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Bottom-up proteomics analyses have been proved over the last years to be a powerful tool in the characterization of the proteome and are crucial for understanding cellular and organism behaviour. Through differential proteomic analysis researchers can shed light on groups of proteins or individual proteins that play key roles in certain, normal or pathological conditions. However, several tools for the analysis of such complex datasets are powerful, but hard-to-use with steep learning curves. In addition, some other tools are easy to use, but are weak in terms of analytical power. Previously, we have introduced ProteoSign, a powerful, yet user-friendly open-source online platform for protein differential expression/abundance analysis designed with the end-proteomics user in mind. Part of Proteosign's power stems from the utilization of the well-established Linear Models For Microarray Data (LIMMA) methodology. Here, we present a substantial upgrade of this computational resource, called ProteoSign v2, where we introduce major improvements, also based on user feedback. The new version offers more plot options, supports additional experimental designs, analyzes updated input datasets and performs a gene enrichment analysis of the differentially expressed proteins. We also introduce the deployment of the Docker technology and significantly increase the speed of a full analysis. ProteoSign v2 is available at http://bioinformatics.med.uoc.gr/ProteoSign., Graphical Abstract Graphical AbstractProteoSign v2: a faster and evolved user-friendly online tool for statistical analyses of differential proteomics.

A stochastic model motivated by the Lagrangian transported probability density function method for turbulent reacting flows and the cellular automata approach for forest fires was put together to simulate propagation of fires in terrains with inhomogeneous composition. In contrast to the usual cellular automata models for fires where the probability of ignition is prescribed, here the ignition of cells is determined by a random walk that mimics turbulent convection and diffusion of the hot gases and firebrands from upwind and neighbouring fire fronts. Radiation is also included. The model is aimed at speed of computation while approximating the key physics through only a few terrain-related inputs and tunable parameters representing fire intensity, hot gas and ember decay timescales, cell ignition delay and local turbulence. These parameters were calibrated against controlled fire experiments and the model was then used to give reasonable predictions for fires of increasing complexity. The presented framework allows improvements for more accurate representation of the flammable material characteristics, fire-induced flow modifications, and most other phenomena present in fires, hence providing an extendable and simple yet physically-realistic novel modelling approach.

BACKGROUND: Oral health is considered essential for individuals’ well-being. Poor oral health has a negative impact on overall human health while contributing and predisposing to other diseases. It has been internationally documented that nurses delay or omit oral care of hospitalized patients and as a result of this, the risk of adverse events is increased. METHODS: Four focus groups were organized (n=30) to elicit the issue under study. Nurse managers and nurses working in medical and surgical departments in 3 acute care hospitals participated in June 2019. The discussions were coordinated by an independent moderator, using a semi-structured interview guide. Recordings of the conversations were transcribed and thematic analysis was performed according to Krueger and Casey guidelines. RESULTS The findings confirm that oral care of hospitalized patients is often omitted and is not acknowledged as an important patient need. The barriers and facilitators that affected oral health care positively or negatively were divided into three themes and included patient’ characteristics, nurses’ knowledge and skills and recourses as well as the working environment . CONCLUSIONS: Oral care is not considered as priority and there are many factors that contribute negatively or positively to its implementation. Nurse managers and nurses can play a crucial role for the adoption of universal oral care practices in hospitalized patients.

Objective The purpose of this study was to adapt and validate the Revised Practice Environment Scale of the Nursing Work Index, to be utilized among the Cyprus nurses’ population. Validated research scales are valuable tools in the hands of researchers in their attempt to recommend alterations within health care systems, especially during reform periods. Results Internal consistency reliability of the scale was satisfactory (alpha = 0.94). Exploratory factor analysis produced a five-factor structure solution. Experts in the field provided further guidance. The findings demonstrated that the Cyprus version of the Revised Practice Environment Scale of the Nursing Work Index is a reliable and valid research instrument, however differences with previous studies on the factor structure were observed, mainly due to cultural reasons. As a valid and reliable scale, it can capture the views of nurses concerning their work environment. The Cyprus version of the Revised Practice Environment Scale of the Nursing Work Index can be used by nurse managers and policy makers to introduce changes that may improve the quality of nursing care provided and enhance the patients’ satisfaction from the health system as a whole.

