Search

Background: Conflict is a competitive interaction of people directly or indirectly related and through this interaction one part tries to thwart goals, intentions and wants of the other part. Objective: To assess the emotional intelligence (EI) role among health professionals (HPs) and its relation to conflict management resolution in a public hospital. Methods: A cross-sectional study was conducted in a public hospital in Greece from March to September 2020. A random sample of sample of 153 HPs participated in the study. A self-completion questionnaire was structured including questions on socioeconomic characteristics, conflict management and EI. Descriptive and inferential statistics were performed using SPSS 25. Results: The majority of the sample (56.9%) usually conflict with colleague, 23.5% with supervisors, 22.9% with subordinates and 20.3% with the hospital administration. Regarding conflict management strategy, 71.9% try to avoid the conflict and 53.6% negotiate for mutual benefit with the opposite side. 53.3% and 44.7% of the sample stated that differences in educational levels and the unclearly messages provoke conflicts. HPs has moderate level of EI (5.6 ±0.7). The increase of employees’ EI is correlated with the decrease of organizational problems. Contrariwise, employees with high EI, are more aware and satisfied with their work, they know their limits and obligations and are probably more adaptable to changes and requirements. Conclusion: Conflicts appear to be common in hospitals settings. The detection of the factors causing them must be a priority of the modern health management which should encourage health care workers to report conflicts without being punitive.

COVID-19 has affected all aspects of human life so far. From the outset of the pandemic, preventing the spread of COVID-19 through the observance of health protocols, especially the use of sanitizers and disinfectants was given more attention. Despite the effectiveness of disinfection chemicals in controlling and preventing COVID-19, there are critical concerns about their adverse effects on human health. This study aims to assess the health effects of sanitizers and disinfectants on a global scale. A total of 91,056 participants from 154 countries participated in this cross-sectional study. Information on the use of sanitizers and disinfectants and health was collected using an electronic questionnaire, which was translated into 26 languages via web-based platforms. The findings of this study suggest that detergents, alcohol-based substances, and chlorinated compounds emerged as the most prevalent chemical agents compared to other sanitizers and disinfectants examined. Most frequently reported health issues include skin effects and respiratory effects. The Chi-square test showed a significant association between chlorinated compounds (sodium hypochlorite and per-chlorine) with all possible health effects under investigation (p-value

The aim: To evaluate the relationship between adherence to the Mediterranean diet and health literacy and to find possible differences based on the demographic characteristics of the participants. Materials and methods: A cross-sectional study was carried out with a convenience sample from the Greek general population (n=203). The questionnaires were distributed through the Google Forms platform, while some of them were given on hand. The questionnaire used included demographic information, questions about the participants’ health status and nutrition habits and the Health Literacy Scale (HLS - EU-Q16) and the MedDietScore. The survey was conducted June – July 2022. The program SPSS v. 26.0 was used for the analysis of data. Results: The mean score in HLS-EU-Q16 was 12.08 (SD=4.17) (15.8%=inadequate level, 30% =problematic level, 54.2%=sufficient level). The mean score in Med DietScore was 31.54 (SD=4.84) and the majority (72.4%) had medium adherence to the Mediterranean diet. Concerning the HLS-EU-Q16, women and those who had not children, were not patients and used the Internet for finding health information had higher score. In contrast, widows/ers and those with elementary education had lower score. With regard to the Med DietScore, those who were patients and had normal weight had higher score than the rest categories. A negative correlation was found between age-HLS-EU-Q16 (r=-.605, p

Inflammatory bowel disease (IBD) is a multisystemic disease with a wide range of extraintestinal manifestations in both ulcerative colitis and Crohn's disease, while increasing evidence supports the interaction between gut and central nervous system, described as "gut-brain axis". According to epidemiological studies, it seems that patients with IBD present more frequently with impaired mental status compared to the general population, leading to diagnostic and management problems in this group of patients. The association between IBD and mental disorders, such as dementia and autism spectrum disorders, has not been fully clarified; genetic factors and the gut-brain axis seem to be involved. The purpose of this review is to present and analyze the epidemiological data about this issue, describe the possible pathogenetic mechanisms and discuss some considerations about the management of patients with IBD and impaired mental status.

