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Background: Diadochokinetic rates tasks are frequently used for the assessment of diadochokinesia (DKK) in young and elderly adults. However, there is scarce research on healthy elderly adults over 65 years old, and little is known about the effect of different types of stimuli (non‐words/real words) in this specific population. Furthermore, the current research supports significant language variations, highlighting the need for language‐specific norms. Aims: To investigate the effect of age, gender and type of stimuli (non‐words versus real words) in DDK rates in healthy elderly adults of over 65 years of age, and to provide normative data for the Greek language. Methods & Procedures: The participants were 791 healthy monolingual Greek‐speaking adults (531 adults, aged 20–39 years; 157 participants aged 65–74 years; and 103 participants aged over 75 years). All participants were monolingual speakers of Greek and had normal hearing acuity, which allowed them to understand and follow instructions. Participants with a medical condition, which would affect DDK rates' performance, were excluded from the study. The time‐by‐count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non‐words (/′gaba/, /′taka/, /′kata/, /′baga/); (2) four disyllabic real words (/′kapa/, /′tapa/, /ka′la/, /′paka/); and (3) two trisyllabic non‐words (/′pataka/, /′badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected DDK rates significantly, with older adults achieving slower DDK rates for all speech stimuli (non‐words/real words). Gender did not have an effect on the performance of DDK rates. The type of speech stimuli affected DDK rates significantly for all age groups. Analytically, trisyllabic non‐word stimuli were articulated more slowly than disyllabic non‐word stimuli, and real words were produced faster than non‐words. A linear regression analysis revealed that only the repetition of non‐words predicted 68.4% of the performance on the repetition of trisyllabic non‐words. Conclusions & Implications: The above results complement prior research, which supports that real word stimuli yield faster performance than non‐word stimuli. Clinicians should keep in mind that age, language and type of stimuli (non‐words/real words) affect significantly the performance of DDK rates, as well as the fact that different types of stimuli tap distinct underlying levels of speech. The current research highlights the need for language‐specific norms for different populations. What this paper adds: What is already known on the subject: DDK rates are significantly affected by the types of stimuli and language used. Moreover, the normal ageing process decreases performance in terms of DDK rates, but scarce evidence exists for healthy elderly adults over 65 years old. What this paper adds to existing knowledge: Most studies have examined DDK rates in healthy elderly people with restricted samples and using non‐word stimuli. The current study administered different types of stimuli (non‐words/words) in a large sample of healthy elderly participants. This is also the first study to attempt to provide DDK normative data for this population in the Greek language. What are the potential or actual clinical implications of this work?: The results of this study strongly suggest that clinicians should bear in mind the significant impact age and language have on performance in terms of DDK rates, especially when normative data are not available for a certain language or age group. Furthermore, non‐word and real‐word stimuli cannot be used interchangeably since they tap into distinct underlying levels of speech, thus providing clinicians with useful information about the level of breakdown and the proper treatment plan. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Pharmacy customer satisfaction is a predictor of customers' behaviour and thus becomes a critical issue in the highly competitive pharmacy sector. Therefore, the aim of this paper was to determine the evaluative criteria that customers use in selecting an independent community pharmacy as their regular one, as well as their contribution to customer satisfaction. Moreover, areas of customer service that can provide competitive parity or advantage to a pharmacy are identified. A survey was carried out among randomly selected customers of pharmacies located in Thessaloniki, Greece, using a structured questionnaire. A total of 223 usable questionnaires were collected. Descriptive statistics and MUlticriteria Satisfaction Analysis (MUSA) were used for data analysis. The findings highlight reputation, community contribution, and professional expertise/behaviour of the pharmacist(s) and staff, as the criteria that contribute the most to customer satisfaction and choice of a pharmacy as a regular one. Also, the study outcomes suggest that the above variables combined with a fast and error‐free service, respect and confidentiality can be used as advantages against competition. The current research findings provide directions for strategic actions that could help a pharmacy to enhance customer satisfaction and consequently build long‐term relationships with patients and stand out from the competition. [ABSTRACT FROM AUTHOR]

In this paper, Stamatoula Pylarinou with her supervisor Prof. Sarantos Kapidakis reports on an analysis of bibliographic data of the publications of Greek hospital personnel, conducted as part of Stamatoula's doctoral research in the Department of Archive, Library and Museum Sciences at the Ionian University in Corfu, Greece. Using freely available data, they demonstrate the questions posed and the insights gained from the analysis of the scientific publications of personnel of public hospitals in Greece, in particular amid the years of austerity in Greece. With regard to impact on practice, they suggest that these procedures for the processing of medline/PubMed bibliographic data can improve communication among hospital librarians and administration or patients, adding value to their duties and enhancing the information and services they can provide. F.J. [ABSTRACT FROM AUTHOR]

Context The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. Discussion and conclusions This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the association between vegetable consumption, in total as well as per type/category, and 10‐year type‐2 diabetes mellitus (T2DM) incidence. Methods: The ATTICA study was conducted during 2001–2012 in 3042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetable consumption (total, per type) was evaluated through a validated semi‐quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10‐year follow‐up, data from 1485 participants were used for the current analysis. Results: After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had a 0.42‐times lower risk of developing T2DM (hazard ratio [HR] = 0.42; 95% confidence interval [CI] = 0.29–0.61); the benefits of consumption were greater in women (HR = 0.29; 95% CI = 0.16–0.53) compared to men (HR = 0.56; 95% CI = 0.34–0.92). Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men. Conclusions: The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at the population level. Highlights: Intake of ≥ 400 g day–1 of vegetables was associated with a reduced risk of T2DM In women, the most significant associations were observed for allium vegetables In men, the most significant associations were for red/orange/yellow vegetables Increment by 100 g day–1 was associated with a 14% lower risk in women Increment by 100 g day–1 was associated with a 5% lower risk in women. [ABSTRACT FROM AUTHOR]

The aim was to (i) compare the rates of perceived stress, post‐traumatic stress symptoms (PTSS) and other potential correlates (i.e., resilience, social support, coping strategies, and loneliness) in the general population between the two COVID‐19 lockdowns in Greece and (ii) explore risk and protective factors of PTSS. Online data were collected amid the first (timepoint 1‐T1) and second lockdown (timepoint 2‐T2) by 1009 and 352 participants, respectively. The PTSD Checklist for DSM‐5 and the Perceived Stress Scale measured levels of PTSS and perceived stress. The Brief Resilience Scale, the COPE, the revised UCLA Loneliness Scale, and the ENRICHD Social Support Instrument measured resilience, coping strategies, loneliness, and social support, respectively. Higher levels of PTSS and perceived stress were reported during T2, compared to T1. Clinically significant levels of PTSS were presented by 26.1% and 35.5% of the participants during T1 and T2, respectively. Higher levels of loneliness and use of maladaptive coping strategies and lower levels of social support, resilience and use of adaptive coping strategies were also found. During both lockdowns, PTSS were predicted by perceived stress, loneliness, reduced resilience and the coping strategies of denial and self‐blame. PTSS were associated with younger age, female gender, being single, not having children, and the evaluation of the pandemic as a crisis. The findings highlight the significant public mental health concerns during the COVID‐19 lockdowns. Understanding the risk and protective factors against PTSS and focusing on vulnerable populations should be prioritized by the governments worldwide in the development of evidence‐based interventions. [ABSTRACT FROM AUTHOR]