Aim To identify strategies to prevent Missed Nursing Care (MNC) that can be implemented by nurse managers/directors on a daily basis. Background Only few recommendations have been established to date aiming at supporting nurse managers/ directors in preventing MNC. However, several strategies are implemented on a daily basis, suggesting that a body of tacit, practical, and wise knowledge is already in place. Method(s) An international qualitative descriptive study based on the positive deviance approach conducted in 2019-2020 and reported according to The Consolidated Criteria for Reporting Qualitative Research. A purposeful sample of 35 nurse managers/directors working in hospitals in Cyprus, Italy, Germany and Switzerland was involved. Codes were extracted from each country and a thematic analysis was performed at the transnational level to identify strategies and interventions preformed to prevent MNC. Results Eight strategies and 22 interventions, mainly with preventive intent and designed at the hospital level, affecting both the processes and the structural dimensions, have been reported as effective in preventing MNC. Conclusion Nurse leaders are involved daily in implementing strategies to minimize MNC at the nursing and at the hospital system levels, integrated with each other. Implications for nursing management Preventing MNC should be a core value of the entire hospital, and not merely a nursing issue: therefore, complex interventions at the system level are required.

Nowadays, due to the technological advances of high-throughput techniques, Systems Biology has seen a tremendous growth of data generation. With network analysis, looking at biological systems at a higher level in order to better understand a system, its topology and the relationships between its components is of a great importance. Gene expression, signal transduction, protein/chemical interactions, biomedical literature co-occurrences, are few of the examples captured in biological network representations where nodes represent certain bioentities and edges represent the connections between them. Today, many tools for network visualization and analysis are available. Nevertheless, most of them are standalone applications that often (i) burden users with computing and calculation time depending on the network’s size and (ii) focus on handling, editing and exploring a network interactively. While such functionality is of great importance, limited efforts have been made towards the comparison of the topological analysis of multiple networks. Network Analysis Provider (NAP) is a comprehensive web tool to automate network profiling and intra/inter-network topology comparison. It is designed to bridge the gap between network analysis, statistics, graph theory and partially visualization in a user-friendly way. It is freely available and aims to become a very appealing tool for the broader community. It hosts a great plethora of topological analysis methods such as node and edge rankings. Few of its powerful characteristics are: its ability to enable easy profile comparisons across multiple networks, find their intersection and provide users with simplified, high quality plots of any of the offered topological characteristics against any other within the same network. It is written in R and Shiny, it is based on the igraph library and it is able to handle medium-scale weighted/unweighted, directed/undirected and bipartite graphs. NAP is available at http://bioinformatics.med.uoc.gr/NAP .

Background: Respecting patients’ dignity has been described as a fundamental part of nursing care. Many studies have focused on exploring the concept of patients’ dignity from the patient and nurse perspective, but knowledge is limited regarding students’ nursing perceptions and experiences. Objective: To explore the issue of patients’ dignity from the perspective of nursing students. Research design: A qualitative study was employed with the formation of four focus groups and the participation of nursing students. Data were analysed via a thematic content analysis of the discussions. Participants and research context: Thirty-four nursing students of a Cyprus University participated in the four focus groups. Each group was homogenous in terms of the year of study and heterogeneous in terms of clinical practice in various wards. Ethical consideration: The study’s protocol was reviewed and approved by the Cyprus National Bioethics Committee. Ethical standards were followed throughout the study. Findings: Several factors that maintain or compromise patients’ dignity emerged. These factors were grouped into five themes: (a) patients’ preferences, verbal abuse and regarding a patient as a unique person; (b) privacy and confidentiality; (c) loss of autonomy and need for help; (d) discrimination and (e) attribution and reciprocity. Discussion: Different understandings of the perceived concept of dignity and the factors that maintain or compromise patient’s dignity were expressed through the eyes and the feelings of nursing students. Students highlighted the importance of promoting patient dignity as an important component of nursing care. Conclusion: Nurse educators can use the findings of this study in order to tailor nursing programmes to emphasise the importance of respecting patients’ dignity. In addition, nurse ward managers can use the findings as means for persuading nurses to change current behaviour.