Objectives To explore rates and factors associated with mandatory vaccination support overall and intentions to get vaccinated specifically for COVID‐19 among individuals in Greece. Methods Using data from a nationally representative cross‐sectional survey conducted in October 2020 among 855 adults (≥18 years) in Greece, we estimated support rates for mandatory vaccination and respondents' intention to get vaccinated for COVID‐19 as well as associations thereof with individual sociodemographic, clinical and contextual characteristics. Results About 74% of respondents supported mandatory vaccination and 62% intended to get vaccinated for COVID‐19. The most prevalent reasons against COVID‐19 vaccination were safety concerns related to the duration of clinical trials and potential side effects. Individuals who reported increased trust in healthcare authorities' recommendations, who revealed that their trust in the State increased due to the way the COVID‐19 pandemic was handled, who used preventive services more often, and those with higher income were more likely to both support mandatory vaccination and to indicate intention to get vaccinated for COVID‐19. Participants with worse or better self‐reported health status (compared to average), younger adults, and females were less likely to intend to get vaccinated for COVID‐19. Conclusion The survey revealed that the majority of the Greek citizens favour mandatory vaccination overall and intend to get vaccinated for COVID‐19, driven mostly by utilization of preventive services and trust in healthcare authorities. However, intention to get vaccinated for COVID‐19 was lower relative to mandatory vaccination support. This suggests a need to intensify evidence‐based yet simplified messaging by esteemed healthcare providers to inform the public on the risks and benefits of vaccines.

Objectives The aim of this study was to explore factors that influence individuals' attitudes towards mandatory vaccination in Greece. Methods A nationally representative cross‐sectional telephone survey was conducted via a random multistage selection process in October 2019 in Greece. The survey was designed to obtain information about whether vaccination should be mandated or not among adults 18 years of age or older. A multivariable logistic regression model was used to estimate the association between individuals' sociodemographic, contextual and clinical characteristics, utilization, satisfaction, and trust in the healthcare system and providers and their preference over mandatory vaccination. Results A total of 901 participants fully completed the survey (response rate 90%‐901/1001). About 85% of the respondents supported mandatory vaccination. Individuals who used preventive services more often compared to those who never or rarely used such, those who reported increased trust in official healthcare authorities' guidelines and recommendations compared to those who reported no trust and those who had underage children living in the household were significantly more likely to support mandatory vaccination. No differences were observed for sociodemographic factors and mandatory vaccination support. Conclusion This survey revealed that most Greek citizens support mandatory vaccination, which was critically affected by the utilization of preventive services and trust in healthcare authorities. Our results suggest that healthcare policy interventions should promote mandatory vaccination through multi‐level initiatives to improve healthcare providers' and the general public's understanding of the value of vaccination.

Purpose: Adherence to treatment can be defined as the degree to which a patient’s behavior is consonant with medical or health advice he or she receive as part of his treatment regimen. The aim of this study was: 1) to measure the rate of treatment adherence to among patients with lung cancer from the prospect of both patients and physicians, 2) to measure the degree of concordance between the two prospect, and 3) to identify factors related to adherence for both prospect (patients and physicians). Materials and Methods: A total of 250 patients were included in this study. Information about socio-economic characteristics, depressive and anxiety symptoms (Hospital Anxiety and Depression scale), nicotine dependence (Fagerstrom scale), barriers to accessing care, and the level of treatment adherence was collected through interview. Physicians were enquired about disease and treatment variables as well as patients’ level of adherence. Results: From the patient perspective, only 1.2% of patients displayed poor adherence; whereas the corresponding percentage among physicians was 12.4%. The concordance between the two was low: 0.244. The correlation of measurements made on the same individual was found to be equal to 0.14. Barriers to accessing medication (O.R.=2.82, 95% C.I.: 1.01-8.09) was the only risk factor when adherence was self-rated; barriers to accessing medication (O.R.=2.45, 95% C.I.: 1.03-5.86), education equal to 12 years (O.R.=0.33, 95% C.I.: 0.13-0.82) or higher than 12 years (O.R.=0.28, 95% C.I.: 0.08-0.96), nicotine dependence (O.R.=1.41, 95% C.I. 1.17-1.69) and HADS anxiety score (O.R.=1.15, 95% C.I. 1.03-1.30) were the predictors in physicians’ rating. Conclusions: Differences in rating adherence may underpin communication gaps between patients and physicians. Systemic determinants of poor adherence should not be overlooked. A concerted effort by researchers, physicians and policy makers in defining as well as communicating adherence, while removing its barriers should be made.

