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Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. Material and Methods: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. Results: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach's alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59–21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03–1.04) and age (OR = 0.07; 99% CI = 0.03–0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01–1.02). Conclusions: The findings suggest that the Greek government's continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group. [ABSTRACT FROM AUTHOR]

The recognition of central sensitization (CS) is crucial, as it determines the results of rehabilitation. The aim of this study was to examine associations between CS and catastrophizing, functionality, disability, illness perceptions, kinesiophobia, anxiety, and depression in people with chronic shoulder pain (SP). In this cross-sectional study, 64 patients with unilateral chronic SP completed a few questionnaires including the Central Sensitization Inventory, the Oxford Shoulder Score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale, the Brief Illness Perception Questionnaire and the "arm endurance" test. On the basis of three constructed linear regression models, it was found that pain catastrophizing and depression (model 1: p < 0.001, R = 0.57, R2 = 0.33), functionality (model 2: p < 0.001, R = 0.50, R2 = 0.25), and helplessness (model 3: p < 0.001, R = 0.53, R2 = 0.28) were significant predictors for CS symptoms in chronic SP. Two additional logistic regression models also showed that depression (model 4: p < 0.001, Nagelkerke R2 = 0.43, overall correct prediction 87.5%) and functionality (model 5: p < 0.001, Nagelkerke R2 = 0.26, overall correct prediction 84.4%) can significantly predict the classification of chronic SP as centrally sensitized. Patients who were classified as centrally sensitized (n = 10) were found to have significantly worse functionality, psychological factors (anxiety, depression, kinesiophobia, catastrophizing), and pain intensity (p < 0.05). Catastrophizing, depression, and functionality are predictive factors of CS symptoms in patients with chronic shoulder pain. Health care providers should adopt a precision medicine approach during assessment and a holistic rehabilitation of patients with unilateral chronic SP. [ABSTRACT FROM AUTHOR]

Background: During the recent pandemic, Healthcare Professionals (HCPs) presented a significant prevalence of psychological health problems and sleep disturbances. The aim of this study was to assess the impact of COVID-19 on HCPs' sleep and mental stress with a separate analysis for primary care HCPs. Methods: A cross-sectional observational study with an online anonymized, self-reported questionnaire was conducted in May 2020 (1st wave) and repeated in December 2020 (2nd wave). Patient health questionnaire-4 (PHQ-4), dimensions of anger reactions-5 (DAR-5) scale, 3-item UCLA loneliness scale (LS) and sleep condition indicator (SCI) were used. Results: Overall, 574 participants were included from the 1st wave, 514 from the 2nd and 469 were followed during both. Anxiety and depression were significantly higher during the 2nd wave vs. the 1st (32.8% vs. 12.7%, p < 0.001 and 37.7% vs. 15.8%, p < 0.001). During the 2nd wave, HCPs scored significantly higher in DAR-5 (9.23 ± 3.82 vs. 7.3 ± 3.3, p < 0.001) and LS (5.88 ± 1.90 vs. 4.9 ± 1.9, p < 0.001) with worse sleep quality SCI (23.7 ± 6.6 vs. 25.4 ± 3.2, p < 0.001). This was more evident in primary care HCPs. Significant correlations were found between SCI and PHQ4, DAR5 and LS. Conclusion: There is a need to support HCPs' mental health and sleep, especially in those working in primary care. [ABSTRACT FROM AUTHOR]

Background: The Shoulder Pain and Disability Index is one of the most common questionnaire to evaluate the impact of shoulder disorders on function. There is no valid and reliable Greek version of the Shoulder Pain and Disability Index available at present for all shoulder disorders. Therefore, the aim of the current study was to test the reliability and validity of the Shoulder Pain and Disability Index in patients with shoulder pain for at least four weeks. Methods: The validation study was conducted in clinical settings by questionnaires comprising the Greek Shoulder Pain and Disability Index and Disability of the Arm, Shoulder, and Hand questionnaire. 130 (68 women and 62 men) Greek reading patients over 18 years old with shoulder pain for at least four weeks were recruited from physical therapy clinics. Internal consistency of the translated instrument was measured using Cronbach's α. to establish test-retest reliability, the patients without any change in their condition after 2–3 days from their initial visit were asked to complete the Shoulder Pain and Disability Index for a second time. An intraclass correlation coefficient was used to assess the test-retest reliability of the Shoulder Pain and Disability Index. The Greek version of the Shoulder Pain and Disability Index and Disability of the Arm, Shoulder, and Hand questionnaire was also administered in both visits. Concurrent validity was measured by correlating the Shoulder Pain and Disability Index with the Greek Shoulder Pain and Disability Index and Disability of the Arm, Shoulder and Hand scale using Pearson's correlation coefficient. Results: The results showed that the Greek Shoulder Pain and Disability Index has good internal consistency (Cronbach α = 0.947), test-retest reliability (ICC =0.926) and concurrent validity (r > 0.7). The standard error of measurement (SEM) and the smallest detectable change (SDC) of the Greek SPADI total score were 4.77 and 13.18. Conclusions: The Greek version of the Shoulder Pain and Disability Index is a reliable and valid measure when administered to patients aged over 18 years old with shoulder pain for at least four weeks. The Greek version of the Shoulder Pain and Disability Index has been found to be reliable and valid when used in patients with shoulder pain for at least four weeks. The results of the psychometric characteristics were compatible with those of the original English version. The Shoulder Pain and Disability Index could be applied to a Greek-speaking population to assess functional limitations and symptoms in patients over 18 years old with shoulder pain for at least four weeks. [ABSTRACT FROM AUTHOR]