Background: Occupational exposure to pathogens forms a major concern among nurses, the largest team among healthcare professionals. Unfortunately, international literature marks high rates of occupational exposure to pathogens among nurses. Data from these studies allow to the implementation of prevention programs to avoid such incidences.Aim:To assess the prevalence of Cypriot nurses’ occupational exposure to pathogens as well as their reporting behaviour following such incidences.Methodology: A cross sectional survey has been conducted among a convenience sample of 577 nurses, during March and May 2010.Results: Our analysis demonstrated that almost half of Cypriot nurses (48.4%) had at least one incidence of occupational exposure to pathogens, with more than 20% of the exposed nurses having been exposed via more than one mode. The majority of them have made a report of the incident, according to the policy of their hospital. Main reasons for not reporting such a critical incident included being too busy and forgetfulness.Conclusions: The results indicate that exposure to pathogens among Cypriot nurses is high, a fact that puts them into danger for acquiring an infection. A risk management program should be implemented to reduce such incidents.

Here we demonstrate quantitation of stimuli-induced proteome dynamics in primary cells by combining the power of bio-orthogonal noncanonical amino acid tagging (BONCAT) and stable-isotope labeling of amino acids in cell culture (SILAC). In conjunction with nanoscale liquid chromatography-tandem mass spectrometry (nanoLC-MS/MS), quantitative noncanonical amino acid tagging (QuaNCAT) allowed us to monitor the early expression changes of >600 proteins in primary resting T cells subjected to activation stimuli. © 2013 Nature America, Inc. All rights reserved.

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 t ...

The functional design and application of a data-independent LC-MS precursor and product ion repository for protein identification, quantification, and validation is conceptually described. The ion repository was constructed from the sequence search results of a broad range of discovery experiments investigating various tissue types of two closely related mammalian species. The relative high degree of similarity in protein complement, ion detection, and peptide and protein identification allows for the analysis of normalized precursor and product ion intensity values, as well as standardized retention times, creating a multidimensional/orthogonal queryable, qualitative, and quantitative space. Peptide ion map selection for identification and quantification is primarily based on replication and limited variation. The information is stored in a relational database and is used to create peptide- and protein-specific fragment ion maps that can be queried in a targeted fashion against the raw or time aligned ion detections. These queries can be conducted either individually or as groups, where the latter affords pathway and molecular machinery analysis of the protein complement. The presented results also suggest that peptide ionization and fragmentation efficiencies are highly conserved between experiments and practically independent of the analyzed biological sample when using similar instrumentation. Moreover, the data illustrate only minor variation in ionization efficiency with amino acid sequence substitutions occurring between species. Finally, the data and the presented results illustrate how LC-MS performance metrics can be extracted and utilized to ensure optimal performance of the employed analytical workflows.