IOANNIDOU C., GALANIS P., TSOUMAKAS K. & PAVLOPOULOU I.D. (2012) Characteristics of dog bites among nursing students and knowledge about their emergency management. International Nursing Review 59, 245-251 Background: Dog bites represent a significant health concern leading to a variety of consequences. Nursing students should be appropriately educated in order to manage and help prevent such injuries. Aim: This paper is the first to report the lifetime experience and characteristics of dog bites among Greek nursing students and their knowledge in managing the above injuries. Methods: A cross-sectional quantitative study was performed using an anonymous questionnaire distributed to first and fourth year nursing students from April though June 2009. A knowledge score based on key questions was set on a scale from 0 to 7, to assess their competence on bite injuries management. Results: Of 237 nursing students recruited, 56 (23.6%) had experienced a dog bite. Men outnumbered women as dog bite victims [ n = 15 (39.5%) vs. n = 41 (20.6%), P = 0.012]. Mean age at the attack was 11.1 (standard deviation = 5.6) years and legs sustained the majority of injuries ( n = 31; 55.4%). Most bites ( n = 39; 69.9%) involved a dog known to the victim, were provoked ( n = 30; 53.6%) and occurred in a public place ( n = 35; 62.5%). Ten (17.9%) of the victims sustained a moderate or severe injury. The majority (67.9%) of students answered correctly to less than or equal to three out of seven key knowledge questions. After multiple linear regression analysis, previous educational course attendance was the only factor associated with increased score (b = 0.48, standard deviation = 0.17, 95% confidence interval = 0.12-0.84, P = 0.009). Conclusions: Dog bites were common and presented characteristic patterns among nursing students, but knowledge in their management was suboptimal. Improved education should be provided during undergraduate studies. [ABSTRACT FROM AUTHOR]

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Background and aim: Personality functioning is predictive of drug misuse and relapse, yet little is known about the role of personality in engagement with the treatment process. This study aimed to estimate the extent to which broad‐ and facet‐level characteristic adaptations contribute to or hinder treatment engagement, while controlling for psychosocial indicators. Design Multi‐site cross‐sectional survey. Setting: In‐patient treatment units covering 80% of residential treatment entries in Greece. Participants: A total of 338 service users, 287 (84.9%) male, 51 (15.1%) female, average age 33.4 years. Measurements Expressions of personality functioning (characteristic adaptations) were assessed using the Severity Indices of Personality Problems (SIPP‐118). Treatment engagement was measured using the Client Evaluation of Self and Treatment, in‐patient version (CEST). Findings Dysfunctional levels of relational capacities predicted counselling rapport [β = 1.50, 95% confidence interval (CI) = 0.326–2.69, P = 0.013], treatment participation (β = 2.09, 95% CI = 1.15–3.11, P < 0.001) and treatment satisfaction (β = 1.65, 95% CI = 0.735–2.57, P < 0.001). Counselling rapport was also predicted by dysfunctional levels in self‐control (β = 1.78, 95% CI = 0.899–2.67, P < 0.001), self‐reflective functioning at the facet‐level (β = 2.24, 95% CI = 1.01–3.46, P < 0.001) and aggression regulation (β = 1.43, 95% CI = 0.438–2.42, P = 0.005). Dysfunctional levels on social concordance (β = −1.90, 95% CI = −2.87 to –0.941, P = 0.001), emotional regulation (β = 1.90, 95% CI = 0.87–2.92, P < 0.001) and intimacy (β = 2.04, 95% CI = 1.31–3.05, P < 0.001) were significant predictors of treatment participation. Treatment readiness and desire for help predicted treatment engagement. Conclusions: In people attending substance use treatment services, maladaptive interpersonal patterns and relational intimacy, emotional dysregulation and impulse control may be associated with low levels of counselling rapport and treatment participation. Low frustration tolerance and aggressive impulses also appeared to predict low participation. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) patients experience two affronts to normal 24‐h rhythms: largely internal events such as medication and external factors such as light, noise and nursing interventions. Aims and objectives: We investigated the impact of light variance within an ICU on 24‐h rhythmicity of three key physiological parameters: heart rate (HR), mean arterial blood pressure (MAP) and body temperature (BT) in this patient population. Design Patients were assigned to beds either in the 'light' or 'dark' side within a single ICU. An actigraph continuously recorded light intensity for a 24–72‐h period. Methods: Measurements of HR, MAP and BT were recorded every 30 min. Results: HR, MAP and BT did not follow 24‐h rhythmicity in all patients. Higher light exposure in the Light Side of the ICU (122·3 versus 50·6 lx) was related to higher HR (89·4 versus 79·8 bpm), which may translate to clinically relevant outcomes in a larger sample. Duration of stay, the one clinical outcome measured in this study, showed no significant variation between the groups (p = 0·147). Conclusions: ICU patients are exposed to varying light intensities depending on bed positioning relative to natural sunlight, affecting the 24‐h rhythm of HR. Larger, well‐controlled studies also investigating the effect of relevant light intensity are indicated. Relevance to clinical practice: Light is a variable that can be manipulated in the constrained environment of an ICU, thus offering an avenue for relatively unobtrusive interventions. [ABSTRACT FROM AUTHOR]

Objectives: To explore the information needs of caregivers of culturally and linguistically diverse (CALD) patients, and how they access and understand health information related to the management of their care person's chronic illness(es). Background: Caregivers of CALD patients experience greater unmet needs compared to the general caregiver population. They experience many challenges in identifying resources and accessing formal supports to aid in self‐management behaviours. Methods: Eleven caregivers were recruited from outpatient clinics in Québec, Canada. Consenting caregivers participated in one face‐to‐face or phone interview. A qualitative descriptive design and inductive content analysis were used to identify themes. Results: Caregivers described a "village" approach to caregiving in which more than one individual was involved in patient care. The specific roles ascribed to caregivers defined their information needs. Caregivers described two categories of information needs: perceived and unperceived. Perceived information needs were explicit, and centred on the medical management of illnesses. Unperceived needs were unrecognized knowledge gaps that emerged during interviews and focused on self‐care. Conclusion: Although caregivers' perceived needs are often met, their unperceived needs remain unmet. Health‐care providers should perform need assessments to identify caregivers' unperceived needs, with the aims of providing culturally competent care and ongoing support. [ABSTRACT FROM AUTHOR]

