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Introduction:Mass gatherings (MGs) often bring together professionals and organizations that collaborate irregularly or have never engaged in joint working. They involve interaction and communication among multiple and diverse services, which can often prove challenging. Planning such an event is of paramount importance for its success, and interorganizational communication ranks among its most important aspects. Nonetheless, there is limited empirical evidence to support interagency communication in MGs.Objective:This study used the 2017 Athens Marathon (Athens, Greece) as the empirical setting to examine how interorganizational communication was perceived among the multiple public health and safety professionals during the planning and implementation phase of the event.Methods:Data comprised 15 semi-structured in-depth interviews with key informants, direct observations of meetings and the event itself, and documentary analysis. Open coding and thematic analysis were used to analyze the data.Results:Findings indicated three key components of interorganizational communication in such an event: (1) shared situational awareness; (2) interorganizational understanding; and (3) implementing liaison officers.Conclusion:This study outlined the factors that influenced interorganizational communication before and during a MG. Practical implications arising from this study may inform the way organizers of marathons and other mass sporting events can engage in effective interorganizational communication.

Background: Understanding the factors that affect the transmissibility of SARS-CoV-2 remains important to keep transmission low and maximize the health benefits of vaccination. We assessed the factors associated with the transmissibility of SARS-CoV-2 based on contact tracing data. Methods: From 1 October to 9 December 2020, 29,385 laboratory-confirmed SARS-CoV-2 cases (index cases, i.e. the first identified laboratory-confirmed cases or with the earliest symptom onset in a setting) and 64,608 traced contacts were identified in Greece. We assessed the prevalence of symptoms in cases, calculated secondary attack rates and assessed factors associated with infectivity and susceptibility to infection. Results: There were 11,232 contacts secondarily infected (secondary attack rate: 17.4%, 95% CI:17.0–17.8). Contacts aged 0–11 and 12–17 years were less susceptible to infection than adults 65 years or older (odds ratio (OR) [95% CI]: 0.28 [0.26–0.32] and 0.44 [0.40–0.49], respectively). Index cases aged 65 years or older were more likely to infect their contacts than other adults or children/adolescents. The odds of infection [95% CI] were higher in contacts exposed within the household (1.71 [1.59–1.85] vs. other) and in cases with cough (1.17 [1.11–1.25] vs. no cough). There was an interaction between the age of the index and the age of the contact with contacts 65 years or older having a higher probability of infection when exposed to cases of similar age than to children. Conclusions: Our findings highlight the role of age and age mixing in infectivity and susceptibility to SARS-CoV-2 infection. Precautions are necessary for individuals 65 or older as they have higher infectivity and susceptibility in contact with their peers. © 2021 Society for Scandinavian Journal of Infectious Diseases.

Background Understanding the factors that affect the transmissibility of SARS-CoV-2 remains important to keep transmission low and maximize the health benefits of vaccination. We assessed the factors associated with the transmissibility of SARS-CoV-2 based on contact tracing data. Methods From 1 October to 9 December 2020, 29,385 laboratory-confirmed SARS-CoV-2 cases (index cases, i.e. the first identified laboratory-confirmed cases or with the earliest symptom onset in a setting) and 64,608 traced contacts were identified in Greece. We assessed the prevalence of symptoms in cases, calculated secondary attack rates and assessed factors associated with infectivity and susceptibility to infection. Results There were 11,232 contacts secondarily infected (secondary attack rate: 17.4%, 95% CI:17.0-17.8). Contacts aged 0-11 and 12-17 years were less susceptible to infection than adults 65 years or older (odds ratio (OR) [95% CI]: 0.28 [0.26-0.32] and 0.44 [0.40-0.49], respectively). Index cases aged 65 years or older were more likely to infect their contacts than other adults or children/adolescents. The odds of infection [95% CI] were higher in contacts exposed within the household (1.71 [1.59-1.85] vs. other) and in cases with cough (1.17 [1.11-1.25] vs. no cough). There was an interaction between the age of the index and the age of the contact with contacts 65 years or older having a higher probability of infection when exposed to cases of similar age than to children. Conclusions Our findings highlight the role of age and age mixing in infectivity and susceptibility to SARS-CoV-2 infection. Precautions are necessary for individuals 65 or older as they have higher infectivity and susceptibility in contact with their peers.

