory of Hygiene, Medical School, Aristotle University, 54124 Thessaloniki, Greece
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Abstract
Despite the considerable financial and organizational resources of health promotion campaigns, their effectiveness in tackling current health problems is limited. In the following commentary, we argue that health promotion is best understood as a behavioural challenge. Behaviour can be understood in terms of three aspects: knowledge, skills and attitudes. While knowledge and skills have received adequate attention, the attitudinal approach has been significantly underutilized. To this end, we have used the examples of prevention of H1N1 transmission, hand washing in hospitals and prevention of cervical cancer to elucidate our points. We also provide recommendations of how the attitudinal approach can enhance the effectiveness of health promotion interventions.
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Stefanidou S, Benos A, Galanopoulou V, Chatziyannis I, Kanakoudi F, Aslanidis S, Boura P, Sfetsios T, Settas L, Katsounaros M, Papadopoulou D, Giamalis P, Dombros N, Chatzistilianou M, Garyfallos A. Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: a male:female comparison. Lupus 2011; 20:1090-4. [PMID: 21700658 DOI: 10.1177/0961203311403640] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to analyse the prevalence of the most relevant clinical features of the diagnosis of systemic lupus erythematosus (SLE) in a sample of male patients with lupus as well as the incidence of the main causes of morbidity in a 5-year period after the diagnosis. A further aim of this study was to investigate the impact of gender on expression and morbidity of SLE. Data were collected from the medical records of 59 male and 535 female patients with SLE who were diagnosed at the hospitals in the region of Thessaloniki. Several differences in the expression and morbidity of the disease were found in relation to the gender of the patient. Male patients had a higher prevalence of thromboses, nephropathy, strokes, gastrointestinal tract symptoms and antiphospholipid syndrome when compared with female patients, but tended to present less often with arthralgia, hair loss, Raynaud's phenomenon and photosensitivity as the initial clinical manifestations. During the 5-year follow-up, positive associations have been found between male gender and the incidence of tendonitis, myositis, nephropathy and infections, particularly of the respiratory tract. In conclusion, this study has provided information regarding the features of clinical expression and morbidity in male patients, and has shown that gender is a possible factor that can influence the clinical expression of SLE.
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Affiliation(s)
- S Stefanidou
- 4th Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece
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Ampanozi G, Kovatsi L, Smyrnakis E, Zaggelidou E, Gavana M, Papadakis N, Benos A. Analysis of fatal motor vehicle collisions: evidence from Central Macedonia, Greece. Hippokratia 2011; 15:32-36. [PMID: 21607033 PMCID: PMC3093142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The objective of this study was to assess the factors associated with the traffic mortality in the region of Central Macedonia in order to produce evidence in building up preventive policies. MATERIAL AND METHODS This study is a descriptive survey covering a three-year period (from 01-01-2006 to 31-12- 2008). The data used were supplied by the regional Road Traffic Police Service in Thessaloniki. RESULTS A total of 280 fatal vehicle collisions were recorded in three years, in which 312 people died. 266 (85.26%) of the 312 people who died were men and 46 (14.74%) were women. The victims were between 1 and 91 years of age (mean ± SD, 42.00 ± 20.36 years). More fatal vehicle collisions were recorded on weekends and holidays than weekdays. Regarding the type of the vehicle, occupants of two-wheeled motor vehicles were in greater risk for dying compared to heavy duty vehicle passengers, who are considered to be protected by the vehicle. Among the 312 fatalities, alcohol was detected in 87 (28%) of the drivers who were responsible for the collision. Most of them (56/86, 64.4%) were between 15 and 44 years of age. In 6 (1.9%) cases, all of them drivers, illicit substances were detected. Vehicle collisions with younger victims were recorded during the early morning hours, whereas older people died more frequently during daytime. CONCLUSIONS The findings of this study are providing evidence for the design and implementation of concrete and urgently needed preventive strategies in order to control the almost completely preventable fatalities of the road crashes.