Background & Aims This study ran within the framework of the Thales Aphasia Project that investigated the efficacy of elaborated semantic feature analysis (ESFA). We evaluated the treatment integrity (TI) of ESFA, i.e., the degree to which therapists implemented treatment as intended by the treatment protocol, in two different formats: individual and group therapy. Methods & Procedures Based on the ESFA manual, observation of therapy videos and TI literature, we developed two ESFA integrity checklists, for individual and group therapy, and used them to rate 15 videos of therapy sessions, delivered by three speech-language therapists (SLTs). Thirteen people with aphasia (PwA) were involved in this study. Reliability of the checklists was checked using Kappa statistics. Each session's TI was calculated. Differences in TI scores between the two therapy approaches were calculated using independent sample t-tests. Treating SLTs' views on what facilitates TI were also explored through a survey. Outcomes & Results Inter- and intra-rater reliability were excellent (.75 ≤ κ ≤ 1.00) for all but one video (κ = .63). Overall, a high TI level (91.4%) was achieved. Although both approaches' TI was high, TI for individual therapy sessions was significantly higher than for group sessions (94.6% and 86.7% respectively), t(13) = 2.68, p = .019. SLTs found training, use of the treatment manual, supervision and peer support useful in implementing ESFA therapy accurately. Conclusions & Implications ESFA therapy as delivered in Thales is well described and therapists can implement it as intended. The high TI scores found enhance the internal validity of the main research project and facilitate its replication. The need for more emphasis on the methodological quality of TI studies is discussed. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to identify perceptions of caring behaviors in student nurses from four countries. Methods This study employed a descriptive, comparative survey design. Four hundred sixty-seven students were recruited from four countries ( Nigeria, India, Greece, and the Philippines) to participate in the study during the months of September 2013 to January 2014. Data were collected using the Caring Behavior Inventory. Findings The highest ranked subscale was 'assurance of human presence' (4.827 ± 0.927), while 'positive connectedness' (4.610 ± 0.949) was the lowest ranked subscale. There were no statistically significant correlations between the Caring Behavior Inventory scale and gender ( F = 0.215, p = .643), educational level ( F = 0.396, p = .529), and family structure of students ( F = 0.680, p = .410), except for age ( F = 9.380, p = .002, η2 = 0.141) and the country of origin ( F = 5.772, p = .001, η2 = 0.036). Conclusion Students from four countries possess positive caring behaviors, specifically on physically based caring interventions, while there is a need to emphasize expressive caring behaviors during nursing education and training. Implication for Nursing Practice Caring interventions should be carried out in order to help students build or enhance their caring behaviors that can be adapted to clinical situations. [ABSTRACT FROM AUTHOR]

Aims To project the impact of scaling-up oral anti-viral therapy and harm reduction on chronic hepatitis C (CHC) prevalence and incidence among people who inject drugs (PWID) in Greece, to estimate the relationship between required treatment levels and expansion of harm reduction programmes to achieve specific targets and to examine whether hepatitis C virus (HCV) elimination among PWID is possible in this high-prevalence setting. Design A dynamic discrete time, stochastic individual-based model was developed to simulate HCV transmission among PWID incorporating the effect of HCV treatment and harm reduction strategies, and allowing for re-infection following treatment. Setting/participants The population of 8300 PWID in Athens Metropolitan area. Measurements Reduction in HCV prevalence and incidence in 2030 compared with 2016. Findings Moderate expansion of HCV treatment (treating 4-8% of PWID/year), with a simultaneous increase of 2%/year in harm reduction coverage (from 44 to 72% coverage over 15 years), was projected to reduce CHC prevalence among PWID in Athens by 46.2-94.8% in 2030, compared with 2016. CHC prevalence would reduce to below 10% within the next 4-5 years if annual HCV treatment numbers were increased up to 16-20% PWID/year. The effect of harm reduction on incidence was more pronounced under lower treatment rates. Conclusions Based on theoretical model projections, scaled-up hepatitis C virus treatment and harm reduction interventions could achieve major reductions in hepatitis C virus incidence and prevalence among people who inject drugs in Athens, Greece by 2030. Chronic hepatitis C could be eliminated in the next 4-5 years by increasing treatment to more than 16% of people who inject drugs per year combined with moderate increases in harm reduction coverage. [ABSTRACT FROM AUTHOR]

Background No studies assessing the association between gagging and dental fear are available in pediatric samples. Aim To assess the psychometric properties of the Greek version of the Gagging Assessment Scale ( GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. Design A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale ( CFSS- DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale ( MDAS). The short form of dentist part of the Gagging Problem Assessment ( GPA-de-c/ SF) was used to objectively assess gagging. Results A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/ SF. Children rated as gaggers on the GPA-de-c/ SF had significantly higher GAS scores. There were no relationships between GPA-de-c/ SF and the CFSS- DS or MDAS. The GAS ratings were significantly correlated with the CFSS- DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). Conclusions The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment. [ABSTRACT FROM AUTHOR]

Background Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection-preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. Methods A meticulous search for and treatment of active, occult, or smoldering infection was undertaken preoperatively. An aseptic/antiseptic technique was used for implantation of each device. Skin preparation is thorough with initial cleansing performed with alcohol followed by povidone-iodine 10% solution, which is also used in the wound and inside the pocket. In addition, we routinely use double gloving, and IV antibiotic prophylaxis 1 hour before and for 48 hours afterwards followed by oral antibiotic for 2-3 days after discharge. The skin is closed with absorbable sutures. The study includes 382 patients having a new pacemaker (n = 333) or battery change, system upgrade or lead revision (n = 49), and 380 patients having a new implantable cardioverter-defibrillator (ICD) (n = 296) or device replacement/upgrade/lead revision (n = 84). Results The pacemaker group, aged 70.2 ± 16.5 years, includes 18% VVI, 49% DDD, 29% VDD, and 4% cardiac resynchronization therapy (CRT) devices. The ICD group, aged 61.3 ± 13.0 years, with a mean ejection fraction of 36 ± 13%, includes 325 ICD and 55 CRT implants. Over 26.6 ± 33.4 months for the pacemaker group and 36.6 ± 38.3 months for the ICD group, infection occurred in one patient in each group (0.26%) having a device replacement. Conclusion A consistent and strict approach of aseptic/antiseptic technique with the use of double gloving and povidone-iodine solution within the pocket plus a 4-day regimen of antibiotic prophylaxis minimizes infections in CIED implants. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions. Aims: To report a series of surveys of public awareness of aphasia from six countries, the largest study conducted this far. Methods & Procedures: Surveys were conducted in Argentina ( N = 800), Canada ( N = 831), Croatia ( N = 400), Greece ( N = 800), Norway ( N = 251) and Slovenia ( N = 400) using the same methodology requesting information on age, sex and occupation, asking whether respondents had heard of aphasia and where they had heard of it. Respondents were tested on their levels of knowledge of aphasia. Outcomes & Results: Results revealed low levels of awareness of aphasia in countries surveyed with marked variability that appeared to interact with occupation, country, age and sex. We surveyed 3483 respondents (mean age = 43.16; SD = 17.68). Between 60% (Croatia) and 16% (Slovenia) said they had heard of aphasia (37.1% overall), but those with actual knowledge ranged from 13.9% (Norway) to 1.0% (Argentina). The combined mean of those with basic knowledge was 9.2%. Those who had heard of aphasia were younger; and females had higher levels of awareness. We also found associations between socio-economic status and awareness. Those working in health, social and educational spheres had the highest levels. Respondents mainly heard about aphasia through the media and work or personal contact with aphasia. Conclusions & Implications: Levels of awareness are low everywhere in absolute terms, and relative to the awareness of other conditions, with significant variability between countries, sex and socio-economic status. We examine how surveys can be utilized to plan ways to increase understanding and discuss the comparison of awareness of aphasia with other conditions. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Nurses in intensive care units confront various challenges and problems during their everyday work that adversely affect performance and patient safety. Despite their importance, performance obstacles have been studied extensively only in the USA, with no validated instrument being available in the Greek setting for their measurement. Aims and objectives To develop a questionnaire that quantifies the obstacles nurses of intensive care units (ICUs) of Greek hospitals might be facing and examine its properties; to assess if such obstacles existed in selected Greek National Health System hospitals. Methods A questionnaire was developed and administered to nurses who were working in intensive care units in Thessaloniki. Exploratory factor analysis was applied, and the reliability, validity and ceiling and floor effects of the constructed scales were evaluated. The potential influence of socio-demographic characteristics on scale scores was assessed by independent sample t-tests and analysis of variance ( ANOVA). Summated mean and median scores were computed. Results Two hundred and five nurses participated with a response rate of 65·3%. Resulting scales were 'Space Adequacy', 'Staff Collaboration', 'Materials' Suitability', 'Time Inefficiencies' and 'Psychological Aggravation'. Cronbach's alpha values ranged between 0·67 and 0·86. Multi-trait analysis confirmed construct validity. Ceiling effects were reasonable, whereas floor effects took acceptable values with the exception of the 'Materials' Suitability' scale. The medians of the scales ranged from 1·50 to 3·33. In terms of the measurement of performance obstacles per se, we found that considerable problems exist in the ICUs in all dimensions. Specifically, the suitability of hospital materials, the lack of appropriate spaces and facilities design and psychological distress were recorded as the most serious. Conclusions The questionnaire is a promising tool that can be exploited in the health care system to assess the obstacles faced by intensive care nursing staff. In fact, there is considerable room for performance improvement in hospitals in Northern Greece. Recommendations Nursing administrators and health care policy makers should administer the questionnaire in all Greek hospitals in order to quantify performance obstacles and identify potential managerial remedies. [ABSTRACT FROM AUTHOR]

