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Aim The aim and objective of this study was to understand how non‐specialized nurses understand the possible barriers and facilitators of inpatient care for type 1 diabetes. Design An interpretative phenomenology approach was conducted. Methods The sample consisted of non‐specialized nurses (N = 24) working in medical, surgical and nephrology wards in the state hospitals in Cyprus. The data were collected during 2016‐2018 from one focus group with nurses (N = 6) and individual semi‐structured interviews with nurses (N = 18) conducted. The Standards for Reporting Qualitative Research checklist used to ensure the quality of the study. Results It is evident from the study findings that nurses experience several barriers in diabetes inpatient care reported which are of great concern since this could have adverse effects on patients' outcomes. Only one facilitator has been reported by few nurses.

The aim of this work is to shortly provide the public with an overview about fake news and artificial intelligence (AI) technology. Especially in our days, where there is a high speed of spreading news, the impact of fake news on public health is crucial and the development of valid and effective means of technology to support the provision of safe and trustworthy information about public health issues is vital. The role of informatics in health area is profoundly important and AI in public health, so people will be able to distinguish the genuine information from the fake one.

International Organizations are seriously concerned about the fake news phenomenon. UNESCO has defined the term of misinformation/disinformation, which are the two faces of fake news. European Commission has conducted a survey about “Fake News” through EU citizens to estimate the awareness and people behaviour related to the appearance of fake news and disinformation on electronic. The findings are quite worrying, since about 40% come across fake news daily and 85% evaluate fake news as a problem. The aim of this work is to introduce an Artificial Intelligence approach, the Decision Trees algorithm to identify fake news on the COVID-19.

Introduction Vaccination is the best method for microbial and viral infections prevention. Especially for health professionals, flu vaccination is the best method to protect them, and the same applies for the patients and the general population from being infected. One of the most important preventive measure is vaccination and the main types of vaccines available, the limitations and side effects are briefly presented. Aim The aim of this paper is to present the necessity of the healthcare professionals to conceptualize the importance of flu vaccination ifor themselves and the general population. Healthcare professionals are influenced by their knowledge, attitudes, and beliefs. Epidemiological surveys on this issue are presented for Greece, European Union, and the USA. Methods A broad scope literature review was conducted based on a strict selection process of articles referring to the general population and the healthcare professionals with emphasis on the time period from the fall of 2018 until the spring of 2020 across Greece. The method used in this research obtained information through bibliographical references throughout Europe, USA, and relevant studies in Greece. Results The results of this research indicated that influenza vaccination among healthcare professionals in Greece in the time period 2018-2019 was higher in primary health centers (PHCs) with a percentage of 43.8% than in Hospitals which was 30.6%. In addition, in the time period 2019-2020 flu vaccination among health professionals was higher in PHCs with a percentage of 57.9% rather than in Hospitals with a percentage of 38.8%. Specifically, flu vaccination rate which took place in hospitals was higher among physicians than in other healthcare personnel. Furthermore, the fundamental reasons for recommending flu vaccination in healthcare professionals are presented, and issues related to denial or acceptance of it are highlighted. Measures and strategies are proposed in order to increase flu vaccination coverage in healthcare facilities in Greece. Conclusions Based on this research review healthcare professionals (HCPs) especially the ones working in ICUs, in ICUs for newborn children, in Departments for acute care infections, in Departments caring of persons with immunodeficiency or Units for transplantation, Oncology and Haematology Departments, and finally, in Emergency Care Units need directly to be vaccinated for the flu virus. Different measures have been undertaken to promote flu vaccination and the percentage of implementation has been highlighted.

This chapter aims at providing the student with a general overview of the Health Organization Development and Design basic concepts. More precisely, this chapter outlines the origins and the future of Health services planning and development and the structure of health organizations. The typology of different international healthcare systems implemented in United Kingdom, United States of America, Greece, Serbia and Germany is also presented.

This chapter aims at providing the student with a general overview of the appropriate structure and ethics healthcare organizations are based on, the concept of ethical leadership, the importance of having clear statements of mission, vision and value in healthcare organizations and the Health Promotion Charters implemented in a Globalized World.