One of the key issues of Human Resource Management is the motivation of employees in continuing education, especially in times of economic crisis such as the one Greece is experiencing today. Investing in continuing training is crucial because it can boost economic and competitive performance at an individual, organizational and social level. The aim of this literature review is to present and understand the factors motivating individuals and, in particular, healthcare professionals for Continuing Education with the primary aim of maximizing their effectiveness and efficiency. A review of the literature was carried out on the basis of research and review studies drawn from international (Medline, PubMed) and Greek (IATROTEK) databases. According to the literature, the predominant motivational factors were acquiring new knowledge, maintaining and improving skills, professional development and improvement, health promotion, professional self-knowledge and empowerment, interaction with colleagues and the rise of professional prestige. Lack of time, economic reasons, overworking and family obligations are the main obstacles to participation in continuing education. In a period of protracted economic downturn, the health sector faces the problem of limited budgetary resources while at the same time the demands for more effective and efficient services are increased. Taking into account the incentives that drive health professionals towards the CE, training strategies are planned and implemented which have as their pillar and orientation the specialized training needs of the employees with the ultimate benefit of improving the health services provided while meeting the increased needs and the expectations of society as a whole.

Introduction Clostridium difficile infection (CDI) has been reported to be a cause of flare-ups in patients with inflammatory bowel disease (IBD). Cytomegalovirus (CMV) infection can cause severe disease and complications in immunocompromised patients in consequence of disease or therapy. Aim Our aim was to describe the prevalence and clinical outcomes of CDI with concomitant CMV infection in IBD patients hospitalized for flare-ups in association with the disease itself and medication used. Methods We prospectively identified consecutive patients referred for CDI management during 2015-2017. Stool samples were tested for Clostridium difficile toxin A and/or B and Glutamate Dehydrogenase in patients with clinical symptoms. CDI patients with IBD history were tested for anti-CMV IgG and IgM antibodies by chemiluminescent microparticle immunoassay and underwent histological analysis for CMV on colon biopsies. Data were collected for demographic characteristics, treatment and outcome. Results 125 patients with CDI were enrolled. Among these patients, 14 (11.2%) were diagnosed with IBD. The mean patient age of IBD patients was 52.5±15.4 years at diagnosis of CDI, 85.7% had UC, 14.3% CD, while the age of patients was shared. Eleven of the total of 14 patients (78.6%) tested positive for anti-CMV IgG. Of these, 3 patients (21.4%) exhibited high CMV IgG avidity, without detectable anti-CMV IgM and biopsy-proven CMV colitis. Of the 14 IBD patients with CDI, 8 patients (57.1%) were receiving anti-tumor necrosis factor (anti-TNF) therapy (21.4 % infliximab or golimumab, 7.1% vedolizumab or adalimumab) and 43.5% of patients were being treated with systemic corticosteroids. Four UC patients (28.6%) on steroids of the 14 CDI patients underwent a colectomy whereas none of the not on steroids patients underwent colectomy (p=0.25). Among them, 1 patient (7.1%) had recurrent CDI after 5 months from the first episode of CDI.These patients were treated with vancomycin, metronidazole and fidaxomicin. The mean age of patients that had a colectomy 65.5±9.32 (n=4) was higher than the mean age of those 47.30±14.49 (n=10) who improved (UMann-Whitney=6. p=0.04). Conclusions Immunosuppressive medications and older age are associated with increased risk of CDI and poor outcome. Although, CMV is a rare colonic pathogen in the immunocompetent patient, it should be included and screened when exacerbation of IBD occurs in patients receiving any type of immunosuppressive therapy.