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. [ABSTRACT FROM AUTHOR]

Background Childhood lead poisoning remains a critical environmental health concern because even low blood lead levels (BLLs) can result in permanent adverse health effects. Social factors and living conditions have been correlated with BLLs. There is no recent survey about the prevalence of elevated BLLs among children in Greece. The purpose of this study was to assess BLLs among children aged 6-36 months born and living in Greece and to evaluate their association with demographic, socio-economic and housing conditions. Methods In a cross-sectional hospital-based study including 814 randomly selected children aged 6-36 months, BLLs and haematological parameters were evaluated. A questionnaire investigating demographic and socio-economic conditions was completed in all children. Statistical analysis was performed using STATA for Windows v.8.5, and P < 0.05 was considered statistically significant. Results The mean BLLs of the population were 2.78 (SD = 2.34) µg/dl, and the median was 2.02 µg/ dl; 11.7% had BLLs above 5 µg/dl, while 15 children (1.8%) exceeded 10 µg/dl. Being a toddler, being Roma or Asian, living in an industrial/low-income neighbourhood or in an old house, using traditional herbs and/or spices and having a mother with a manual occupation were independent risk factors for elevated BLLs. Conclusion Lead exposure remains a threat for optimal health especially for toddlers and children of socio-economically disadvantaged families living in Greece. A nationwide survey to assess lead exposure in children is necessary to guide prevention governmental policies. [ABSTRACT FROM AUTHOR]

Aims To (i) describe an intervention implemented in response to the HIV-1 outbreak among people who inject drugs (PWIDs) in Greece (ARISTOTLE programme), (ii) assess its success in identifying and testing this population and (iii) describe socio-demographic characteristics, risk behaviours and access to treatment/prevention, estimate HIV prevalence and identify risk factors, as assessed at the first participation of PWIDs. Design A 'seek, test, treat, retain' intervention employing five rounds of respondent-driven sampling. Setting Athens, Greece (2012-13). Participants A total of 3320 individuals who had injected drugs in the past 12 months. Intervention ARISTOTLE is an intervention that involves reaching out to high-risk, hard-to-reach PWIDs ('seek'), engaging them in HIV testing and providing information and materials to prevent HIV ('test') and initiating and maintaining anti-retroviral and opioid substitution treatment for those testing positive ('treat' and 'retain'). Measurements Blood samples were collected for HIV testing and personal interviews were conducted. Findings ARISTOTLE recruited 3320 PWIDs during the course of 13.5 months. More than half (54%) participated in multiple rounds, resulting in 7113 visits. HIV prevalence was 15.1%. At their first contact with the programme, 12.5% were on opioid substitution treatment programmes and the median number of free syringes they had received in the preceding month was 0. In the multivariable analysis, apart from injection-related variables, homelessness was a risk factor for HIV infection in male PWIDs [odds ratio (OR) yes versus no = 1.89, 95% confidence interval (CI) = 1.41, 2.52] while, in female PWIDS, the number of sexual partners (OR for > 5 versus one partner in the past year = 4.12, 95% CI = 1.93, 8.77) and history of imprisonment (OR yes versus no = 2.76, 95% CI = 1.43, 5.31) were associated with HIV. Conclusions In Athens, Greece, the ARISTOTLE intervention for identifying HIV-positive people among people who inject drugs (PWID) facilitated rapid identification of a hidden population experiencing an outbreak and provided HIV testing, counselling and linkage to care. According to ARISTOTLE data, the 2011 HIV outbreak in Athens resulted in 15% HIV infection among PWID. Risk factors for HIV among PWID included homelessness in men and history of imprisonment and number of sexual partners in women. [ABSTRACT FROM AUTHOR]

In times of economic downturn, perceived realistic intergroup threats (e.g., labour competition) often dominate political and media discourse. Although local outgroups (e.g., local immigrants) can be experienced as sources of realistic threats, we propose that such threats can also be perceived to be caused by distant outgroups (e.g., European Union members perceiving Greece to threaten their economies) and that such distant threats can carry over into local intolerance (e.g., increasing intolerance towards local immigrant groups). We predicted and found in two studies that perceived distant realistic threats carried over into local intolerance via two different pathways. First, direct reactions towards the distant outgroup can generalize to culturally similar local outgroups (the group-based association pathway). Secondly, Study 2 indicated that when the distant threat was attributed to stereotypical outgroup traits (e.g., being lazy), distant realistic threats activated local realistic threats, which subsequently influenced local intolerance (the threat-based association pathway). Taken together, our studies indicate that perceived realistic threats foreign can turn domestic, but in two different ways. [ABSTRACT FROM AUTHOR]

Background Previous studies suggest that children with Down's syndrome ( DS), a genetically based neurodevelopmental disorder, demonstrate motor problems and cognitive deficits. The first aim of this study was to examine motor skills and executive functions ( EFs) in school-age children with DS. The second aim was to investigate the relationship between these two performance domains. Methods The Test of Gross Motor Development ( TGMD-2), the Movement Assessment Battery Children-2 checklist ( MABC2-checklist) and the Trail-Making Test for young children ( Trails- P) were used to assess motor and cognitive performances of 18 children (11 boys, 7 girls) with DS aged between 7 and 11 years (9.06 ± 0.96) and an age- and sex-matched sample of 18 typically developing ( TD) children (11 boys, 7 girls; 8.99 ± 0.93). Results Individuals with DS showed the expected difficulties in attentional control, response suppression and distraction, as well as in locomotor and object control skills, as indicated by poorer performance than TD individuals. Motor performance (bottom-up as well as top-down measures) and EF correlated positively, with regard to the group with DS only though. In the most complex task (distraction), the children of the DS group achieving lower locomotor scores showed lower efficacy scores on the Trails- P. Additionally, strong relationships were found for the perspective of teachers on all sections of the MABC2- Checklist and EF. Conclusion The findings from this study suggest that children with DS are not only impaired in higher-order EF, but showing also deficits in locomotor and object control skills. This study stresses the importance of early interventions facilitating cognitive abilities and motor skills. [ABSTRACT FROM AUTHOR]