Scand J Caring Sci; 2012; 26; 372–380 Patient satisfaction as an outcome of individualised nursing care Background: The association between individualised nursing care and patient satisfaction has been previously found. However, there is a lack of studies examining this association between individualised care and patient satisfaction in a cross-cultural study. Aims: This study examines the association between individualised care and patient satisfaction in a sample of general surgical patients from five European countries. Methods: A cross-sectional design and survey method were used to collect data from general surgical patients (N = 1315, response rate 78%) in 72 inpatient wards in 26 general acute hospitals’ in 2009 using self-completed questionnaires the Individualised Care Scale and the Patient Satisfaction Scale. Data were analysed using descriptive statistics, Pearson correlation coefficients and multiple stepwise regression analyses. Results: Surgical patients reported that the care they received was only moderately individualised overall, but individuality was taken into account well in patients’ clinical situation and decisional control over care. Patients were satisfied with their care, mostly with the technical aspects of care and least with the information given. There were between-country differences in patients’ perceptions of individuality in care and patient satisfaction. A positive correlation between the level of individualised care received and patient satisfaction was found, confirming that individualised nursing care delivery influences patients’ satisfaction with care and demonstrating that this quality of care indicator might be able to be used as a predictor of patient satisfaction, one outcome of care. Conclusion: The findings of this study strengthen previous results and further reporting the existence of a relationship and the positive correlation between individualised care and patient satisfaction. The results can inform administrative decisions and policy on introducing nursing approaches to care that would increase patient satisfaction.

Aim. The aim of this study was to compare patients’ and nurses’ perceptions of individualised care in five European countries, the Czech Republic, Cyprus, Finland, Greece and Hungary. Background. Individualised nursing care has been studied from both patients’ and nurses’ perspectives, but to date, there are no studies comparing these perspectives internationally. Methods. A cross-sectional comparative survey design was used. Data were collected from nurses (n = 960; response rate, 79%) and patients (n = 1315; response rate, 78%) in 71 surgical units from 26 acute hospitals in 2009. Data were collected using two Individualised Care Scales (ICS-Nurse and ICS-Patient) and analysed statistically using descriptive and inferential statistics. Results. Differences in patients’ and nurses’ assessments of individualised nursing care were found between each country. Nurses, compared with patients, assessed that they supported patient individuality more often. The Meannurses ranged from 3·61 (SD 0·90, Greece)–4·31 (SD 0·53, Hungary), and the Meanpatients ranged from 3·05 (SD 1·09, Greece)–3·79 (SD 1·00, Cyprus). To a large extent, the care provided was individualised as defined by the Meannurses 3·75 (SD 0·92, Greece)–4·36 (SD 0·49, Hungary) and the Meanpatients 3·41 (SD 0·95, Greece)–4·18 (SD 0·79, Cyprus). In Cyprus and Finland, patients’ assessments of the individuality in their care corresponded well with nurses’ assessments. Clear between-country differences in both patients’ and nurses’ assessments were found in both subscales of the ICS. Conclusions. An in-depth analysis of the European between-country differences is required to define the causes of differences that may be due to the differing content of education, the organisation of nursing work, ideology and values assigned to individualised care and health care systems and processes in each country. Relevance to clinical practice. Obtaining both patients’ and nurses’ assessments of individualised care may facilitate the further development of individualised nursing care and be used to help to harmonise European health care processes and nursing care.

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients’ and nurses’ perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026–1037. Abstract Aim. This paper is a report of an international study of patients’ and nurses’ perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers’ perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses’ caring actions when compared to nurses’ views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients (n = 1659) and their nurses (n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses’ and patients’ responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses’ and patients’ views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses’ responses were higher compared to patients (P

Objectives: Caring for a family member with Alzheimer's disease is associated with increased burden and depression. Effective coping with the hardships and demands of caring may help to sustain the caregiver and lessen the effect of the stressors. The objective of this study was to examine caregivers’ coping styles and the relationship with reported levels of burden and depression. Method: A cross-sectional correlation study was employed. One hundred and seventy-two caregivers of patients suffering from Alzheimer's type dementia participated in the study. All patients were recruited from neurology clinics. The Greek versions of four measuring instruments used were: the Memory and Behaviour Problem Checklist, the Burden Interview, the Centre for Epidemiological studies-Depression scale and the Ways of Coping Questionnaire. Results: Positive coping is negatively correlated with burden (r = −0.20) and wishful thinking strategies were related positively (r = 0.16). The relation between depression and positive coping strategies is highly significant (p

Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses (n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area.