OBJECTIVES: Planning and implementing public health initiatives in mass gatherings such as the Olympic Games pose unique challenges for interorganizational collaboration, which involves interaction among multiple and diverse agencies. Nonetheless, there is limited empirical evidence to support interagency collaboration and public health planning decisions in mass gatherings and how leadership can shape such interactions. We empirically explored these topics in the 2012 London Olympics to identify lessons to inform planning for future mass gatherings.\ud \ud STUDY DESIGN: This is a qualitative case study. \ud \ud METHODS: Data comprised 39 semistructured interviews with key informants conducted before, during, and after the games; in addition, direct observations of field exercises and documentary analysis were also used. Open coding and thematic analysis was used to analyze the data.\ud \ud RESULTS: We identified two main leadership challenges that influenced interagency collaboration: organizational public health leadership and coordinating collaborative decision-making. Two facilitative conditions helped overcome the previous challenges: nurturing interorganizational linkages and creating shared understanding by activating codified frameworks at the organizational level.\ud \ud CONCLUSIONS: Our study highlights leadership issues in interagency collaboration in mass gatherings. Practical implications arising from this study may inform the ways the organizers of mass gatherings, public health and safety agencies, and professionals can engage in effective partnerships and joint working.

Background Central pancreatectomy (CP), a partial resection of the pancreas, is indicated for the excision of neuroendocrine tumors (NETs) of the pancreas, when located at the neck or the proximal body. Specifically, CP is preferable in functional NET and in nonfunctional sized 1 to 2 cm or/with proliferation marker Ki67 Methods In 1 year, we performed CP in two patients, following the aforementioned criteria. They presented with tumor of the body of the pancreas, which was found in random check with computed tomography, with negative hormonal blood tests and they underwent magnetic resonance imaging and endoscopic ultrasound/fine-needle biopsy/pathological examination. Results The patients underwent CP with Roux-en-Y pancreaticojejunal anastomosis of the distal pancreatic stump and jejunal patch of the proximal pancreatic stump. Histological exam revealed NET sized 2.8 cm and 1.45 cm, Grade I and II, respectively. Postoperatively both patients developed small pancreatic leakage, which did not affect their physical condition and stopped after 20 and 30 days. No one needed pancreatic enzymes supplements or developed new-onset diabetes mellitus. Conclusion CP provided adequate, functional remaining pancreatic tissue in both patients. Small leakages were treated conservatively and retreated without septic complications. As a result, CP might be considered as safe and effective technique for pancreatic neck/proximal body NET.

One of the main reasons for the ever-improving quality of health services in countries that are popular destinations for medical tourism and compete with the quality of services in developed countries is due to the increasing use of modern medical technology. The purpose of this study was to investigate the factors affecting medical tourism destination selection in Greece. A cross-sectional study with retrospective data collection was carried out. The study sample consisted of 446 adult patients with good knowledge/use of the English language, recently discharged from dialysis and IVF units in Greece who filled in a self-administered questionnaire. Statistical analysis was carried out with the SPSS 21.0 statistical package. Overall, 84.9% of the participants reported that the clinic's state of the art medical equipment appeared to be very important for their final decision. Moreover, 90.8% stated that the comfort of the medical equipment was another significant factor. The use of modern medical technology can improve medical tourism experience and grow the contribution to its market growth.