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Background Studies have shown an association between intensive care unit environments and symptoms of psychological distress in family members of critically ill patients. Objective To investigate levels of cardiac anxiety in family members of intensive care unit patients. Methods From March 2012 to July 2013, on the third day after the patient's admission, 223 family members of 147 patients completed the Cardiac Anxiety Questionnaire. A total score was calculated from 3 subscales: fear and worry about heart sensations, avoidance of activities reproducing cardiac symptoms, and heart-focused attention and monitoring of cardiac activity. Results Among the family members, 142 were women (63.7%) and 81 (36.3%) were men, 150 (67.3%) were married, and 37 (16.6%) were unemployed. Their mean score for overall cardiac anxiety was 1.11 (SD, 0.64), significantly higher (P< .001 ) than for the general Greek population. Although all 3 subscales scores were significantly higher than for the general population, the highest score was recorded for the avoidance subscale (mean, 1.77; SD, 0.68).The relationship to the patient had a significant effect on heart-focused attention (F5 = 3.51; P=.03).The mean score for patients' siblings (2.0; SD, 0.01) differed significantly (P=.02) from the mean for other family member groups. Older adults (P=.02) and married participants (P=.05) reported higher levels of fear and worry related to cardiac stimuli, and women further reported higher levels of cardioprotective avoidance behavior (P=.02). Conclusions A noticeable number of family members of critical care patients had moderate to severe cardiac anxiety during the hospitalization of their relatives. [ABSTRACT FROM AUTHOR]

Breast self-examination is a screening option for young women. Among students, knowledge about breast selfexamination ranges from insufficient to average. This descriptive study was planned in order to determine the health beliefs and perceptions of nursing students regarding breast self-examinations. We recruited 538 nursing students in a single Higher Technological Educational Institute in Greece. Data were collected using the Champion's Health Belief Model Scale. Parametric tests were used in the data analysis. We found significant differences in the results of the subscales of Champion's Health Belief Model Scale on comparing people with respect to nationality, previous education about breast self-examination, smoking status and semester in which they were studying. The 'confidence' subscale was positively associated with the frequency of breast self-examination. The results of the present study demonstrated that nursing students have knowledge about breast-self examination but inadequate practice. [ABSTRACT FROM AUTHOR]

We evaluated olfactory dysfunction in 154 adults (74 men, mean age 60.9 ± 11.9 years), of whom 119 had type 2 diabetes mellitus (T2DM). Olfactory function was assessed with “Sniffin’ Sticks.” A total Threshold-Discrimination-Identification (TDI) score was calculated. Type 2 diabetes mellitus, hypertension, and hyperlipidemia were associated with lower olfactory scores (all TDI scores <0.001). Age was negatively associated with odor threshold, odor identification, and TDI score (P = .009, <.001, and <.001, respectively). After adjusting for age, gender, body mass index, smoking, alcohol, diabetes, hypertension, hyperlipidemia, and cardiovascular disease, only T2DM and hypertension were associated with TDI score (R square = 0.281). Diabetic complications were associated with olfactory dysfunction (P = .006): TDI scores were lower in the presence of diabetic peripheral neuropathy (P = .017) and retinopathy (P = .047). In conclusion, T2DM and hypertension are independently associated with olfactory dysfunction while diabetic peripheral neuropathy and retinopathy are significantly associated with lower olfactory scores. The clinical relevance of these findings needs to be further examined. [ABSTRACT FROM PUBLISHER]