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Pavlidou E, Zafrakas M, Papadakis N, Agorastos T, Benos A. Time trends of female breast cancer mortality in Greece during 1980-2005: a population based study. Postgrad Med J 2010; 86:391-4. [DOI: 10.1136/pgmj.2009.091728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sanders D, Baum FE, Benos A, Legge D. Revitalising primary healthcare requires an equitable global economic system - now more than ever. J Epidemiol Community Health 2009; 65:661-5. [PMID: 19955097 DOI: 10.1136/jech.2009.095125] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The promised revitalisation of primary healthcare (PHC) is happening at a time when the contradictions and unfairness of the global economic system have become clear, suggesting that the current system is unsustainable. In the past two decades, one of the most significant impediments to the implementation of comprehensive PHC has been neoliberal economic policies and their imposition globally. This article questions what will be required for PHC to flourish. PHC incorporates five key principles: equitable provision of services, comprehensive care, intersectoral action, community involvement and appropriate technology. This article considers intersectoral action and comprehensiveness and their potential to be implemented in the current global environment. It highlights the constraints to intersectoral action through a case study of nutrition in the context of globalisation of the food chain. It also explores the challenges to implementing a comprehensive approach to health that are posed by neoliberal health sector reforms and donor practices. The paper concludes that even well-designed health systems based on PHC have little influence over the broader economic forces that shape their operation and their ability to improve health. Reforming these economic forces will require greater regulation of the national and global economic environment to emphasise people's health rather than private profit, and action to address climate change. Revitalisation of PHC and progress towards health equity are unlikely without strong regulation of the market. The further development and strengthening of social movements for health will be key to successful advocacy action.
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Affiliation(s)
- David Sanders
- School of Public Health, University of the Western Cape, P Bag X17, Bellville 7535, South Africa.
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Panagopoulou E, Triantafyllou A, Mitziori G, Benos A. Dyadic benefit finding after myocardial infarction: a qualitative investigation. Heart Lung 2009; 38:292-7. [PMID: 19577700 DOI: 10.1016/j.hrtlng.2008.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 09/01/2008] [Accepted: 10/17/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to explore the process of dyadic benefit finding after myocardial infarction. METHODS For the purposes of the study, a qualitative methodology using intepretative phenomenologic analysis was used. Semistructured interviews were conducted with 11 couples. Patients were predominantly male, aged between 50 and 70 years, and partners were aged between 45 and 64 years. All couples were married. RESULTS In terms of the patients, the following themes emerged: a catalyst for change/wake-up call; change of life philosophy; being protected/being invincible; humanistic attitudes. With regard to the spouses, the following themes emerged: active search for benefit/failure to find benefit and improvement of relationship. CONCLUSION The study revealed no compatibility in the process of benefit finding between patients and spouses. Clinical implications for cardiac rehabilitation interventions are discussed.
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Polyzos SA, Kita M, Efstathiadou Z, Goulis DG, Benos A, Flaris N, Leontsini M, Avramidis A. The use of demographic, ultrasonographic and scintigraphic data in the diagnostic approach of thyroid nodules. Exp Clin Endocrinol Diabetes 2008; 117:159-64. [PMID: 19085697 DOI: 10.1055/s-2008-1080922] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Thyroid nodules are a common diagnostic challenge mainly because of the need to exclude thyroid malignancy. The aim of this study was to evaluate the usefulness of demographic, ultrasonographic and scintigraphic findings in differentiating benign from malignant thyroid lesions in patients presenting with thyroid nodules. MATERIALS AND METHODS 941 patients, who presented with palpable thyroid nodules and underwent at least one fine-needle aspiration biopsy (FNAB), were retrospectively evaluated. RESULTS The thyroid was assessed by ultrasonography (US) in 796 patients and by scintigraphy (SC) in 774 patients. The final diagnostic outcome was established after surgery (n=183) or after a minimum of one-year clinical follow-up period. Higher rates of malignancy were observed in male gender (p<0.001), in patients presenting with a solitary nodule in US (p<0.001), in nodules with maximum diameter > or =4.5 cm in US (p=0.024) and in nodules detectable by SC (p=0.006). There were no statistical differences in the rates of malignancy among cystic, solid or mixed nodules in US or among "hot", "warm" or "cold" nodules in SC. CONCLUSIONS Male gender, solitary nodule and nodule diameter > or =4.5 cm can serve as adjuncts to FNAB in predicting the risk of thyroid malignancy in patients presenting with thyroid nodules.
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Affiliation(s)
- S A Polyzos
- Department of Endocrinology, Hippokratio General Hospital, Thessaloniki, Greece.