Purpose Although the accessory soleus muscle is a rare supernumerary muscle of the leg, its presence has been well discussed in the literature. This rare anatomic variation has been described mainly in the anatomic, surgical, and radiology literature. Awareness of the muscle's presence and its clinical presentation can help with diagnosis without surgical exploration. This narrative review summarizes the available data describing the anatomy, clinical presentation, diagnosis, associated pathologies, and treatment options of this accessory muscle. Methods A literature review was performed to provide a comprehensive report of the existing data regarding the accessory soleus muscle. PubMed, Heal Link, and Google Scholar were searched for articles in English reporting on the accessory soleus muscle. The search was conducted using the following key words: "soleus muscle" and "accessory soleus muscle". PubMed was searched primarily, and then cross-referenced articles were found via Heal Link and Google Scholar. Results from non-English studies were excluded. Results A total of 148 articles were reviewed. The majority of the articles was composed of case reports along with a review of the literature. After the initial screening, 33 irrelevant studies, 47 duplicates, and 9 non-English articles were excluded; thus, 59 studies were eligible for analysis. Conclusion Although the accessory soleus muscle is a rare anatomic variation, many cases have been reported in the literature. Nonetheless, the results reported in this literature review are still inconclusive regarding why some patients are symptomatic and others are not, and the recommendation of therapy protocols. Recognizing this anomaly is important in deciding the right diagnosis and planning the appropriate treatment. However, further research is needed to investigate the symptoms' presentations and propose specific treatment protocols.

One of the main reasons for the ever-improving quality of health services in countries that are popular destinations for medical tourism and compete with the quality of services in developed countries is due to the increasing use of modern medical technology. The purpose of this study was to investigate the factors affecting medical tourism destination selection in Greece. A cross-sectional study with retrospective data collection was carried out. The study sample consisted of 446 adult patients with good knowledge/use of the English language, recently discharged from dialysis and IVF units in Greece who filled in a self-administered questionnaire. Statistical analysis was carried out with the SPSS 21.0 statistical package. Overall, 84.9% of the participants reported that the clinic's state of the art medical equipment appeared to be very important for their final decision. Moreover, 90.8% stated that the comfort of the medical equipment was another significant factor. The use of modern medical technology can improve medical tourism experience and grow the contribution to its market growth. © 2020 The authors and IOS Press.

Purpose: Although the accessory soleus muscle is a rare supernumerary muscle of the leg, its presence has been well discussed in the literature. This rare anatomic variation has been described mainly in the anatomic, surgical, and radiology literature. Awareness of the muscle’s presence and its clinical presentation can help with diagnosis without surgical exploration. This narrative review summarizes the available data describing the anatomy, clinical presentation, diagnosis, associated pathologies, and treatment options of this accessory muscle. Methods: A literature review was performed to provide a comprehensive report of the existing data regarding the accessory soleus muscle. PubMed, Heal Link, and Google Scholar were searched for articles in English reporting on the accessory soleus muscle. The search was conducted using the following key words: “soleus muscle” and “accessory soleus muscle.” PubMed was searched primarily, and then cross-referenced articles were found via Heal Link and Google Scholar. Results from non-English studies were excluded. Results: A total of 148 articles were reviewed. The majority of the articles was composed of case reports along with a review of the literature. After the initial screening, 33 irrelevant studies, 47 duplicates, and 9 non-English articles were excluded; thus, 59 studies were eligible for analysis. Conclusion: Although the accessory soleus muscle is a rare anatomic variation, many cases have been reported in the literature. Nonetheless, the results reported in this literature review are still inconclusive regarding why some patients are symptomatic and others are not, and the recommendation of therapy protocols. Recognizing this anomaly is important in deciding the right diagnosis and planning the appropriate treatment. However, further research is needed to investigate the symptoms’ presentations and propose specific treatment protocols. © 2019 by Begell House, Inc.

Background: This study used the 2012 London Olympic Games as the empirical context to examine how interagency collaboration took place among the diverse public health and safety agencies involved in this mass gathering event. In order to develop our understanding of how collaboration among the key stakeholders in a mass event may be improved, this study aims at capturing the components that affected the ability of interagency collaboration to deliver its potential. Methods: An exploratory case study design was used. Data were collected before, during and after the Games through semi-structured interviews, direct observations and documentary analysis. Template analysis was used to analyze the interviews' transcripts, the field notes from observations and the documents. The analysis generated a framework of factors influencing interagency collaboration including leadership, communication, governance and knowledge. Results: Leadership shaped interagency collaboration through several characteristics including processes, skills, behaviours and relationships. Findings indicated that accountability issues, the use of guidelines and legislation and the physical presence of the leaders were perceived as fundamental to the implementation of effective collaboration. Effective leaders were supportive, persistent, good listeners and easy to talk. Moreover, interpersonal trust formed the basis for positive interagency collaboration. Conclusion: Recognizing and understanding the above leadership characteristics is an important step towards the support of the collaborative endeavours in mass gathering events.