Background: The aim of this study was to comprehend how people with diabetes view their experiences of the possible barriers and facilitators in inpatient care for type 1 diabetes from non-specialized nurses. Design: An interpretative phenomenology analysis (IPA) was conducted. Methods: The sample consisted of people with type 1 diabetes 1 (n = 24) who use the services of the state hospitals in Cyprus. The data were collected in two phases: firstly, focus groups with people with diabetes (n = 2) were conducted and analysed, and then individual semi-structured interviews with people with diabetes (n = 12) were conducted. Results: It is evident from the findings that people with diabetes experienced several barriers in diabetes inpatient care, which is concerning since this can have adverse effects on patients&rsquo, outcomes. No facilitators were reported. Conclusion: Significant results were found in relation to the barriers to diabetes inpatient care. Crucially, the findings demonstrate that all these factors can negatively affect the quality of care of patients with diabetes, and most of these factors are related not only to diabetes care but also generally to all patients who receive inpatient care. Interestingly, no participant reported any facilitators to their care, which further affected the negative perceptions of the care received.

Introduction: Several research studies have started to investigate the health conditions of medical doctors and nurses in order to find a relationship if any between their work environment, their usually heavy duties and the result of these two parametric on patients' health. Aim: The present research study is an effort to investigate the relationship between the physical activity and sleep disorders among health care professionals, particularly among medical doctors and nurses. Methods: Participants of the study were asked to fill a questionnaire which was a mixture of other internationally accredited questionnaires regarding physical activity level as well as sleeping functions. Data were collected among 204 physicians and nurses. The statistical analysis revealed a correlation between physical activity and some aspects of sleep disorders. Results: A total number of 204 questionnaires have been distributed to medical doctors and nurses working in public hospitals in Athens Greece from the middle of February until the middle of April 2020. The hospitals were assigned by the health authorities to the fight of the pandemic of COVID 19. The majority of the participants were women 71,3% and 28,7% were men. From a total of 204 half of them were medical doctors and half of them were nurses. 43% were married, 49% were single and 8% were divorced and there were no widows. Regarding the participant nurses, 43% had a university degree and 38,4% had a technological education degree. The results of the statistical analysis showed that there are positive correlations between the level of physical activity during the daily work and the free time of the participants with parameters that are related to sleep disorders. Conclusion: The sample of the study was not a large one but nevertheless a stressful situation such as is the epidemic of COVID19 can provide useful information in order to better understand the relationship between physical activity and sleeping disorders in such working conditions. © 2020 Marianna Diomidous.

Introduction The aim of this research is to inform the health professionals about the ways of introducing and operating the the Diagnosis Related Groups (DRG's) system in the Hellenic National Health System, through the use of the development technologies. An effort is also made to explore the main dimensions of the implementation of the DRG's system, in specific European-Countries that have both adopted the public coverage schemes and the Bismarck health insurance institutions for countries with extensive experience in their implementation. Material and methods A review of the literature was attempted to investigate the ways of financing of the health services, and of the identification and functionality of the DRG's as well as of the methods used by European countries to investigate this prospective compensation system. Results The efficient application of DRGs gives the possibility to improve the economic management of Greek hospitals by retaining the costs and consequently contributing to the wise and effective management of hospital expenses. A short training of health professionals on the importance of DRGs in the effective running of Greek hospitals, led to the development of a website. This website will give information on this new method of pricing of hospital health services provided, and will contribute to the overall improvement of health services. Conclusion Introduction of DRGs, in Greek hospitals will establish a positive condition to solve many emerging health issues and to improve the overall functionality of the health system. Additionally, with the proper implementation of the DRG;s, the financial management of the Greek hospitals, can be improved by keeping the costs down through the proper utilization of the available resources.

Electronic patient records are important for quality health services and efficient patient data management. In emergency care, saving valuable time during patient care is of great significance. One out of two fatalities due to trauma occur half an hour after the injury. The aim of this study was to investigate the potential effect of an electronic trauma documentation system on the length of stay in an emergency department.A 2-year observational study was conducted in the emergency department of a university hospital located in central Greece. The purpose was to compare 3 length-of-stay parameters with and without the use of an electronic documentation system. Ninety-nine trauma patients were monitored with the use of the electronic system, whereas 101 patients were monitored with a paper-based method (control group).Statistical analysis using independent-samples t tests indicated that the time between admission and completion of the planned care was significantly lower in the electronic documentation patient group (100 ± 92 minutes) than in the control group (149 ± 29 minutes) (P.01). A similar effect was found on the total ED length of stay (127 ± 93 minutes in electronic documentation group vs 206 ± 41 minutes in control group, P.01) and the time between completion of care and discharge from the emergency department (26 ± 10 minutes in electronic documentation group vs 57 ± 23 minutes in control group, P.01).We investigated 3 length-of-stay parameters and found that all were lower with the use of the electronic documentation system. This finding is important regarding the quality of trauma patient care because saving time during the first hours after the injury may determine the outcome of the trauma patient.