Background A number of studies have suggested that language in individuals with Down syndrome (DS) may not be simply delayed compared with language in typically developing (TD) children, but deviant. The deviance has been detected in the comprehension of pronouns, and it has triggered proposals for the existence of a specific syntactic deficit in individuals with DS. However, the developmental path of pronoun comprehension in individuals with DS is unknown as there are no studies examining individuals of different ages. Aims To perform a pilot study examining pronoun comprehension in adolescents and adults with DS in comparison with TD children. Research questions include: Are some pronoun types more difficult than others for each of the two groups (DS and TD)? Is there a difference in performance between the two groups? Does performance correlate with chronological age in the DS group? Methods & Procedures Using a manual picture selection task, we examined the comprehension of different types of pronouns in 14 Greek-speaking individuals with DS, ranging from 10 to 34 years of age. We also tested a control group of TD children as well as a typical adult group. The TD and DS groups were recruited and tested in pre-schools and schools/centres for individuals with learning disabilities, respectively. Within- and between-group comparisons were performed for all conditions. For the DS group, correlations between chronological age and performance in each condition were also explored. Outcomes & Results Results reveal a significant positive correlation of age with performance in the DS group, but only in structures that also presented difficulties to TD children. Structures that presented difficulties only to individuals with DS do not appear to be less problematic for older participants. Conclusions & Implications These findings provide support to the deviance hypothesis by suggesting that the syntactic deficit in the comprehension of pronouns in individuals with DS is present in individuals of a wide age range. At the same time, the results, if corroborated by large-scale studies, suggest that some aspects of grammatical development in individuals with DS may continue even after adolescence and well into adulthood. We argue that these findings can contribute towards more targeted intervention practices by increasing our knowledge of the behavioural phenotype of DS. [ABSTRACT FROM AUTHOR]

The article discusses a study into the mortality of people in their 80s and 90s who were admitted to internal medicine wards with acute illnesses. Out of 101 study participants, 46 died either during their hospitalization or within six months of being discharged. The authors note that the leading predictors of death were hyperkalemia and functional status at time of admission.

In this work, Web 2.0 technologies in higher education are evaluated using students' perceptions, satisfaction, performance and behaviour. The study evaluates the Web 2.0 tools as stand-alone entities as well in terms of their cross-operability and integration (confluence) to synergistic contributions towards the enhancement of student learning. Significant correlations and interdependencies on the students' behaviour over the used platform and their performance in various time points within the course time line have been revealed. [ABSTRACT FROM AUTHOR]

Negative (vs positive) intergroup contact may have a disproportionately large impact on intergroup relations because of valence-salience effects, whereby negative contact causes higher category salience (Paolini, Harwood, & Rubin, 2010). One correlational and three experimental studies in three conflict areas (Northern Ireland, Arizona's border area, and Cyprus; Ns = 405, 83, 76, and 91) tested the moderation of these valence-salience effects by individuals' histories of outgroup contact. Consistent with a perceived fit principle valence-salience effects of face-to-face, television-mediated, and imagined contact held among individuals with negative or limited histories of outgroup contact; these effects were significantly reduced or nonsignificant among individuals with positive or extensive past outgroup contact. These moderation effects suggest that positive and diverse intergroup contact in the past buffers against the harmful effects of negative contact experiences in the present, thus limiting the potential for negative spiralling of intergroup relations. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

People with mental illness are among the most stigmatized and discriminated against as a result of lack of knowledge among the public. Our study explored adolescents' perceptions of people with mental illness through drawings, described these perceptions, and tested the possible changes in perceptions after an educational mental health intervention. Drawings were collected before and after an educational mental health intervention from 59 Greek secondary school students. One group of participants served as the experimental group and received the educational mental health intervention. Content analysis of the drawings was used to analyze data. The drawings provided a clear understanding of adolescents' perceptions towards people with mental illness. After the educational mental health intervention the negative elements presenting the people with mental illness were less among the experimental group, while the drawings among the comparison group did not change. The findings support that educational mental health intervention can have a positive impact on adolescents' perceptions towards people with mental illness. Health professionals can use the findings of our study in order to develop and implement similar interventions. [ABSTRACT FROM AUTHOR]

Low exercise capacity and high obesity levels are the main characteristics of people with serious mental illness (SMI). We conducted a pilot study on the effects of a 3-month exercise and dietary intervention on the aerobic capacity and body composition of obese adults with SMI taking Olanzapine, a second generation antipsychotic medication known to induce weight increments. Fifty adults with SMI (15 males and 35 females) followed a 3-month weight loss intervention programme based on exercise and diet. Pre- and post-intervention, a submaximal O2 exercise test was performed in order to assess O2max anthropometric and body composition measurements were also performed. All participants were obese (body mass index (BMI): 33.61 ± 0.91 kg/m2). Pre- and post-intervention, a submaximal O2 exercise test on the treadmill was performed in order to assess O2max anthropometric and body composition measurements were also performed. Significant reductions in body weight, BMI, body fat and waist circumference were found from pre to post (p < 0.01). O2max was significantly improved in both genders (males: pre: 30.63 ± 2.06 vs. post: 33.19 ± 1.77 ml.kg−1 min−1, females: pre: 25.93 ± 1.01 vs. post: 29.51 ± 1.06 ml.kg−1 min−1, p < 0.01). A significant correlation was found between the change in O2max and the change in body weight and BMI (p < 0.05). Multiple regression analysis revealed that the relative change in O2max explained approximately 26% of the variance in the changes for both BMI (p = 0.07) and body weight (p = 0.06). A treatment of exercise and diet improves the aerobic capacity and body composition of obese adults with SMI, despite the use of Olanzapine. [ABSTRACT FROM AUTHOR]

Objectives Gender may be associated with postoperative pain. This study aimed to assess pain intensity and postoperative analgesic requirements in female and male patients scheduled for major abdominal surgery. Methods Sixty-five patients, 31 men and 34 women, scheduled for major abdominal surgery were recruited. Anesthesia and intraoperative analgesics were standardized in all patients. Postoperatively, all patients had access to a 60 mL PCA pump containing 1 mg/ mL morphine and 50 μg/ mL droperidol. Morphine consumption and VAS scores at rest and after cough were recorded 2, 4, 8, 24, and 48 hours postoperatively. Results Of the 65 patients recruited for the study, 30 women and 30 men aged 65 ± 8.9 and 66 ± 9.0 years, respectively, were included in the analysis. Morphine consumption was examined 2, 4, 8, 24, and 48 hours after surgery and did not differ in women vs. men (mean ± standard deviation, 4.4 ± 3.2 vs. 5 ± 4.8, 7.2 ± 4.8 vs. 8.7 ± 6.9, 10.4 ± 7.1, vs. 12.5 ± 8.5, 22.9 ± 11.6 vs. 25.6 ± 14.5, and 36.2 ± 15.7 vs. 39.7 ± 21.7 mg, P = 0.384). Cumulative morphine consumption was not significantly different in women vs. men when normalized for body mass index (mean ± standard deviation, 0.17 ± 0.13, 0.28 ± 0.20, 0.40 ± 0.30, 0.88 ± 0.46, and 1.38 ± 0.59 mg/kg/m2 in women and 0.18 ± 0.18, 0.31 ± 0.25, 0.46 ± 0.32, 0.95 ± 0.54, and 1.47 ± 0.81 mg/kg/m2 in men at 2, 4, 8, 24, and 48 hours postoperatively ( P = 0.567). Both genders exhibited similar VAS pain scores (mm) at rest and after cough ( P = 0.476, P = 0.378, respectively). Conclusions Postoperative morphine requirements did not differ between female and male patients undergoing major abdominal surgery. Pain intensity reported at rest and after cough did not differ between the 2 groups. [ABSTRACT FROM AUTHOR]