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Polyzos SA, Kita M, Goulis DG, Benos A, Flaris N, Leontsini M, Avramidis A. Epidemiologic analysis of thyroid fine needle aspiration biopsies over a period of 18 years (1987-2004). Exp Clin Endocrinol Diabetes 2008; 116:496-500. [PMID: 18523917 DOI: 10.1055/s-2008-1058082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Fine Needle Aspiration Biopsy (FNA) is a method widely used in the assessment of thyroid nodules. The main aim of this 18-year retrospective study was the investigation of the diagnostic value of FNA cytology in thyroid malignancy. SUBJECTS AND METHODS We retrospectively reviewed 1376 patients who underwent 1938 FNAs from 1987 to 2004 in the Department of Endocrinology, "Hippokration" General Hospital, Thessaloniki, Greece. Of them 178 subsequently underwent total or subtotal thyroid resection and a pathology report was available. RESULTS FNA cytology shows a sensitivity of 76.2% and a specificity of 90.5% for thyroid malignancy, with a significant agreement between FNA cytology and the histology following resection surgery (Cohen's method, p<0.05). There was a considerable improvement in the diagnostic value of FNA cytology during the sub-period 1996-2004 as compared to the sub-period 1987-1995. CONCLUSIONS 1) FNA is a reliable diagnostic method in the assessment of thyroid malignancy, 2) a non-diagnostic FNA should always be repeated, 3) meticulous follow-up is mandatory, even after a cytological result of benign hyperplasia and 4) increased experience can improve the diagnostic value of FNA in thyroid malignancy.
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Affiliation(s)
- S A Polyzos
- Department of Endocrinology, Hippokratio General Hospital, Thessaloniki, Greece.
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Panagopoulou E, Mintziori G, Montgomery A, Kapoukranidou D, Benos A. Concealment of Information in Clinical Practice: Is Lying Less Stressful Than Telling the Truth? J Clin Oncol 2008; 26:1175-7. [DOI: 10.1200/jco.2007.12.8751] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Efharis Panagopoulou
- From the Lab of Hygiene; Lab of Physiology, Medical School, Aristotle University, Thessaloniki, Greece
| | - Gesthimani Mintziori
- From the Lab of Hygiene; Lab of Physiology, Medical School, Aristotle University, Thessaloniki, Greece
| | - Anthony Montgomery
- From the Lab of Hygiene; Lab of Physiology, Medical School, Aristotle University, Thessaloniki, Greece
| | - Dorothea Kapoukranidou
- From the Lab of Hygiene; Lab of Physiology, Medical School, Aristotle University, Thessaloniki, Greece
| | - Alexis Benos
- From the Lab of Hygiene; Lab of Physiology, Medical School, Aristotle University, Thessaloniki, Greece
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Quizphe A, Benos A, Lloyd B, Narayan R, Schuftan C, McCoy D, de la Paz D, Legge D, Mashal J, Smith L, Kagis M, Issa G, Baum F, Shukrallah A, Serag H, John P, Chowdury Z, Sanders D, Shannon S, Peng KK. Reed Elsevier and the arms trade revisited. Lancet 2007; 369:988; discussion 989-90. [PMID: 17382817 DOI: 10.1016/s0140-6736(07)60487-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Farmaki E, Evdoridou J, Pouliou T, Bibashi E, Panagopoulou P, Filioti J, Benos A, Sofianou D, Kremenopoulos G, Roilides E. Fungal colonization in the neonatal intensive care unit: risk factors, drug susceptibility, and association with invasive fungal infections. Am J Perinatol 2007; 24:127-35. [PMID: 17304423 DOI: 10.1055/s-2007-970078] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A prospective study was conducted to determine risk factors for fungal colonization, drug susceptibility, and association with invasive fungal infections (IFIs) in a neonatal unit. On admission and weekly thereafter, surveillance fungal cultures were taken from mouth, rectum, and trachea of neonates with expected stays of > 1 week. Fungal colonization was detected in 72 (12.1%) of 593 neonates during 12 months. CANDIDA ALBICANS was isolated from 42% of colonized neonates. Although early colonization (age 1.3 +/- 0.2 days) was found in 2.5% of the neonates, late colonization (age 17.6 +/- 1.4 days) was noted in 14.2% of neonates hospitalized for > 5 days. Neonates born vaginally were at higher risk for early colonization than those delivered after cesarean section ( P = 0.01). By multivariate logistic regression, very low birthweight was the only independent risk factor for late colonization. Ten IFIs (nine candidemias) were diagnosed, yielding a rate of 1.1%. These episodes occurred in 6.9% of colonized neonates, compared with 0.76% of noncolonized neonates ( P = 0.002). C. ALBICANS was susceptible to azoles, but some non- ALBICANS CANDIDA spp. exhibited decreased susceptibility to these drugs.