We investigated the factors that shape the working environment and workload, as these are reflected by the presence of conflicts among employees of a General Hospital in Greece. A cross-sectional study was conducted using a 20-part questionnaire, which was administered to 200 health care professionals. 24,5% of the participants referred that they want to quit their profession soon and nurses showed the majority and the doctors the lowest percentage (60%vs 7%). The willingness to change the working environment did not appear to depend on gender, marital status, work position and work schedule. The majority of the respondents reported that conflicts occur at their workplace, with the medical staff showing the greatest average number of conflicts in relation to both the other two professional groups. In particular, it was found that those who did not have a managerial position were 3.9 times more likely to choose to compromise in a conflict.

Background The operating room is a special place in a hospital structure, which has a very high psychological load and many moments of tension, often leading to difficulties in communication between the health professionals involved, as well as cases of verbal and physical violence. Purpose The purpose of the study was to investigate the existence of verbal violence in the operating rooms of three general hospitals in the Peloponnese region of Greece. Methods A cross-sectional survey was conducted of health professionals (physicians and nurses) employed in the operating rooms of three general hospitals in the Peloponnese region. For the data collection, the Verbal Abuse Scale questionnaire (VAS) was used. A total number of 80 questionnaires were self-completed and collected. The statistical analysis was performed with the SPSS Statistics software v.25 (IBM Corp., Armonk, NY). Results Regarding the frequency of verbal violence faced by health professionals, 36.8% of physicians stated that they experience verbal violence once a year whereas more than 20% of nurses reported that such incidents occur more than once a month (p=0.148). For the physicians, the abuser was usually their supervisor, while for the nurses, a physician. The majority of physicians stated that they felt mainly anger (2.94 ± 1.35), disgust (2.58 ± 1.54), and sadness/hurt (2.35 ± 1.37) after the verbal abuse, whereas most of the nurses felt anger (3.49 ± 1.39), disgust (3.05 ± 1.52) and frustration (2.95 ± 1.47). Conclusion Nurses are more often the victims of verbal abuse than physicians and are more likely to feel frustrated after experiencing verbal abuse. Gradual change to the organizational culture is an important measure to stop the occurrence of such incidents.

Background: Detection of adverse drug reactions (ADRs) is a challenging matter for healthcare professionals who contribute significantly to the pharmacovigilance system through their participation inspontaneous reporting. Objective: The objective of this study was the detection and reporting of ADRs related to antibiotics in primary health care in the region of Peloponnese. Methods: A cross-sectional study was conducted in all national health system primary health units of the Peloponnese region in Greece. A self-administered questionnaire was distributed to a total of 404 physicians who provided services in these settings. Descriptive and multivariate statistical analysis was performed using the SPSS 25.0. Levels of significance were two-tailed and statistical significance was set at p =0.05. Results: 306 out of 404 physicians responded to the questionnaire, giving a response rate of 75.8%. 81.6% of physicians stated that they rarely observe ADRs related to antibiotic administration during their practice, 49.8% rarely report them, and 33.7% never report them. Non-serious side effects (42.5%), physicians’ workload (24.1%), and the lack of knowledge about the reporting obligation (20.6%) have been declared as the main reasons of non - reporting. In addition, physicians with ≤10 years of clinical practice rarely reported that they experienced ADRs after antibiotics’ administration compared to those with more work experience and specialized physicians (p= 0.001). Conclusion: ADRs reporting rates among physicians in primary healthcare are low. Changes in physicians’ attitudes are vital and can be achieved through consistent and continuous training programs as well as the inclusion of ADRs and pharmacovigilance themes into the tertiary education curricula.

Many changes occur in a woman's body during pregnancy. These changes (biological, chemical, hormonal, anatomical) can make a pregnant woman both physically and mentally vulnerable. Thus, the aim of this study is to evaluate the quality of life (QoL) in association with depression symptoms in pregnancy.A cross-sectional study was conducted in 123 pregnant women who visited one of the largest obstetrics and gynecology centers in Greece. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depression symptoms and World Health Organization Quality of Life instrument to evaluate quality of life. The collected data were organized with the SPSS software, version 25.The results showed that 15.5% of pregnant women were at an increased risk of developing depression symptoms; 91% of the women declared that their QoL was good/very good, whereas 92.7% was very satisfied with their health status. Depression symptoms seem to be positively correlated with the low household income, unpleasant event during pregnancy, and the trimester of pregnancy. Additionally, unmarried women, an unpleasant event during pregnancy and the second trimester of pregnancy proved to be negatively associated with the quality of life. Women without a risk of depression had better QοL than women who were at risk of depression symptoms.It is important to evaluate the QοL of women during pregnancy with the aim of good prenatal health. The organization of the necessary interventions for mothers' health and their newborns are also of vital importance.