Background: The aim of this review is to identify the roles and activities of nurses working with people with diabetes and to examine the facilitators and barriers in caring for such people. Methods: A systematic review was conducted. From 531 abstracts reviewed, 29 studies were included (18 studies comprised questionnaire surveys, one was an intervention study, two used both questionnaires and interviews, and eight of them used interviews). Barriers and facilitators were extracted and combined using qualitative synthesis. Results: The literature review revealed three major roles and a number of barriers. A model for achieving enhanced nursing care of patients with diabetes has been developed according to the findings of this literature. Specifically, a stepladder suggesting that through better nursing training and education and by providing adequate resources, time, and synergies to diabetes specialists, nurses will be able to correctly perform their diabetes care roles, which include patient education, advanced care, and psychological support. Conclusions: Taking into serious consideration that a large number of hospital users are people with diabetes and that there is an inconsistency among countries about the work settings of Diabetes Specialist Nurses (DSNs), it is important to give greater focus to inpatient care and perhaps to enhance nurses’ roles by eliminating any barriers that prevent them from providing adequate quality care. Furthermore, integrated care involving the role of DSNs within the inpatient care would have been more beneficial for patients.

Background: Parental and peer smoking are considered major predictors of smoking in adolescence. We investigate the impact of family and social environment and parental anti-smoking socialization on the intensive and extensive margins of smoking for Greek adolescents. Method and Material: Information on 873 adolescents was collected through a self-reported survey and regression analysis examined associations with five different smoking outcomes (current/lifetime smoking status/intensity and onset). Subgroup analyses and interactions provided further insights. Results: Prevalence of adolescent smoking is high. Family and peer smoking habits and smoking restrictions at home reduce probability and intensity of smoking. Parental smoking increases probability of current smoking by 5% (95% CI: 0.01-0.09) as does having all your friends smoking by 30% (95% CI: 0.16-0.45). Parental anti-smoking advice delays onset of smoking by 0.76 years (95% CI: 0.15-1.39) but does not affect current smoking. Conclusion: Family and social environments play a significant role in preventing or promoting smoking and should be regarded as crucial factors when devising policy to curb adolescent smoking.

rEViEw Abstract introduction: There is an increasing number of people who travel around the world. Every traveler is exposed to nearly all infectious risks which may occur during his travel time. Some of the main risk factors can be water quality, temperature and high humidity and the exposure to multi- resistant microorganisms. To tackle the upcoming problem there is an imperative need to develop a new branch of medicine with the name of travel medicine. review results: A consultation prior to departure for an upcoming trip is required, focusing to a personalized healthcare p lan, based on international scientific protocols and epidemiological studies.Travelers must acquire essential information about the prevailing hygie- ne conditions and climatic differentiations that occur in the region. Additionally there are several health risks upon the arrival at destination. A scheduled visit to a health professional is necessary, especially in the case of travelers suffering from chronic diseases or those taking medication, while vaccination is considered essential for specific destination countries. Healthcare professionals should be able to inform travelers and evaluate their needs. According to research studies on notion and attitudes travelers' specific risks, only few of them are well-informed during a trip. While most studies indicate that travelers have some kind of pre travel medical consultation, not all of them proceed to the required vaccinations and medications. Conclusion: Travelling for business or leisure around the world may be unhealthy. The importance of proper preparation prior to the travel requires to be adequately informed by specialized healthcare professionals, and to receive appropriate vaccinations and medications, when required. The results of the review of notions and attitudes of travelers during the trip indicate not only the need for further development of the branch of travel medicine but especially the need for the expansion and the availability of health services.

Summary Objectives: Health informatics is a well established and important multi-disciplinary and inter-disciplinary field that not only involves informatics but also medicine, nursing, engineering, biology and other-related subjects. The program has been organized on the basis of an inter-university approach with the participation of five Greek universities. The paper aims at providing a current description of the academic program and a preliminary evaluation of the implementation phase. Methods: The paper presents a case study of a curriculum implementation from the phase of curriculum development to the phase of implementation and evaluation. Due to the interdisciplinary character of the course appropriate procedures were undertaken to ensure that mixed backgrounds can assimilate the broad spectrum of the teaching material taught. In the first stages of the implementation international students mainly from Europe attended the course. In addition, local graduates provided an extra dimension to the multi-layered difficulties and challenges of such a course implementation. Results: The students registered in the course were from different backgrounds and disciplines. They were mainly from health sciences and engineering schools. The interdisciplinary arrangement of the course facilitated the proper exchange of thoughts, skills, and knowledge among and between students and teachers. Conclusions: The postgraduate course in health informatics at the University of Athens has now been running for more than fifteen consecutive years and is one of the first and longest standing courses in Europe. Continuous evaluation and adaptation is required to fit within the changing and evolving amazing field of biomedical and health informatics.