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Affiliation(s)
- Evangelia Farmaki
- 3rd Department of Pediatrics, Aristotle University, Thessaloniki, Greece
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Katragkou A, Kotsiou M, Antachopoulos C, Benos A, Sofianou D, Tamiolaki M, Roilides E. Acquisition of imipenem-resistant Acinetobacter baumannii in a pediatric intensive care unit: A case-control study. Intensive Care Med 2006; 32:1384-91. [PMID: 16788807 DOI: 10.1007/s00134-006-0239-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Accepted: 05/17/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the risk factors associated with nosocomial acquisition of imipenem-resistant Acinetobacter baumannii (IRAB) among pediatric intensive care patients. A retrospective case control study was conducted in a pediatric intensive care unit (PICU). PATIENTS AND PARTICIPANTS Cases were children in whom IRAB was isolated from any clinical specimen obtained at least 48 h following admission to PICU. Controls were children without IRAB matched to cases in 2:1 ratio. Twenty-six cases were matched with 52 controls according to the chronological order of admission. MEASUREMENTS AND RESULTS Between July 2001 and December 2003, 52 (62%) of 84 clinical A. baumannii isolates were found nonsusceptible to imipenem (MIC > or = 8 microg/ml). Demographic variables, comorbid conditions, clinical picture at admission, invasive procedures, use of antimicrobials and other drugs were analyzed as potential risk factors. Use of carbapenems and other beta-lactams, aminoglycosides, ranitidine, mechanical ventilation, central venous or urinary catheters and length of stay in PICU were among the factors significantly associated with IRAB acquisition in the univariate analysis. By multivariate analysis, however, only aminoglycoside use and length of stay in the PICU were independent risk factors. CONCLUSIONS Acquisition of IRAB by PICU patients was independently associated with aminoglycoside use and prolonged stay in the unit. Studies of evaluation of infection control policies need to be pursued.
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Affiliation(s)
- Aspasia Katragkou
- Third Department of Pediatrics, Aristotle University, Hippokration Hospital, Konstantinoupoleos 49, 54642, Thessaloniki, Greece
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Panagopoulou E, Montgomery A, Benos A. Quality of life after coronary artery bypass grafting: evaluating the influence of preoperative physical and psychosocial functioning. J Psychosom Res 2006; 60:639-44. [PMID: 16731241 DOI: 10.1016/j.jpsychores.2005.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 10/18/2005] [Accepted: 11/22/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to determine the influence of preoperative physical and psychosocial functioning on quality of life 1 and 6 months after coronary artery bypass grafting (CABG). METHODOLOGY The study used a prospective design. A total of 157 patients admitted for elective CABG in a Greek city hospital participated in the study. RESULTS Results showed significant improvements in the quality of life of the patients after CABG [F(2, 95)=36.337; P<.001]. Structural equation modeling analyses showed that preoperative psychological distress was the only preoperative predictor of quality of life at 1 month (beta=-.22; P<.01) and at 6 months (beta=-.28; P<.001) after the operation. CONCLUSION Results highlight preoperative distress as a screening criterion to identify patients likely to benefit less from cardiac surgery.
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Affiliation(s)
- Efharis Panagopoulou
- Laboratory of Hygiene, Medical School, Aristotle University, Thessaloniki, Greece.
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Panagopoulou E, Montgomery A, Benos A. Burnout in internal medicine physicians: Differences between residents and specialists. Eur J Intern Med 2006; 17:195-200. [PMID: 16618453 DOI: 10.1016/j.ejim.2005.11.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Revised: 10/06/2005] [Accepted: 11/17/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Burnout poses a substantial problem for physicians' well-being and for the quality of health care. The role of workload in comparison to subjective work characteristics has been rarely studied. The purpose of this study was to explore the associations of burnout with workload and subjective work characteristics in internal medicine specialists and residents. METHODS A cross-sectional study using an anonymous mailed survey was used. Some 103 specialists and 143 residents participated in the study. Burnout was measured using the Maslach Burnout Inventory. Subjective work characteristics included perceived job demands in terms of time pressure, mental effort and emotional labor. Workload was assessed in terms of average number of hours worked per week. RESULTS Emotional exhaustion in medical specialists was only predicted by perceived job demands [odds ratio 3.7 (CI 1.7-7.9), P<0.001]. Emotional exhaustion in medical residents was only predicted by emotional labor [odds ratio 1.9 (CI 1.2-3.0), P=0.003]. Depersonalization among medical specialists was only predicted by emotional labor [odds ratio 2.7 (CI 1.1-6.7), P=0.032], while depersonalization among medical residents was only predicted by number of hours worked per week [odds ratio 1.1 (CI 1.1-1.2), P=0.007]. DISCUSSION Perceived working conditions were more important than workload in explaining the variance in burnout. In addition, burnout in medical specialists and residents was linked to different characteristics of their working environment.