Standard Precautions have been introduced as a means to protect health professionals from exposure to pathogens. This study examines the extent of Cypriot nurses' compliance with the main aspects of Standard Precautions and explores the possible associations with the nurses' characteristics. Self-completed questionnaires that examined the frequency of the implementation of Standard Precautions were distributed to a convenience sample of 668 nurses.The response rate was 89.37%.The results showed inadequate compliance with Standard Precautions. Full compliance with all the main aspects of Standard Precautions was reported by only 9.1% of the participants. Male nurses and those who had not been exposed previously to pathogens reported better compliance, in comparison to female nurses and those who had been exposed previously. Nurses who had participated previously in an educational program about Standard Precautions reported a higher frequency of implementing them than those who had not participated. The nurses' age and frequency of the implementation of Standard Precautions were found to be significantly and positively correlated. The results can be used to enhance nurses' safety by focusing on areas of non-compliance.

The Ministry of Health of Cyprus (approval no: Y.Y. 5.14.02.4(2)) and the Cyprus National Bioethics Committee (approval no: EEBK/EΠ/2008/1) reviewed and approved the research protocol as Cyprus was the coordinating country for the research study. Abstract BACKGROUND: Patients' decisional control over care is the ability or power for patients to decide what their involvement will be in healthcare decisions. There is evidence of limited agreement between the perceptions of patients and the perceptions of nurses and/or caregivers with regard to the degree of patient involvement in the planning and performance of their care. AIM: To analyse and compare patients' and nurses' perceptions of patients' decisional control over their own care. METHOD: A multisite cross-sectional comparative survey design was employed. Data were collected from hospitalised surgical inpatients (n = 1315) and their caregivers (n = 960 nurses) in five European countries. The Individualised Care Scale part B was used for collecting data from both the patients and nurses. Ethical standards were followed throughout the study. RESULTS: Significant between-country differences were found between patients and nurses. In all countries, both patients and nurses regarded that decisional control over care had been actualised (ICS-B: M = 3.75-4.47 and 3.48-4.33, respectively), but there were significant differences in their perceptions regarding four of the six items of the decisional control factor of the ICS-B. CONCLUSIONS: The results show that there are disparities between patients' and nurses' perceptions of patient involvement in care, probably due to cultural issues that need further exploration. CLINICAL RELEVANCE: The disparities between patients' and nurses' perceptions on patients' decisional control over their care should be taken into consideration as a potential cause of patient dissatisfaction with nursing care. The study was funded by the Cyprus University of Technology (EX 11/2008).

Introduction An Amyand’s hernia is a rare occurrence of an inguinal hernia, with an estimated prevalence of 1%. The major complications of an Amyand’s hernia include necrotizing fasciitis of the anterior abdominal wall and secondary intestinal perforation. Though the incidence of this type of hernia is low, the appendix may easily become initially incarcerated, possibly leading to strangulation and perforation. Case presentation A 92-year-old female patient presented to our emergency department with clinical signs of an incarcerated right inguinal hernia, accompanied by fever. A clinical examination revealed localized abdominal pain, reflecting to the right side of her groin. Laboratory tests showed leukocytosis (13,200/μL), while an abdominal X-ray showed colon distension with evidence of intestinal obstruction. Ultrasonography was performed and confirmed the presence of an inflamed tubular structure inside her right inguinal canal. Our patient underwent emergency surgery. We started with a right inguinal incision, which revealed an incarcerated right inguinal hernia, containing her ruptured appendix and showing macroscopic evidence of malignancy. A specimen biopsy was immediately performed and the results showed a ruptured cecal adenocarcinoma. The incision was slightly extended upwards, and a right hemicolectomy performed. Conclusions Diagnosis of an Amyand’s hernia occurs primarily as an incidental finding during surgery and the optimal therapeutic approach must be considered individually for each case. Owing to the rarity of Amyand’s hernia and the wide variance of its clinical characteristics, every case provides useful information toward the treatment of this type of hernia.