The development of biological agents against tumor necrosis factor (TNF) has revolutionized the management of inflammatory bowel disease (IBD), frequently achieving induction and maintenance of remission in both ulcerative colitis and Crohn’s disease. However, a loss of response due to the development of anti-drug antibodies (ADA) is seen annually in approximately 20% of IBD patients receiving anti-TNF therapy. Current evidence suggests that the use of immunomodulators (IMM), such as thiopurines (azathioprine and 6-mercaptopurine) or methotrexate, may prevent or suppress ADA formation. In this article, we present a comprehensive review of the available literature regarding the efficacy of IMM in the prevention and suppression of ADA development to anti-TNF therapy in patients with IBD.

Background: Disease Management (DM) is an approach to health care that coordinates resources across the entire health care delivery system and throughout the course of a disease.

Background: The inappropriate, irrational use or misuse of antibiotics is observed in all health systems and in all patients’ groups worldwide, especially for children, where antibiotics continue to be the drugs most commonly prescribed. Methods: A cross-sectional study was conducted in all public pediatric clinics in the Republic of Cyprus, from April to May 2015. A questionnaire was distributed to pediatricians in order to identify the antibiotic prescription practices in common childhood diseases and attitudes towards Pharmacovigilance. The SPSS 19.0 was used for the statistical analysis. In total 42 pediatricians and pediatric residents filled out the questionnaire. Results: A significant percentage of the respondents administered empirical therapy for possible group A streptococcus infection (59.5%), they implemented the “watchful waiting” tactic in acute otitis media (66.7%), whereas 11.9% of them administered antibiotics for the prevention of secondary respiratory tract infections. The majority of physicians did not feel diagnostic uncertainty leading to antibiotics prescribing (90.2%) and their prescribing habits were not influenced by parental demand (80.5%). Although 23.1% of physicians observed often/very often Adverse Drug Reactions (ADRs) after antibiotic administration during their clinical practice, however, 47.6% of the pediatricians declared that they did not report them. Conclusion: Health professionals’ continuing education on the use of therapeutic guidelines and protocols and the development of Pharmacovigilance programs could significantly contribute to the avoidance of the misuse of antibiotics in hospital care as well as to health professionals’ awareness on rational prescribing.

UNLABELLED Anemia in the elderly is often related to a higher prevalence of chronic diseases such as chronic kidney failure, arthritis, and malignancy. Erythropoiesis-stimulating agents (ESAs) have been used for years to effectively treat anemia and when used appropriately can substantially improve the health status and quality of life of older adults. Following the 2008 recession in Greece, the government introduced ESA price control restrictions, but no prescribing restrictions, in an effort to reduce drug expenditure. OBJECTIVE ESA prescribing patterns and treatment costs were analyzed to determine inappropriate or appropriate use of these agents and related health care resources in Greece. METHOD A retrospective register-based drug utilization study was carried out using data from prescriptions dispensed at the public pharmacy of the largest social insurance fund (IKA-ETAM), for patients receiving ESAs over a six-month period. For each patient, demographic data, ESA dosage regimen, treatment indication and cost, prescriber specialty, and prescription origin were recorded. RESULTS A total of 14,387 prescriptions from 6,074 patients (median age 74 years) were reviewed. A substantial number of patients (13.5%) were treated for off-label indications, for which the average cost per patient per indication was higher. ESA dosage/frequency of administration varied but was in accordance with recommendations. The percentage of patients who received innovator and biosimilar erythropoietin (EPO) was 88% and 12%, respectively. CONCLUSION For the optimization of ESA utilization and the reduction of treatment costs, strict ESA prescription monitoring, development of registries, and criteria for off-label indications and biosimilar use in naive patients under the umbrella of risk-sharing agreements should be proposed.