Background and Objective Periodontitis and acute myocardial infarction ( AMI) are two diseases that share common risk factors. The role of periodontitis as an independent risk factor for cardiovascular disease has been under debate. The aim of this study was to investigate whether an association exists between periodontitis and AMI in a nondiabetic population, using multiple periodontal case definitions. Material and Methods Periodontal examination was performed in 204 patients with AMI. The control group comprised 102 healthy subjects, without significant coronary disease, confirmed angiographically. Periodontitis was assessed using measurements of clinical attachment loss ( CAL), probing depth and number of missing teeth. From these measurements, five different case definitions of periodontitis were generated. Results Using the continuous forms of periodontal measurements, the odds ratio (95% confidence interval) of the association with incident AMI was 1.74 (1.26-2.50), 1.83 (1.10-3.17) and 1.08 (1.06-1.13) for mean CAL, probing depth and number of missing teeth, respectively. A consistent positive association was observed regardless of the case definition of periodontitis. Conclusion In this nondiabetic population, the association between periodontitis and AMI was consistent across different measurements and/or definitions of periodontitis. The strength of the association increased concomitantly with the robustness of the criteria used to define periodontitis. [ABSTRACT FROM AUTHOR]

Background There is lack of data in Greece on the trends in energy and nutrient intake. The present study aimed to examine differences in these parameters among first-grade children of Crete, Greece, between 1992/93 and 2006/07. Methods Children (aged 5.7-7.6 years) from two-representative cross-sectional samples participated during 1992/93 ( n = 245) and 2006/07 ( n = 257). Nutrient and food intakes were assessed using estimated 3-day-food records. Nutrient intakes were estimated as amounts per 4185 kJ (1000 kcal) of energy intake ( EI), whereas macronutrients were estimated as percentage of total EI. Results Between 1992/93 and 2006/07, respectively, significant increases ( P < 0.05) were observed in the intake of energy (boys: 7996 versus 8646 kJ; girls: 7265 versus 7963 kJ), calcium (boys: 488 versus 587 mg; girls: 464 versus 594 mg), iron (boys: 5.8 versus 7.3 mg; girls: 5.7 versus 7.4 mg) and vitamins B2 (boys: 1.01 versus 1.17 mg; girls: 1.0 versus 1.16 mg) and B6 (boys: 0.80 versus 0.87 mg; girls: 0.75 versus 0.95 mg), for boys and girls, respectively. Among boys, the intake of protein (13.6 versus 14.6% of EI) and total trans fatty acids ( TTFA) (0.84 versus 0.99 g) was also significantly lower in 1992/93 ( P < 0.016). Between 1992/93 and 2006/07, total fat (boys: 42.9% versus 42.8%, girls: 42% versus 43.1%) and saturated fat (boys: 15.5% versus 15.4%, girls: 15% versus 15.3%) exceeded the 30-35% and <10% dietary recommendations, respectively, A significantly higher proportion of children in 2006/07, compared to 1992/93, had a higher intake of total energy (>120% of the recommended energy allowance). Conclusions The intake of several macronutrients (protein, TTFA, total and saturated fat) in this sample of children did not meet the recommended intakes in either time period. [ABSTRACT FROM AUTHOR]

Aim To compare the clinical and microbiological outcome of the 1-h ultrasonic debridement of chronic periodontitis patients ( CPP) with and without frequent sessions of oral hygiene reinforcement. Methods Clinical measurements and subgingival plaque were collected from 44 CPP at baseline, 3- and 6-months. The control group received a single session of 1-h full-mouth ultrasonic debridement, while oral hygiene instructions ( OHI) were reiterated over four visits. In the test group, OHI were limited in the 1-h treatment session. At 3-months, both groups received additional debridement and OHI. The 'Checkerboard' DNA- DNA hybridization technique quantified Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola in plaque. Results At three months, smaller reductions in plaque and bleeding indices, and in P. gingivalis numbers were noted in the test group, while these differences disappeared at six months. After the 3-month re-treatment visit, the test group presented with a greater probing pocket depth ( PPD) reduction. Plaque negatively affected PPD in a similar manner after both treatment approaches. Conclusions Lack of oral hygiene reinforcement in the 1-h full-mouth debridement resulted in higher plaque and bleeding scores and numbers of P. gingivalis at three months; professional removal of dental biofilm every three months is beneficial in subjects with compromised plaque control. [ABSTRACT FROM AUTHOR]

Background To date, there are no dietary intervention studies available jointly examining the changes produced in cardiometabolic risk indices and diet quality assessed with the Healthy Eating Index 2005 (HEI-2005). The present study aimed to evaluate the effect of a 3-month multicomponent lifestyle intervention on several cardiometabolic risk indices, physical activity levels and diet quality. Methods A total sample of 108 hypercholesterolaemic adults (40-60 years old) were randomised to two intervention groups provided with and instructed to consume daily: (i) plain milk ( n = 37) or (ii) enriched milk ( n = 40) respectively; both groups were attending a 3-month dietary counselling programme. For the needs of the present study both intervention groups were analysed together IG: n = 77) and were compared against a control group following usual diet ( CG: n = 31). Results Regarding diet quality HEI scores for 'milk' ( P = 0.021), 'dark green/orange vegetables and legumes' ( P = 0.050) and 'total HEI score' ( P = 0.045) were improved in the IG compared to the CG. The IG also improved 'whole grains' and 'calories from solid fats, alcoholic beverages and added sugars' scores compared to their baseline values. Both groups improved the 'total vegetable' HEI score. Regarding physical activity levels and cardiometabolic risk indices, the IG significantly increased the daily number of steps ( P = 0.005) and decreased body weight ( P = 0.021), body mass index ( P = 0.019) and waist circumference ( P = 0.027) to a higher extent compared to the changes observed in the CG. Moreover, the IG significantly decreased systolic ( P = 0.001) and diastolic blood pressure ( P = 0.050) compared to baseline values. Conclusions The present study revealed that this 3-month lifestyle and nutrition counselling intervention programme appears to have favourable effects on diet quality, physical activity levels, anthropometric and certain cardiometabolic risk indices. [ABSTRACT FROM AUTHOR]

Aim To examine microbiological and immunological alterations following two periodontal surgical techniques, over a 6-month period. Materials and methods A total of 30 chronic periodontitis patients participated in the present randomized controlled clinical trial and were randomized in two groups. Modified Widman flap (MWF) was applied in the control group and apically positioned flap (APF), without intervention to the bone, in the experimental group. Gingival crevicular fluid samples and subgingival plaque samples from the operated sites were collected at baseline, 6th, 12th and 24th post-operative week. Results No major differences were noticed in immunological and microbiological profile of patients receiving either modified MWF or APF, for a period of 6 months. Conclusions The choice of the periodontal surgical procedure does not seem to affect the immunological and the microbiological profile of patients with chronic periodontitis. [ABSTRACT FROM AUTHOR]