The purpose of this European survey was to examine the relationship of surgical patients' and nurses' personal characteristics with their perceptions of caring behaviors. Caring Behaviors Inventory (CBI) was completed by convenience samples of 1,659 patients and 1,195 nurses from six countries of Europe. The results showed that the older the patients, the more positive were their evaluations of CBI. Those with planned admission and good/very good health conditions gave higher ratings compared to those with an emergency and poor health conditions. Type of admission, age, and health conditions explained 5.2% of CBI variance. Nurses with more work experience and experience in the unit gave significantly higher ratings compared to nurses with less experience. Nurses' total experience and gender explained 2.3% of the variance of perceived care. Therefore, in a multinational surgical environment, caring behaviors may be influenced by other variables, better captured by using different research methods. This study was funded by the Cyprus University of Technology.

Ethical approval: University of Turku Ethics Committee, 1/2009, 14.1.2009. Abstract BACKGROUND: Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies. OBJECTIVES: The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries. DESIGN: This study had an international, multisite, prospective, cross-sectional, exploratory survey design. SETTINGS: The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey. PARTICIPANTS: Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study. METHODS: Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model. RESULTS: Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care. CONCLUSIONS: The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes.

Signaling through the T cell receptor (TCR) initiates adaptive immunity and its perturbation may results in autoimmunity. The plasma membrane scaffolding protein LAT acts as a central organizer of the TCR signaling machinery to activate many functional pathways. LAT-deficient mice develop an autoimmune syndrome but the mechanism of this pathology is unknown. In this work we have compared global dynamics of TCR signaling by MS-based quantitative phosphoproteomics in LAT-sufficient and LAT-defective Jurkat T cells. Surprisingly, we found that many TCR-induced phosphorylation events persist in the absence of LAT, despite ERK and PLCγ1 phosphorylation being repressed. Most importantly, the absence of LAT resulted in augmented and persistent tyrosine phosphorylation of CD3ζ and ZAP70. This indicates that LAT signaling hub is also implicated in negative feedback signals to modulate upstream phosphorylation events. Phosphorylation kinetics data resulting from this investigation is documented in a database (phosphoTCR) accessible online. The MS data have been deposited to the ProteomeXchange with identifier PXD000341.

Although respect and human presence are frequently reported in nursing literature, these are poorly defined within a nursing context. The aim of this study was to examine the differences, if any, in the perceived frequency of respect and human presence in the clinical care, between nurses and patients. A convenience sample of 1537 patients and 1148 nurses from six European countries (Cyprus, Czech Republic, Finland, Greece, Hungary and Italy) participated in this study during autumn 2009. The six-point Likert-type Caring Behaviours Inventory-24 questionnaire was used for gathering appropriate data. The findings showed statistically significant differences of nurses’ and patients’ perception of frequency on respect and human presence. These findings provide a better understanding of caring behaviours that convey respect and assurance of human presence to persons behind the patients and may contribute to close gaps in knowledge regarding patients’ expectations.