This post hoc analysis of the Assessing The Treatment Effect in Metabolic Syndrome Without Perceptible diabeTes (ATTEMPT) study assesses the 3½ year incidence of new-onset diabetes (NOD) and related cardiovascular disease (CVD) events in patients with metabolic syndrome (MetS), after multifactorial (lifestyle and drug, including atorvastatin) intervention. Patients were randomized to group A (low-density lipoprotein cholesterol [LDL-C] target <100 mg/dL) and group B (<130 mg/dL). The incidence of NOD during the 42-month follow-up was very low, 0.83 to 1.00/100 patient-years in patients with MetS and MetS with impaired fasting glucose, respectively. Older age, increased waist circumference, and persistent MetS were determinants of NOD. One CVD nonfatal event occurred in the 28 patients with NOD. Our findings suggest that treating the characteristics of MetS is achievable and beneficial. New-onset diabetes incidence and CVD events were negligible and not different from what is expected in the general population. [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]

The article discusses a study on whether differences in technical efficiency derived from data envelopment analysis (DEA) and stochastic frontier analysis (SFA) can be explained by factors of the external operating environment. Topics include the study focusing on technical efficiency in dialysis facilities, the tendency for factors of the external environment to influence management's ability to transform inputs into outputs, and the potential role of DEA and SFA in informed decision-making.

Background: Existing evidence on guidance of postpartum fitness activities is scarce. Research question: To examine the effects of a low impact exercise programme on the physical and psychosocial well-being of postpartum women. Type of study: Randomised controlled trial. Methods: Forty healthy primiparous Greek women were randomly assigned at 4-6 week postpartum to follow either a low impact exercise training programme, involving 50-60 min of aerobic, stretching and strengthening exercise, 3 days a week, for 12 weeks (experimental group; n=20) or no training programme at all (control group; n=20). Prior to initiation of the study and 12 weeks later, participants answered the Lederman Postpartum Self-Evaluation Questionnaire, in order to evaluate psychosocial well-being, and mothers' body weight and infant feeding methods were recorded, in order to evaluate women's' physical well-being. All data were analyzed using Mancova test, a Linear Mixed model and the Chi-square test. Results: Psychosocial well-being parameters were significantly improved in the experimental group, as compared with the control group, including "quality of partner relationship" (p<.05) and "satisfaction from labour and delivery experience" (p<.05). Differences in body weight changes between the two groups were insignificant, while the experimental group was more stable regarding the infant feeding method after the 12-week period (p = ns) as opposed to the control group (p<0.001). Conclusions: Implementation of a low impact exercise training programme appears to improve the psychosocial well-being of postpartum women. Healthcare providers should consider incorporation of a low impact exercise training programme into their management plan of women after childbirth. [ABSTRACT FROM AUTHOR]

Variable and model selection problems are fundamental to high-dimensional statistical modeling in diverse fields of sciences. Especially in health studies, many potential factors are usually introduced to determine an outcome variable. This paper deals with the problem of high-dimensional statistical modeling through the analysis of the trauma annual data in Greece for 2005. The data set is divided into the experiment and control sets and consists of 6334 observations and 112 factors that include demographic, transport and intrahospital data used to detect possible risk factors of death. In our study, different model selection techniques are applied to the experiment set and the notion of deviance is used on the control set to assess the fit of the overall selected model. The statistical methods employed in this work were the non-concave penalized likelihood methods, smoothly clipped absolute deviation, least absolute shrinkage and selection operator, and Hard, the generalized linear logistic regression, and the best subset variable selection.The way of identifying the significant variables in large medical data sets along with the performance and the pros and cons of the various statistical techniques used are discussed. The performed analysis reveals the distinct advantages of the non-concave penalized likelihood methods over the traditional model selection techniques. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to determine the factors influencing patient evaluation of the health services which can be incorporated in feasible proposals for the application of marketing policies. Method. The research was conducted in May-September 2007 in two hospitals, one in Athens and in one in a provincial region. Data were collected using a structured questionnaire, specially designed to be clear to the health service users. Selection of participants was based on the method of multiple stage random sampling, and the sample consisted of 217 patients. Results. Satisfaction with the health services was rated at a mean of 6.9 points by the Athens patients and 6.1 points by those in the provincial area, on a 10 point scale. Linear regression analysis revealed a significant degree of interdependence among six specific factors that were examined as independent variables, and their correlation with satisfaction (R2=0.527, P=0.001, F=29.68). Concerning the level of interdependence, the most powerful dependence was related to the evaluation of particular services (B=1.49, t=11.5) and the expected rating of services evaluation (B=0.17, t=2.49). Conclusions. The users of the health services in the provincial hospital consistently indicated lower levels of satisfaction, but also higher expectations. Conversely, in the Athens hospital, the users appeared to be more rationally informed about the services that they expected to receive. It can be concluded that the way in which the services are provided to the users (i.e., the management facilitations), which shapes the end product that is offered to health services users, influences to a considerable degree their opinion and their final satisfaction with the services provided. [ABSTRACT FROM AUTHOR]

This article presents statistical research pertaining to geology. The article examines the problem of negative empirical covariances to temperature date in a geothermal field. The experimental data was carried out in Nea Kessani, Greece. An overview of the geothermal field of Nea Kessani is offered. The article investigates comparisons in terms of cross-validation, allowing the evaluation of bias, estimation accuracy, and goodness-of-fit. Further extensions for the application of the research are presented.