The aim of the study was a cost and clinical effectiveness analysis between moist wound healing dressings and gauze in a homecare set up for the treatment of stage III and IV pressure ulcers up to complete healing. In addition, we assessed the overall economic burden on the Healthcare System. Treatment method for each patient was chosen randomly by using sealed opaque envelopes. The authors monitored the healing progress and recorded treatment costs without interfering with the treatment process. The healing progress was estimated by using surface measurement transparent films. To estimate treatment costs, the authors took into account labor costs, cost of dressings, as well the cost of other materials such as cleansing gauzes, normal saline, syringes, examination gloves, antiseptics and adhesive tape. The patient group under treatment with moist wound healing dressings consisted of 27 men and 20 women aged 75.1 ± 8,6 and had an average ulcer surface of 43.5 ± 30.70 cm(2) ; the patient group under treatment with gauze comprised 25 men and 23 women aged 77.02 ± 8.02 and had an average ulcer surface 41.52 ± 29.41 cm(2) (p = 0.25, 95% CI, Student's t test). The average healing time for the moist wound healing dressings group' was 85.56 ± 52.09 days, while 121.4 ± 52.21 days for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The dressing change frequency per patient was reduced in the "moist wound healing dressings group," 49.5 ± 29.61, compared with a dressing change frequency per patient of 222.6 ± 101.86 for the "gauze group" (p = 0.0001, 95% CI, Student's t test). The use of moist wound healing dressings had a lower total treatment cost of 1,351 € per patient compared with, the use of gauzes (3,888 €).

Inflammatory bowel disease (IBD) consists of two disorders: Crohn's disease (CD) and ulcerative colitis (UC). Over the past few decades, a great body of knowledge has accumulated regarding the pathogenesis of IBD, and effective pharmaceutical agents, such as inhibitors of tumor necrosis factor (anti-TNF), have been introduced. Although these agents have dramatically improved the outcome of IBD, up to 70% of patients with CD and 10-30% of those with UC still undergo surgery within 10 years from diagnosis. Because of their young age and high recurrence rates, these patients are appropriate candidates for laparoscopic surgery as an alternative to laparotomy. Recently, considerable attention has been focused on perioperative outcomes of patients who are receiving anti-TNF agents and require surgery. The aim of this narrative review is to discuss the current evidence regarding the impact of perioperative anti-TNF treatment on post-operative complication rates with a special focus on laparoscopic surgery.

Introduction One of the greatest challenges in the healthcare field is planning the health workforce under limited financial resources while being fully capable of responding to an affordable, fair and efficient healthcare system. This study aimed to demonstrate the implementation process of the health workforce planning tool 'Workload Indicators of Staffing Needs' introduced by the World Health Organization. Methods A descriptive and cross-sectional study was carried out at four (two public and two private) hospitals in Greece, to estimate midwifery staff requirements at ward level during 2015-2016, using the WISN software tool. Focus group discussions, structured interviews and annual service statistics from the hospitals' records were used to obtain data. Results Results for both private hospitals showed a shortage in the number of midwives. However, after combining the interpretation of the results, as indicated by the WISN methodology and the structured interviews, current and required staffing is in balance in both. On the other hand, both public hospitals indicate a surplus of midwives (1.83 and 1.33 ratios for the General hospitals in Korinthos and Kalamata, respectively). Conclusions This study demonstrated the implementation process of the WISN methodology through its application in midwifery staff at four hospitals in Greece and confirmed its usefulness in estimating staffing requirements. The application of the WISN methodology should be viewed as a vital tool in assessing overstaffing and understaffing through the estimation of workload pressure among different categories of health staff, thus providing the basis for effective health workforce redistribution in Greece.

Background: Anti-TNFa medications represent the first effective biologic therapy for IBD that has largely revolutionized treatment. The aim of this study was to quantify the risk of MM and other skin cancers among patients from Northern Greece area with IBD who take immunosuppressive or biologic anti-TNF medications. Methods: The current study was conducted during a 3-year period (2014-2016). Clinical history and metabolic data of all patients were extracted from the IBD database that is kept since 1980. 101 patients with IBD from Northwestern Greece, were studied. Results: The mean age of enrolled patients was 44.2±15.9 years old ranging from 17 years to 77 years old. No sun burn was reported from the 44.6% of the patients, 53.5% presented mild reticular veins in the face, and lack of any elastosis was noticed in 60.4%. The occurrence of two cases with squamous and basal cell carcinoma is an important finding. The absence of any case with MM should not quiet down but should strengthen our efforts for further implementation of preventive measures. Conclusions: Furthermore, education of patients to avoid deleterious sun exposure may help decrease MM incidence.