Background Some small cohort studies have noted that obesity co-exists with lower serum iron levels. The present study aimed to examine the association between being overweight and iron deficiency ( ID) in a large cohort of Greek children and adolescents. Methods A representative sample of 2492 primary schoolchildren aged 9-13 years old was examined. Anthropometric, biochemical, clinical, dietary intake and physical activity data were collected. Results The prevalence of ID and iron deficiency anaemia ( IDA) was higher in obese boys and girls compared to their normal-weight peers ( P < 0.05). Serum ferritin was higher in obese compared to normal-weight boys ( P = 0.024) and higher in obese compared to normal-weight and overweight girls ( P = 0.001). By contrast, a negative association was found between transferrin saturation and adiposity in both boys and girls ( P = 0.001 and P = 0.005). Furthermore, obese girls had significantly higher fibre intake than normal-weight girls ( P = 0.048) and also overweight and obese boys and girls recorded significantly fewer pedometer steps than their normal-weight peers ( P < 0.001). Finally, obesity more than doubled the likelihood of ID in both boys (odds ratio = 2.83; 95% confidence inteval = 1.65-4.85) and girls (odds ratio = 2.03; 95% confidence interval = 1.08-3.81) after controlling for certain lifestyle and clinical indices as potential confounders. Conclusions The present study shows that obese children and adolescents were at greater risk for ID and IDA than their normal-weight peers. Low grade inflammation induced by excessive adiposity may be a reason for the observed low iron levels. This is also strengthened by the elevated serum ferritin levels, comprising an acute phase protein that is plausibly increased in inflammation. [ABSTRACT FROM AUTHOR]

Background Heart failure is a serious chronic syndrome that is accompanied by significant physical and psychological burdens, resulting in poor quality of life. Aim To assess the quality of life of patients with severe heart failure and its correlation with patient demographic, socio-economic and clinical characteristics. Method We studied 199 patients with heart failure who were hospitalized in the Cardiology Department of three general hospitals of Greece during a 1-year period. Demographic and socio-economic data were obtained using a short questionnaire, while clinical data were obtained from medical record review. The assessment of the patients' quality of life was performed using Minnesota Life with Heart Failure Questionnaire ( MLWHFQ). Findings The mean MLWHFQ score was 62.7 (±20.3). Significantly lower quality of life was found in patients with diabetes mellitus (Coefficient beta (β) = 11.4; 95% Confidence Interval ( CI), 5.2-17.5), hypertension (β = 10.3; CI, 1.4-19.1), chronic renal failure (β = 13.9; CI, 5.9-21.9), chronic respiratory failure (β = 11.2; CI, 4.7-17.7), cancer (β = 12.3; CI, 2.3-22.4), psychiatric disease (β = 10.5; CI, 0.6-20.4) and those patients who were classified in New York Heart Association class IV (β = 10.6, CI = 4.1-17.0). Conclusions The average score of the MLWHFQ was high, and this reflects the poor quality of life of patients. Higher scores in specific patient groups show the negative influence of these factors in quality of life. The holistic care of patients with heart failure by a multidisciplinary team of healthcare professionals could improve their quality of life. [ABSTRACT FROM AUTHOR]

Infrahumanization theory has claimed that groups tend to infrahumanize, and thus denigrate, each other irrespective of group status. However, research on infrahumanization has mainly addressed status in the context of national, ethnic, and regional divisions. The present studies tested the effect of group status in infrahumanization by employing occupational groups of varied status, both in abstract (blue-collar vs. white-collar workers) and specific terms (lawyers vs. shopkeepers, and high school teachers vs. university faculty members and primary school teachers). The results showed that only relatively higher status groups always attributed uniquely human emotions more to their in-group than to lower status out-groups. In contrast, lower status groups showed no bias in attributions of uniquely human emotions, or were biased in favour of the higher status out-group. The discussion of these results points to the role of consensus in the distribution of social value amongst groups of asymmetric status. [ABSTRACT FROM AUTHOR]

Background Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in obese people. Methods The present study aimed to evaluate the efficacy of an 8-week stress management programme that includes progressive muscle relaxation (PMR) and diaphragmatic breathing on weight loss and eating behaviour in a sample of overweight and obese women who started a weight-loss programme. A total of 34 women with a mean ( SD) body mass index of 38.17 (7.19) kg m−² and mean ( SD) age 47.35 (11.64) years were recruited from the outpatients Obesity Clinic of a public hospital in Athens. Participants were randomly assigned into a Stress Management ( SM) and a control group. Anthropometric measurements were taken before and after the intervention, and the participants completed the following questionnaires: Dutch Eating Behaviour Questionnaire ( DEBQ), Eating Attitudes Test (Eat-26), Health Locus of Control ( HLC) and Perceived Stress Scale ( PSS) before and after the intervention. Results The findings indicated a significant improvement in weight loss in the SM group [4.44 (0.83) kg] after intervention compared to the control group [1.38 (0.78) kg] ( P < 0.05). A higher restrained eating behaviour was observed in the SM group after intervention compared to the control group, although there was no significant difference in perceived stress levels. Conclusions The intervention group showed greater weight reduction, possibly because of the stress management programme, and a greater dietary restraint was demonstrated by them compared to the control group. It is likely that stress management could facilitate weight loss in obese women; however, more studies are needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

Background Water balance is achieved when water intake from solid and fluid foods and drinking water meets water losses, mainly in sweat, urine and faeces. Seasonality, particularly in Mediterranean countries that have a hot summer, may affect water loss and consequently water balance. Water balance has not been estimated before on a population level and the effect of seasonality has not been evaluated. The present study aimed to compare water balance, intake and loss in summer and winter in a sample of the general population in Greece. Methods The Water Balance Questionnaire ( WBQ) was used to evaluate water balance, estimating water intake and loss in summer ( n = 480) and in winter ( n = 412) on a stratified sample of the general population in Athens, Greece. Results In winter, mean (SD) water balance was −63 (1478) mL/day−1, mean (SD)water intake was 2892 (987) mL/day−1 and mean (quartile range) water loss was 2637 (1810-3922) mL/day−1. In summer, mean (SD) water balance was −58 (2150) mL/day−1, mean (SD) water intake was 3875 (1373) mL/day−1 and mean (quartile range) water loss was 3635 (2365-5258) mL/day−1. Water balance did not differ between summer and winter ( P = 0.96); however, the data distribution was different; in summer, approximately 8% more participants were falling in the low and high water balance categories. Differences in water intake from different sources were identified ( P < 0.05). Conclusions Water balance in summer and winter was not different. However, water intake and loss were approximately 40% higher in summer than in winter. More people were falling in the low and high water balance categories in summer when comparing the distribution on water balance in winter. [ABSTRACT FROM AUTHOR]

Background There is a lack of data in Greece on trends in food intake according to weight status and physical activity ( PA), despite the high prevalence of obesity. The present study aimed to examine differences in these parameters among first-grade children from Crete, Greece, over a 15-year period. Methods Children (aged 5.9-7.6 years) from two representative cross-sectional studies participated during 1992/93 ( n = 245) and 2006/07 ( n = 257). Estimated 3-day food records were used to assess food consumption and energy-density ( ED) [kJ g−1 (kcal g−1)]. Moderate-to-vigorous- PA ( MVPA) and cardiorespiratory-fitness were assessed by questionnaires and the 20-m shuttle-run test (20m SRT), respectively. Results In 2006/07, compared to 1992/93, both sexes had a significantly higher intake of dairy products and snacks ( P < 0.001), a lower intake of cereals ( P < 0.001) and higher cardiorespiratory fitness levels ( P < 0.001). Among girls, fruit/vegetable consumption was higher ( P < 0.05), although legume intake was lower ( P < 0.005). Among overweight/obese ( OW/ OB) children, ED significantly decreased ( P < 0.05) and the mean consumption of fruits/vegetables was higher ( P < 0.001). The percentage of OW/ OB boys was significantly higher ( P < 0.001); however, MVPA was significant higher in this group compared to 1992/93 ( P < 0.001). During the two time-periods, active children in 2006/07 appeared to have a lower ED than active ones in 1992/93 ( P < 0.001). Conclusions Several differences in food intake were observed among first-grade children of Crete between 1992/93 and 2006/07, as characterised by significant increases in the consumption of dairy products and snacks and a decrease in the intake of cereals, among both sexes. Future school-based interventions in this population should emphasise the need to increase fruit/vegetable, unrefined cereal and legume consumption. [ABSTRACT FROM AUTHOR]