Introduction: Social networks (1) have been embedded in our daily life for a long time. They constitute a powerful tool used nowadays for both searching and exchanging information on different issues by using Internet searching engines (Google, Bing, etc.) and Social Networks (Facebook, Twitter etc.). In this paper, are presented the results of a research based on the frequency and the type of the usage of the Internet and the Social Networks by the general public and the health professionals. Objectives: The objectives of the research were focused on the investigation of the frequency of seeking and meticulously searching for health information in the social media by both individuals and health practitioners. The exchanging of information is a procedure that involves the issues of reliability and quality of information. Methods: In this research, by using advanced statistical techniques an effort is made to investigate the participant’s profile in using social networks for searching and exchanging information on health issues. Results: Based on the answers 93 % of the people, use the Internet to find information on health-subjects. Considering principal component analysis, the most important health subjects were nutrition (0.719 %), respiratory issues (0.79 %), cardiological issues (0.777%), psychological issues (0.667%) and total (73.8%). Conclusions: The research results, based on different statistical techniques revealed that the 61.2% of the males and 56.4% of the females intended to use the social networks for searching medical information. Based on the principal components analysis, the most important sources that the participants mentioned, were the use of the Internet and social networks for exchanging information on health issues. These sources proved to be of paramount importance to the participants of the study. The same holds for nursing, medical and administrative staff in hospitals.

SummaryBackground: Medicine and biomedical sciences have become data-intensive fields, which, at the same time, enable the application of data-driven approaches and require sophisticated data analysis and data mining methods. Biomedical informatics provides a proper interdisciplinary context to integrate data and knowledge when processing available information, with the aim of giving effective decision-making support in clinics and translational research.Objectives: To reflect on different perspectives related to the role of data analysis and data mining in biomedical informatics. Methods: On the occasion of the 50th year of Methods of Information in Medicine a symposium was organized, which reflected on opportunities, challenges and priorities of organizing, representing and analysing data, information and knowledge in biomedicine and health care. The contributions of experts with a variety of backgrounds in the area of biomedical data analysis have been collected as one outcome of this symposium, in order to provide a broad, though coherent, overview of some of the most interesting aspects of the field.Results: The paper presents sections on data accumulation and data-driven approaches in medical informatics, data and knowledge integration, statistical issues for the evaluation of data mining models, translational bioinformatics and bioinformatics aspects of genetic epidemiology.Conclusions: Biomedical informatics represents a natural framework to properly and effectively apply data analysis and data mining methods in a decision-making context. In the future, it will be necessary to preserve the inclusive nature of the field and to foster an increasing sharing of data and methods between researchers.

The aim of the study was to describe computed tomography (CT) findings in middle ear cholesteatoma in pediatric patients. A cohort of 32 children with cholesteatoma (3-14 years old) entered the study. From them, 30 presented acquired cholesteatoma (AC), and 2 presented congenital cholesteatoma. All of the children were investigated using CT before surgery of the middle ear and mastoid. Computed tomography was performed with 1- or 2-mm axial and coronal sections of both temporal bones. Nineteen children with AC (63.3%) revealed a diffuse soft-tissue density isodense with muscle, whereas in 6 of them, the mass mimicked inflammation. The remaining revealed localized soft-tissue mass with partially lobulated contour. In AC, ossicular erosion was detected in 23 cases (76.7%), abnormal pneumatization in 19 cases (63.3%), and erosion-blunting of spur and enlargement of middle ear or mastoid in 8 cases (26.7%). The 2 congenital cholesteatomas revealed soft-tissue mass with polypoid densities, while a semicircular canal fistula was detected in one of them. High-resolution CT facilitates early diagnosis and appropriate treatment of pediatric cholesteatoma by assessing the anatomic abnormalities and the extent of disease, which are crucial in middle ear and mastoid surgery.