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Panagopoulou E, Kavaka N, Giannakopoulos S, Aslanoglou T, Smirnakis E, Kiranou M, Gavana M, Gruffydd M, Zdoukos T, Benos A. Integrating communication, clinical and research skills in medical education: The Daisy Project. Educ Health (Abingdon) 2006; 19:106-10. [PMID: 16531307 DOI: 10.1080/13576280500534602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Efharis Panagopoulou
- Laboratory of Hygiene & Social Medicine, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Benos A. Another health care system is possible. Int J Health Serv 2003; 33:391-3. [PMID: 12800895 DOI: 10.2190/fjml-w4mb-067u-rhhv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A statement prepared by groups at the European Social Forum held in Florence in 2002 declares health to be a fundamental and universal right, a right that is being denied by current neoliberal policies. The statement presents some essential principles for maintaining or restoring this right through a European network.
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Affiliation(s)
- Alexis Benos
- Medical Department, Aristotle University of Thessaloniki, Greece.
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Kouvidis GK, Benos A, Kyriakopoulou G, Anastopoulos G, Triantafyllou D. Colour Doppler ultrasonography of the ophthalmic artery: flow parameters in normal subjects. The significance of the resistance index. INT ANGIOL 2000; 19:319-25. [PMID: 11305730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND The aim of this study was to assess the flow characteristics in ophthalmic arteries and to detect their possible relationships to those in the common and internal carotid arteries. METHODS Sixty healthy subjects (age range 20-74 years) with normal vascular findings, stratified by age and sex were recruited to the study. A colour Doppler ultrasound examination of the neck arteries was performed, followed by a colour Doppler ultrasound examination of the 120 ophthalmic arteries included. Peak systolic velocity, end diastolic velocity and resistance index (RI) of the common carotid, internal carotid and ophthalmic arteries, as well as the insonation depth of the ophthalmic arteries were measured. RESULTS The mean values (standard deviation) of the measured parameters for the ophthalmic arteries were: insonation depth: 38.38 mm (2.60 mm), peak systolic velocity: 34.71 cm/sec (6.38 cm/sec), end diastolic velocity: 7.95 cm/sec (1.70 cm/sec), resistive index: 0.77 (0.04). The resistance index of the ophthalmic arteries was, in all cases, greater than that of the ipsilateral common carotid artery which in turn, was greater than that of the internal carotid. The value of the index in the ophthalmic arteries, when the circulation is normal in the extra- and intracranial arteries is rarely lower than 0.70. CONCLUSIONS When an inversion of the ratio between the resistance index of the ophthalmic artery and that of the common carotid or an index value lower than 0.70 in the ophthalmic artery is observed, further investigation is needed as this situation cannot be considered normal. The resistance index seems to be the most reliable parameter for the estimation of normal circulation in ophthalmic arteries.
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Affiliation(s)
- G K Kouvidis
- Radiology Department, 7th IKA Hospital, Athens, Greece
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Grekas D, Balaskas E, Kampouris H, Benos A, Konstantinou A, Sioullis A, Tourkantonis A. Effective treatment of secondary hyperparathyroidism in hemodialysis patients by titration of intravenous calcitriol dosage. Clin Nephrol 1999; 52:167-71. [PMID: 10499312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
AIM Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administration of calcitriol in hemodialysis patients. PATIENTS AND METHODS The current study evaluates the use of i.v. calcitriol dosing in relation to the severity of the HPTH in 35 hemodialysis patients with serum phosphate < 6.5 mg/dl. Arbitrarily, patients with plasma IPTH levels (intact PTH) between 288 and 576 pg/ml (288 pg/ml = four-fold the upper normal limit) were given initially 1 microg i.v. calcitriol at the end of each dialysis (group A, n = 15). Patients with IPTH between 577 and 864 pg/ml received 2 microg i.v. calcitriol (group B, n = 10) and patients with IPTH more than 865 pg/ml were given 3 - 4 microg i.v. calcitriol (group C, n = 10). As IPTH levels decreased, the dose of i.v. calcitriol was also decreased gradually. Patients were followed-up for 4 months after the end of calcitriol treatment. RESULTS During the i.v. calcitriol treatment period, the observed plasma IPTH concentrations compared with the baseline values were significantly lower (p < 0.01 for A and B group and p < 0.05 for C group) from the sixth month onwards in group A and C and from the third month onwards in group B. At the 12th month of follow-up, all patients being off i.v. calcitriol treatment for four months, a sharp and significant increase (p < 0.01 for group A and B and p < 0.05 for group C) of plasma IPTH was recorded in all three groups of patients. Alkaline phosphatase was also gradually decreased in all studied groups. Serum Ca and P remained unchanged in most patients. CONCLUSION In conclusion, the study presented here demonstrates that the titration of i.v. calcitriol dosage according to the severity of HPTH is an effective and safe treatment of HPTH in chronic hemodialysis patients. It also shows that parathyroidectomy could be avoided in the majority of patients with severe HPTH, if an appropriate dose of calcitriol not aggravating hyperphosphatemia is administered.