This paper suggests a recursive application of Fama and MacBeth's (1973) testing procedure to assess the significance of macroeconomic factors and firm-specific effects priced in explaining the cross-sectional variation of expected stock returns over time. The paper applies the suggested testing procedure to investigate the source of risks of the Athens Stock Exchange (ASE). Among the variables examined, it finds out that the changes in the short term interest rates and firm size can explain a significant proportion of the variation of the ASE individual returns. The paper argues that the significance of interest rate changes can be associated with monetary policy changes introduced by the Greek authorities after the mid-nineties. These changes were focused on targeting interest rates, instead of monetary aggregates. [ABSTRACT FROM AUTHOR]

Quantile regression analysis is used to estimate the public-private sector wage differential in Greece. The results suggest that wage differences between sectors are mainly attributed to the employee's endowment. The decomposition of the wage differential shows that the endowment component (characteristics differential) increases as we move up to the upper quantiles and the unobserved components decrease at higher quantiles. (The views expressed in this paper are those of the author and not those of the Bank of Greece.) [ABSTRACT FROM AUTHOR]

The aim of this paper is to improve our understanding of the empirical determinants of firm growth by extending the literature to include a new group of variables related to foreign direct investment (FDI), namely the degree of foreign ownership and technology spillovers. Based on recent developments in the field, our analysis also encompasses the role of sunk costs and financial constraints, while quantile regression techniques are adopted as more suitable to the data available (2,640 manufacturing firms operating in Greece in the 1992–1997 period). Our findings highlight the role of FDI in increasing firm growth with varying intensity depending on industry groups and regression quantiles, and vindicate the use of new variables. [ABSTRACT FROM AUTHOR]

AIM: To asses the orthodontic treatment service provided by 5 orthodontists in Greece. DESIGN: A retrospective cross-sectional study. SUBJECTS AND METHOD: One hundred cases were randomly selected from the model stores of 5 practices in the Athens area. MAIN OUTCOME MEASURED: The Index of Complexity, Outcome and Need (ICON) was used to assess the need, complexity of the problem, outcome, the degree of improvement and whether the completed case was acceptable or not. STATISTICAL ANALYSES: The reliability of the examiner using the ICON was assessed using Root Mean Square. Logistic regression analysis was employed to explore the variables related to acceptability of the finish. RESULTS: 94 of cases were considered as needing orthodontic treatment. 61 cases were classified as difficult or very difficult. 23 cases were substantially improved. However, 47 were worse or minimally improved. 88 finishes were considered acceptable. CONCLUSION: An objective appraisal of the quality of orthodontic care provided in 5 practices in Athens has been undertaken. The quality of care is very good. The Index of Complexity, Outcome and Need appears to be a valuable tool to assess the multiple facets of orthodontic provision. [ABSTRACT FROM AUTHOR]

An error correction model of Greek agriculture for the period 1961-1994 is estimated using a dynamic system of output and input share equations derived from a translog profit function. Nested within this model are a static model and three simpler dynamic models: a partial adjustment model, autoregressive error model and finite distributed lag model. The data-generating process rejects the static model and simpler dynamic models in favour of the more general error correction model, which is also found to perform better than the static model in terms of consistency with the regularity properties implied by economic theory. [ABSTRACT FROM PUBLISHER]

The article reports on a study published within the issue related to mathematics students' understanding of distinction between the concepts of function and relation in Greece. It examines students' awareness of the discrimination between function and relation, and the discrimination between the dependent and the independent variables. It presents results of the questionnaires and interviews that students experienced difficulties in answering them. It states that the students' examples and their application of the definition explored a constrained perception of the function concept. Therefore, in order to overcome the obstacle of confusing the function with a relation, it suggests a teaching of function oriented towards activities which demand the measure of a magnitude.

The article focuses on the ten articles authored by prominent researchers that participated in the 2nd International Workshop in Applied Probability 2004, which was held at the Department of Statistics and Insurance Science, University of Piraeus, in Greece on March 22 to 25, 2004. The main objective for holding these workshops is to survey recent research advances in probability and its applications in diverse areas of science and technology.