Purpose: Theoretically, patient satisfaction is correlated with nursing care, but there is not sufficient evidence to support it. The aim of this study was to address three research questions: (a) What is the correlation between caring as perceived by patients and patient satisfaction? (b) Are there differences across various countries on the correlation on caring as perceived by patients and patient satisfaction? (c) Do caring behaviors affect patient satisfaction? Design: A multicenter correlational design was adopted involving surgical patients from six European countries: Cyprus, Czech Republic, Greece, Finland, Hungary, and Italy. Methods: A convenience sample of 1,565 patients was recruited in autumn 2009. The short version of the Caring Behaviours Inventory (CBI; 24 items) and Patient Satisfaction Scale (PSS; 11 items) were used. Data analysis included descriptive statistics, as well as correlation analysis and stepwise multiple regression, to examine relations between caring behaviors and patient satisfaction. Findings: According to the patients involved, nurses performed caring behaviors between very frequently (score = 5) and always (score = 6). Patient satisfaction with nursing care was also high, between satisfied (score = 3) and very satisfied (score = 4). A positive correlation emerged between CBI and PPS (r= 0.66, p < .01) ranging between countries from 0.27 to 0.85 (Czech Republic r= 0.27, Cyprus r= 0.76, Finland r= 0.71, Greece r= 0.85, Hungary r= 0.63, and Italy r= 0.45 [p < .01]). Among the CBI dimensions, “connectedness” mainly explains patient satisfaction (R2= 0.404, p < .001), followed by “assurance” (R2= 0.032, p < .001) and “respectful” (R2= 0.005, p < .001). Conclusions: Caring behaviors enacted by nurses determine a consistent proportion of patient satisfaction. This association between them suggests several implications for nursing education, practice, and management. Clinical Relevance: The results may be utilized by policymakers, nurse ward managers, nurse educators, and clinical nurses as a background for taking appropriate measures to improve nursing care provided, thereby enhancing patient satisfaction.

Since air pollution levels are strongly dependent on atmospheric conditions, it is important to take both into consideration when examining the effects of weather on human health. In this study, the discomfort conditions were estimated by using several air-quality stress indices based on air-pollutant concentrations in the center of Thessaloniki. Also, the temporal fluctuations in heat waves were analysed by using several thermal stress indices, like the number of hot days during the summer period, for the years 1970-2005, with maximum temperatures greater than a threshold temperature. It was found that air quality conditions in the urban area of Thessaloniki can be characterised as acute for the last years, with respect mainly to photochemical pollutants and suspended particulates (PM(10) and PM(2.5)). The consequence is that discomfort to humans in the center of Thessaloniki due to environmental conditions is caused by temporary thermal stress during the heat waves and permanent air quality stress. Journal of Environmental Protection and Ecology

In the present study, an attempt was made to give a preliminary estimate of heat-related mortality in Northern Greece, during the summer period, for the years 1970-2009, with special regard to extreme heat waves. Long-term trends in the human mortality data, for the hot period of the year, can be influenced by different demographic factors (changes in the size and age structure of the population), the population adaptation to the local climate, the temporal fluctuations in extreme heat waves, and the significant increasing trend in cumulative thermal stress on people, at least partially related to anthropogenic climatic change. The plots of summer excess mortality (all causes of death as well as the cardiovascular and respiratory mortality) versus several biometeorological parameters, indicate a pronounced significant increase of mortality rates, with strong and extreme cumulative thermal stress indices. Journal of Environmental Protection and Ecology

Background Nurses may acquire an infection during the provision of nursing care because of occupational exposure to microorganisms. Relevant literature reports that, compliance with Standard Precautions (a set of guidelines that can protect health care professionals from being exposed to microorganisms) is low among nurses. Additionally, high rates of exposure to microorganisms among nurses via several modes (needlesticks, hand contamination with blood, exposure to air-transmitted microorganisms) occur. The aim of the study was to study the factors that influence nurses' compliance with Standard Precaution in order to avoid occupational exposure to pathogens, by employing a qualitative research design. Method A focus group approach was used to explore the issue under study. Four focus groups (N = 30) were organised to elicit nurses' perception of the factors that influence their compliance with Standard Precautions. The Health Belief Model (HBM) was used as the theoretical framework and the data were analysed according to predetermined criteria. Results Following content analysis, factors that influence nurses' compliance emerged. Most factors could be applied to one of the main domains of the HBM: benefits, barriers, severity, susceptibility, cues to action, and self-efficacy. Conclusions Changing current behavior requires knowledge of the factors that may influence nurses' compliance with Standard Precautions. This knowledge will facilitate in the implementation of programs and preventive actions that contribute in avoiding of occupational exposure.