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Affiliation(s)
- D Grekas
- First Medical Department, University Hospital AHEPA, Thessaloniki, Greece
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Konstas AG, Dimitrakoulias N, Kourtzidou O, Filidis K, Bufidis T, Benos A. Frequency of exfoliation syndrome in Greek cataract patients. Acta Ophthalmol Scand 1996; 74:478-82. [PMID: 8950398 DOI: 10.1111/j.1600-0420.1996.tb00603.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The frequency of exfoliation syndrome (EXS) was investigated in a group of Greek patients undergoing extracapsular cataract surgery. Five hundred and nine (509) consecutive cataract patients without any other manifest ocular abnormality were prospectively examined for the presence of EXS. Patients were clinically divided into 3 groups: group I (EXS group) consisted of patients in whom exfoliation material deposition could be seen; Group II (possible EXS group) comprised patients who demonstrated a number of pigmentary signs and group III (normal subjects) comprised patients with senile cataract and no sign of EXS. EXS was found in 140 (28%) of our patients, possible EXS in 119 (23%) and the rest (49%) had no evidence of EXS. Patients with EXS were older (mean age 73.8) when compared to the possible EXS group (70 years) and the control group (64.7 years). The IOP was significantly higher in patients with EXS (mean 15.5 mmHg versus 14.3 mmHg in the other two groups). Blue irides were significantly more common in patients with EXS (19%) than in the possible EXS group (14%) and the controls (4%). EXS is common in Greek cataract patients and this study has identified a large group of patients who may be at an early stage of development of the condition. EXS may predispose to the development of cataract in Greek patients.
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Affiliation(s)
- A G Konstas
- Department of Ophthalmology, Aristotle University of Thessaloniki, Greece
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Lionis CD, Sasarolis SM, Koutis AD, Antonakis NA, Benos A, Papavasiliou S, Fioretos M. Measuring the prevalence of diabetes mellitus in a Greek primary health care district. Fam Pract 1996; 13:18-21. [PMID: 8671099 DOI: 10.1093/fampra/13.1.18] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a common disease in developed countries, but in Greece national figures on its prevalence are lacking. OBJECTIVES The aim of this study was to identify the burden of known diabetes mellitus through its estimation in the area of responsibility of the Spili Health Centre, based on the health information system that had been established in Primary Health Care in rural Crete. METHOD The diagnosis of diabetes was retrospectively documented by reviewing all medical records (n = 47151) at the Spili Health Centre and its five regional outposts during the period 1/6/1988-1/7/1993. The diagnostic criteria of WHO were used to establish the diagnosis. RESULTS After excluding the patients who had died, we found 210 patients with diabetes mellitus. Thirty cases were evaluated with OGTT because of mild but not diagnostic elevations of fasting plasma glucose, on more than one occasion. The prevalence of diabetes after age and sex standardization of that for the European population was estimated at 1.52% (1.31% in males and 1.68 in females). CONCLUSIONS Our study shows that: 1) the role of the GPs and one appropriate information system in measuring the prevalence of known diabetes mellitus are now considered important within the Greek context; 2) diabetes mellitus seems not to be a rare disease in rural Crete. The estimated prevalence appears to be similar to the prevalence rates reported in other areas of rural Greece.
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Affiliation(s)
- C D Lionis
- Department of Social and Family Medicine, Medical School, University of Heraklion, Crete, Greece
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