Background: Recent natural disasters have made disaster training a public priority. Multiple methods of disaster preparedness training have been established in hospitals worldwide. Nevertheless, researchers have not yet discovered the most effective method for training hospital personnel in the area of disaster preparedness. Aim: The aim of this study is to test the hypothesis that a brief educational intervention would improve hospital staff knowledge about the hospital disaster plan and procedures. Methods: A quasi-experimental design was used. The intervention group included 56 professionals and the comparison group included 35 professionals in Greece. The intervention group attended a 5-h course that addressed the basic principles of hospital disaster management. A structured questionnaire was used to estimate the participants' changes in knowledge. Repeated measures analysis of variance (ANOVA), t-test, one-way ANOVA and chi-square test were used to analyse the data. Results: The intervention resulted in a significant improvement in knowledge. The mean score was significantly higher immediately after the intervention programme [86; standard error (SE): 2] than before (44.5; SE: 1.7) (P Language: en

Mass gatherings such as the Olympic Games pose unique challenges for interorganizational collaboration. Such events often bring together organizations that collaborate irregularly or have never engaged in joint working. They involve interaction and collaboration among multiple and diverse agencies aiming at delivering a service to a large clientele, which can often prove challenging. This study used the 2012 London Olympic Games as the empirical setting to examine the interagency collaboration among the multiple and diverse public health and safety organizations involved in one of the world's largest mass gatherings. A single, holistic and exploratory case study design was used and data were collected before, during and after the Games through 39 semi-structured interviews with key informants, direct observations of field exercises and documentary analysis. Data collection commenced in May 2011, 14 months before the actual Games, and was completed in October 2012, two months after the completion of the Games. Template analysis was used to thematically analyze the interviews' transcripts, the fieldnotes from observations and the documents. Findings discuss interagency collaboration in mass gatherings along three main activity domains: leadership, communication and learning. In each domain, a number of challenges and facilitators emerged influencing interagency collaboration. Regarding the leadership domain, the lack of engagement of the leading organization and the ambiguous interoganizational decision-making processes negatively influenced collaboration. Shared micro-level leadership and the use of interorganizational linkages enabled collaborative working. Experienced positional leaders of each organization enabled the decision-making process at the interagency operational level by exercising a range of interpersonal leadership capabilities including flexibility and the ability to negotiate. Codified frameworks at the organizational level also provided leaders with common ground to assist them manage the complex interorganizational processes. Within the second domain, the complex intraorganizational structure of the involved agencies and the high density of information transmitted were associated with a dysfunctional communication experience. Findings revealed that the crafting of boundary-spanning roles and intense face-to-face interaction positively contributed to interagency collaboration. Online information systems and formal intersectoral dissemination of reports were essential in gaining common situational awareness. The implicit cultural rules in the form of communication etiquette shaped how interorganizational collaboration was perceived. Finally, sharing the acquired knowledge was a necessary step to create an enabling collaborative environment among interacting organizations. Experiential learning was identified as a significant factor which helped promote joint understanding and partnership work. Informal interpersonal exchanges and formal knowledge transfer activities facilitated knowledge sharing across interorganizational boundaries, helping to break down silos. The study outlines challenges and strategies that shaped interagency collaboration in the context of mass gatherings. Practical implications arising from this study inform the ways organizers of mass gatherings, public health and safety agencies and professionals can engage in effective partnerships and joint working.