According to a common definition, interprofessional education (IPE) is described as "occasions when two or more professions learn from and about each other to improve collaboration and the quality of care". The Leonardo project under the name European Interprofessional Education Network (EIPEN) in health and social care, has been dealing with the challenges of interprofessional education. The EIPEN project tries to develop a transnational network of universities and employers in the six participating countries and at the same time to promote good practices in interprofessional learning and teaching in health and social care. IPE provides opportunities for students and practitioners to learn with, from and about each other during qualifying and post-qualifying training and in their practice. IPE in health and social care includes the education and training of practitioners in human and animal medicine, dentistry, nursing, physiotherapy, occupational therapy, pharmacy and all other health professions including public and environmental health and health promotion, and social work. The outcomes of the EIPEN Project will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics. The methodology on the development of the Greek Interprofessional Network was based on a series of workshops aiming to document the educational process in healthcare institutes and universities followed by the assessment of the needs for the development of an interprofessional environment. The outcomes will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics.

Vaccination decreases children mortality and its' application, especially in the developing world, is a means towards the achievement of the United Nations Millennium Development Goals. Objects: We sought to develop, apply and, evaluate a web-based immunization registry system that logs and calculates the vaccination timetable based on the age, gender, and previously administered vaccine doses. Method: We designed and created a computational system based on the Greek National Immunization Program. The system was used by pediatricians and parents for a period of 4 months (01/09/2009-31/12/2009) in Patra, Greece. Participants were asked to answer to a questionnaire. Results: In total 60 parents and 60 pediatricians used the online system and 500 vaccinations were logged. We observed time-application errors and missed doses, mainly among children older than 2 years (27%). A considerable 17% of the participants did not have the essential vaccination card and 7% of them had lost it. Parents had a positive opinion (56) about the online system mainly based on the usability and high availability. On the other hand, health-care professionals considered that the electronic assistance in calculating dosage intervals and the logging capabilities of the system, that offers the possibility to extract and statistically analyze data, were the main advantages of the system (54). Conclusion: The use of information technology may help parents to keep up with the immunization schedules, health-care professionals to calculate dosage intervals, provide them with a valuable data analysis tool and, contribute in the effective application of the national immunization policy.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) and obstructive sleep apnea syndrome are two diseases, which often coexist in one person. The sleep apnea is often caused by an interruption to breath when sleeping, due to an obstruction of the upper airway during inhalation, causing chronic snoring, morning headaches, increased body weight, blood pressure and sleepiness during the day. Aim: The purpose of this study is to investigate the extend of this problem among a large group of elderly people living in the Attica Basin. Material and Methods: Material of the study was 500 people aged 70 and above years old, including 274 men and 226 women. Data collection was facilitated with the use of an anonymous questionnaire with the purpose to identify patients with apnea, after a personal interview with the researcher. Data analysis was performed with the use of the statistical package SPSS 17. Results: Based on their responses to the questionnaires, it was found that 98.0% of the participants have abnormal sleepiness during the day. The 35.4% of them show no apnea, while 36.0% of the sample suffer from mild sleep apnea. It is important though, the fact that about one out of three seniors, 28.6%, shows sleep apnea in a high risk level. Conclusions: COPD is a complex disease that occurs in a large proportion of the elderly. Emphasis should be given on early diagnosis and treatment of sleep apnea syndrome, in order to improve the quality of the elderly life.

Original paper SUMMARY Introduction: Successful research manage- ment requirements include; equal teamwork and efficient coordination, in order to in- crease the impact of the research outcomes and provide added value knowledge. Aim of this paper is to discuss the strategies that have been followed during the RN4CAST study, the largest nursing multi-country research project ever conducted in Europe. The paper focuses on the core research strategies rather than on the administrative activities, which are inevitably also required for the success of a large scale research. Results and discussion: This paper is an extension of a conference presentation in the International Conference of the Eu- ropean Federation for Medical Informatics (MIE) 2011 in Oslo, and was subsequently published in the Studies in Health Technol- ogy and Informatics book series (IOS Press) under the title "Research management: the case of RN4CAST." Management of a multi- country nursing survey requires the use of common data collection tools, applicable to every context, research protocols supporting the scope of the research, data models for multi-country analyses and global dissemina- tion strategies. Challenges that may be faced during the implementation of the study include the individualized confrontation of obstacles during data collection, the coher- ence of national procedures (for example permissions for data collection) in European level, and the challenge to gain information of added value for the EU, by aggregating the national survey results through a powerful data analysis model. Communication strate- gies are also discussed. Keywords. Research Management, Nurs- ing, RN4CAST.