Heat stress-related mortality is among main impacts of climatic extremes on human society. An extreme heat wave can be catastrophic or not depending on its intensity, extent and duration, but also on the population adaptation to the local climate and the awareness of the public authorities. Excess monthly mortality was established, for total and cardiovascular and respiratory mortality, by calculating deviations of the observed number of deaths from an expected number of deaths (baseline mortality) for each summer month of the examined period. The net mortality change was clearly positive during the extended hot periods of the most severe heat waves. The aims of this study were to analyse mortality during heat waves in Northern Greece, separately for June, July and August, during the period 1970-2009, and to quantify a preliminary relationship between heat stress and excess mortality, taking into consideration the population adaptation to the local climate. There is a need to further improve public health responses to weather extremes and to heat-waves in particular that may result in a large excess of mortality in Greece. Journal of Environmental Protection and Ecology

As a result of climate change, heat waves are expected to increase in severity and frequency. Hot weather extremes appear to have a profound effect on human health and well-being. In addition, humidity affects human comfort, and the perceived temperature by humans is largely dependent on atmospheric moisture content. The danger posed by the combined effect of air temperature and humidity has lead biometeorologists to develop various discomfort indices in order to define the danger and alert the pubic. In this study, the discomfort conditions were estimated by using several biometeorological indices: the discomfort index, relative strain index, heat index and humidex, during the summer period (June, July and August) for the years 1970-2005, based on long-term meteorological data. During the heat waves, the results for the biometeorological discomfort indices (for that time period) indicate a high thermal stress on people in the center of Thessaloniki. Journal of Environmental Protection and Ecology

Introduction Tuberculous colitis is a rare form of tuberculosis and is found in immunosuppressed patients, usually with the clinical appearance of Crohn's disease. The purpose of this article is to report a rare case of tuberculous colitis in a transplant patient, presenting in the form of bowel obstruction and acute abdomen. Case presentation Methods A male patient, 51 years old, with a history of kidney transplant in a foreign country 19 months before, presented at the emergency department, after being referred by a primary care center, with obstipation during the previous week and acute abdominal pain. The patient had the clinical appearance of acute abdomen. Five days before the patient underwent colonoscopy, which revealed an intraluminal mass that partially occluded the lumen of the ascending colon. Blood tests revealed a mildly elevated WBC count and anaemia. Imaging studies revealed air in the peritoneal cavity and free fluid in the pelvis. The patient was diagnosed with perforation of a hollow viscus and was admitted for surgery Results During laparotomy the findings were a perforation of the cecum, a fragile mass (pseudopolyp), which occluded the lumen approximately in the middle of the ascending colon, diffuse erosions of the mucosa and pseudomembranes. A bezoar was found impacted at the level of the occlusion. There was also marked lymph node enlargement in the mesentery and ischaemia of the cecum. A typical right hemicolectomy was performed and special care was taken so, as not to damage the renal transplant. The pathological and microbiological (from free peritoneal fluid) investigation suggested the diagnosis of tuberculous colitis. Further blood tests and respiratory investigation confirmed the diagnosis of active tuberculosis, with the colon as a primary site. The patient received the appropriate antituberculous treatment. Conclusions Tuberculous colitis is a rare form of tuberculosis and is found in immunosuppressed patients. Deferential diagnosis from other forms of colitis is usually problematic. Tuberculous colitis rarely manifests itself in the form of acute surgical abdomen. The possible diagnosis of tuberculous colitis must be always in mind when treating transplant patients.

Taking into consideration the heavily stressed air quality conditions in the city of Thessaloniki, Greece, an attempt was made to study the temporal fluctuations in heat wave occurrence and intensity during the summer period (June, July and August) for the years 1970-2005. The results demonstrate a continuous warming trend as well as the increase of the frequency of hot days and heat wave episodes. The discomfort conditions were estimated by using several thermal stress indices (TSI) based on long-term meteorological data in the center of Thessaloniki. The results for the physiological indices indicate a high thermal stress on people, during the heat waves. Combined with the air pollution effects, the stress on humans due to environmental conditions has been very harmful to public health. Journal of Environmental Protection and Ecology