Aims: To describe crucial information needs of ICU charge nurses, and to compare these needs in two countries in Europe. Background: ICU charge nurses are on the front line for ensuring that the activities of their units are running smoothly. They are accountable for making sure that the right tasks are performed under the right circumstances, with the right people, at the right time. Design and participants: An online survey based on a previous observation study regarding the ad hoc decision-making of ICU shift leaders. A total of 257 Finnish and 50 Greek ICU charge nurses participated in this study, from 17 Finnish and 16 Greece ICUs for adults. Methods: Our survey incorporated 122 statements divided into six dimensions (patient admission, organization and management of work, allocation of staff, allocation of material, special treatments and patient discharge) with a rating scale from 0 to 10. Analysis involved descriptive statistics. Mann-Whitney U and Kruskal-Wallis tests were used to compare the answers of the two countries. Validity was verified with confirmatory factor analysis and the reliability was tested with Cronbach's α values. Results: The most crucial information needs of ICU charge nurses concerned the overall organization and management of work. Both staff-related and individual patient-related information was needed. Information needs of Finnish and Greek charge nurses concerned similar kinds of situations in ICUs. However, there were some differences that might depend on the cultural differences between the countries. Conclusions: Accurate and real-time information is a prerequisite for ICU charge nurses' ad hoc decision-making during daily care management. Identification of the most crucial information is needed when tools for information management are developed. Relevance to clinical practice: The results of this study indicated that a major portion of immediate information needs of ICU charge nurses are internationally common in similar settings. [ABSTRACT FROM AUTHOR]

Background Williams syndrome (WS) is a genetic disorder causing intellectual disability. Children with WS often exhibit various kinds of maladaptive behaviours that affect their social functioning. In order to determine whether these behaviours are syndrome-specific, it would be necessary to compare children with WS with children with other syndromes as well as to provide data on the socio-emotional profile in WS from a variety of cultures. The present study investigated the behavioural profile and its relation to maternal stress in Greek young children with WS in comparison with young children with Down syndrome and typically developing (TD) children. Methods Participants were 60 mothers, 20 in each syndrome group and 20 in the control group. The three groups were matched for mental age. The behavioural profile of the participants was investigated through the Child Behaviour Checklist (1.5-5 years) and maternal stress through the Parental Stress Index. Results In accordance with studies in other cultures, it was found that young children with WS received significantly higher rates in emotional problems and anxiety/depression, compared with both children with Down syndrome and TD children. Moreover, mothers of children with WS reported significantly higher scores in the Total Stress index compared with mothers of TD children. However, in contrast with previous studies, only 25% of children with WS fell into the clinical range in the total Child Behavior Checklist score. Conclusion The consistency of the socio-emotional characteristics of children with WS across cultures and developmental stages implies a strong influence of the genetic phenotype. However, Greek mothers avoided to characterize these behaviours as pathological. Implications of these findings for clinical practice are also discussed. [ABSTRACT FROM AUTHOR]

Background This study explored typically developing children's attitudes towards peers with intellectual disabilities, with special reference to the type of school they attended. Materials and Methods Two hundred and fifty-six Greek children aged 9-10 (135 in inclusive settings) completed a questionnaire and an adjective list by Gash ( European Journal of Special Needs Education 1993; 8, 106) and drew a child with intellectual disabilities, commenting also on their drawings. Results Typically developing children expressed overall neutral attitudes towards peers with intellectual disabilities. Type of school differentiated their attitudes, with children from inclusive settings being more positive towards peers with intellectual disabilities and choosing less negative adjectives to describe them than children from non-inclusive settings. Girls and students who expressed more positive social, emotional and overall attitudes towards students with intellectual disabilities chose more positive adjectives to describe a child with intellectual disabilities. It was also found that children from inclusive settings drew children with intellectual disabilities as more similar to a child with Down syndrome in comparison with children from non-inclusive settings. Conclusions Effective inclusive practices should be promoted to foster social acceptance of students with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the association between nurses' characteristics (educational level, country, work title, gender, type of work, age, and length of working experience) and their assessments of individualized care. Design: A cross-sectional comparative survey using questionnaires was employed to sample nurses from seven countries. Methods: Data were collected from orthopedic and trauma nurses from Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the United States ( N= 1,163, response rate 70%) using the Individualized Care Scale-Nurse (ICS-Nurse) and a sociodemographic questionnaire in 2008. Data were analyzed using descriptive statistics and general linear models. Results: When compared with practical nurses, registered nurses, length of working experience, and the country of the nurses were associated with assessments of the support of patient individuality in specific nursing activities (ICS-A-Nurse) and country assessments of individuality in the care provided (ICS-B-Nurse). The background and experience within nursing teams together with the country affect the delivery of individualized care. Conclusions: Overall, our findings suggest that nurses' personal attributes have important effects on their assessments of individualized nursing care that will be useful when making context-dependent recruitment decisions. Clinical Relevance: The characteristics of nurses contribute to the care delivered in healthcare organizations. Recognition of these nurse-related factors may help nurse leaders in the development and management of clinical practice. Journal of Nursing Scholarship, 2012; 44:3 ©2012 Sigma Theta Tau International. [ABSTRACT FROM AUTHOR]

Background The role of information on patients' decision to non-adhere is important, yet not well explored. Objective To identify differences between perceived information needs for hypertension and medication to treat it, to explore the information channels used by patients and to test what type of information is more important to adhere to medication. Design, setting and participants A questionnaire study was designed and conducted by telephone in the Centre for the Treatment of Hypertension in Athens, Greece, among 743 individuals. Main variables studied The main variables included perceived information needs, information channels, non-adherence to medication and socio-demographic characteristics. Main outcome measures Non-adherence to medication was measured using the Morisky scale. Results Patients reported feeling better informed about hypertension (90%) than medication to treat it (80%). The doctor remains the dominant information source, while the Media and magazines on health issues were reported more frequently than the family and the pharmacist. Feeling well informed about medication for hypertension was a predictor of better adherence. Other determinants of adherence were the use of the Internet and the Media. Discussion The results confirm the importance of patients leaving the consultation feeling well informed about their medication as this improves adherence. They also show that the use of the Internet and the Media can be beneficial for adherence. Conclusions Given the restricted time the doctor can usually spend with the patient, it is important to know that more emphasis on the information regarding medication is important. [ABSTRACT FROM AUTHOR]

The study was conducted to investigate and compare the attachment styles of maltreated and non-maltreated children through the use of the family drawing technique. The sample consisted of ten maltreated and ten non-maltreated children between the ages of five and 11. The findings revealed that the maltreated children depicted significantly more items in their drawings linked to an insecure attachment pattern than non-maltreated children, while the non-maltreated children made use of significantly more drawing features linked to a secure attachment pattern. These results corresponded to scores on the Child Behaviour Checklist (Achenbach, 1991). All maltreated children scored in the clinical range. The family drawings of maltreated children significantly evidenced a greater distress − represented by an insecure attachment pattern - than the drawings of non-maltreated children represented by a secure attachment style. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]