Recent natural disasters have made disaster training a public priority. Multiple methods of disaster preparedness training have been established in hospitals worldwide. Nevertheless, researchers have not yet discovered the most effective method for training hospital personnel in the area of disaster preparedness.The aim of this study is to test the hypothesis that a brief educational intervention would improve hospital staff knowledge about the hospital disaster plan and procedures.A quasi-experimental design was used. The intervention group included 56 professionals and the comparison group included 35 professionals in Greece. The intervention group attended a 5-h course that addressed the basic principles of hospital disaster management. A structured questionnaire was used to estimate the participants' changes in knowledge. Repeated measures analysis of variance (ANOVA), t-test, one-way ANOVA and chi-square test were used to analyse the data.The intervention resulted in a significant improvement in knowledge. The mean score was significantly higher immediately after the intervention programme [86; standard error (SE): 2] than before (44.5; SE: 1.7) (P0.001). The mean score 1 month later was significantly lower (77.2; SE: 2.3) than that immediately after the intervention programme (P0.001), but significantly higher than the mean score before the intervention programme (P0.001). Participants in the control group achieved a score of 40 (SE: 2.4), which was significantly lower than the scores of the intervention group after the course (P0.001).The disaster training course had a great benefit for the participants. This study suggests that a brief educational intervention is beneficial, but more must be done.

Background: Recent natural disasters have made disaster training a public priority. Multiple methods of disaster preparedness training have been established in hospitals worldwide. Nevertheless, researchers have not yet discovered the most effective method for training hospital personnel in the area of disaster preparedness. Aim: The aim of this study is to test the hypothesis that a brief educational intervention would improve hospital staff knowledge about the hospital disaster plan and procedures. Methods: A quasi-experimental design was used. The intervention group included 56 professionals and the comparison group included 35 professionals in Greece. The intervention group attended a 5-h course that addressed the basic principles of hospital disaster management. A structured questionnaire was used to estimate the participants' changes in knowledge. Repeated measures analysis of variance (ANOVA), t-test, one-way ANOVA and chi-square test were used to analyse the data. Results: The intervention resulted in a significant improvement in knowledge. The mean score was significantly higher immediately after the intervention programme [86; standard error (SE): 2] than before (44.5; SE: 1.7) (P

Mass gatherings such as the Olympic Games pose unique challenges for interorganizational collaboration. Such events often bring together organizations that collaborate irregularly or have never engaged in joint working. They involve interaction and collaboration among multiple and diverse agencies aiming at delivering a service to a large clientele, which can often prove challenging. This study used the 2012 London Olympic Games as the empirical setting to examine the interagency collaboration among the multiple and diverse public health and safety organizations involved in one of the world's largest mass gatherings.\ud \ud A single, holistic and exploratory case study design was used and data were collected before, during and after the Games through 39 semi-structured interviews with key informants, direct observations of field exercises and documentary analysis. Data collection commenced in May 2011, 14 months before the actual Games, and was completed in October 2012, two months after the completion of the Games. Template analysis was used to thematically analyze the interviews' transcripts, the fieldnotes from observations and the documents.\ud \ud Findings discuss interagency collaboration in mass gatherings along three main activity domains: leadership, communication and learning. In each domain, a number of challenges and facilitators emerged influencing interagency collaboration. \ud \ud Regarding the leadership domain, the lack of engagement of the leading organization and the ambiguous interoganizational decision-making processes negatively influenced collaboration. Shared micro-level leadership and the use of interorganizational linkages enabled collaborative working. Experienced positional leaders of each organization enabled the decision-making process at the interagency operational level by exercising a range of interpersonal leadership capabilities including flexibility and the ability to negotiate. Codified frameworks at the organizational level also provided leaders with common ground to assist them manage the complex interorganizational processes. \ud \ud Within the second domain, the complex intraorganizational structure of the involved agencies and the high density of information transmitted were associated with a dysfunctional communication experience. Findings revealed that the crafting of boundary-spanning roles and intense face-to-face interaction positively contributed to interagency collaboration. Online information systems and formal intersectoral dissemination of reports were essential in gaining common situational awareness. The implicit cultural rules in the form of communication etiquette shaped how interorganizational collaboration was perceived. \ud \ud Finally, sharing the acquired knowledge was a necessary step to create an enabling collaborative environment among interacting organizations. Experiential learning was identified as a significant factor which helped promote joint understanding and partnership work. Informal interpersonal exchanges and formal knowledge transfer activities facilitated knowledge sharing across interorganizational boundaries, helping to break down silos. \ud \ud The study outlines challenges and strategies that shaped interagency collaboration in the context of mass gatherings. Practical implications arising from this study inform the ways organizers of mass gatherings, public health and safety agencies and professionals can engage in effective partnerships and joint working.