Inflammatory bowel disease (IBD) is a multisystemic disease. The ear is a rare but recognized site of extraintestinal manifestations of IBD. In external ear, the more common manifestations of IBD are pyoderma gangrenosum, metastatic Crohn's disease and relapsing polychondritis and the treatment includes corticosteroids and anti-TNF agents. Sensorineural hearing loss (SNHL) is the most common ear disease in IBD and especially in patients with ulcerative colitis. In most cases of IBD patients with SNHL, the hearing loss is attributable to autoimmune inner ear disease (AIED). Diagnosis of AIED is based on clinical presentation, the demonstration of a progressive sensorineural hearing loss in periodic audiological tests, a response to immunosuppressive drugs and exclusion of other causes of SNHL. The only diagnostic test that is available for clinical use is the Otoblot test (Western blot for antibodies against 68 kD protein-inner ear antigens). Initial therapy is usually steroids, with a step up to anti-TNF-a therapy and cochlear implantations with failure of treatment. Furthermore, Cogan's syndrome, a chronic disease characterized by deafness, vertigo keratitis and aortitis, has been associated with IBD and mainly with Crohn's disease.

The aim of this study was to evaluate alcohol consumption and narcotics use among patients with inflammatory bowel diseases (IBD). A comprehensive literature search was conducted in Medline using relevant keywords. The references of the retrieved articles were also searched to identify additional articles. Only English-language studies that provided evidence on alcohol consumption and/or narcotics use among non-hospitalized IBD patients were included in the present review. Twelve studies were included that examined the use of alcohol among IBD patients. The prevalence of alcohol consumption among IBD patients appeared to be similar to that of the general population. The majority of the studies reported worsening of IBD symptoms among patients who consumed alcoholic beverages. Four studies were identified that evaluated narcotics use as analgesia among IBD patients. Narcotics use was prevalent among IBD patients and correlated with a longer disease duration and comorbid mental illnesses. The available evidence suggests that alcohol consumption may have a deleterious effect on IBD symptoms. Furthermore, a considerable proportion of IBD patients are reported to use a narcotic as analgesia and this was correlated with their mental health status. Further studies are needed to address these important facets of IBD.

Background: Patients with mental health problems are in high risk to develop addiction, since smoking incidence is three times higher than that of the general population. The aim of the study was to investigate the factors affecting mental health patients’ smoking habits. Methods: The sample of study were 356 patients out of 403 initially approached, with 142 hospitalized in hospital facilities and 214 in community settings. The «Smoking in psychiatric hospitals” and General Health Questionnaire (GHQ-28) questionnaires were used. A principal component analysis was performed using the correlation coefficients of the various variables and an orthogonal varimax rotation, in order to interpret the seven factors emerging. Among the variables the most important factors appeared to be the type of healthcare facility, legal status, depression and age. Results: The type of healthcare facility was correlated to demographic characteristics, clinical features, psychopathology and functionality, but also to the attitudes and behaviors related to smoking. More specifically, the in-hospital patients were heavier smokers, about 90% of the patients said they would consider quitting smoking. The various variables had only a small effect on the intention to quit smoking. The comparison of the coefficients of determination of each variable, showed that age had the strongest effect (R2=0.152), while the GHQ D subscale (severe depression) had the least significant effect (R2=0.023). From all (7) factors, it appears that hospitalization was positively correlated with factor 5 and negatively with the factors 2, 3 and 6, legal status (commitment order) negatively with factors 1 and 4, while depression (or consuming antidepressants) positively factor 4 and negatively to factors 1 and 3. Finally, age was the only variable that is associated with the agent 7. Conclusions: Patients are permissive to staff’s smoking in the healthcare facility and may resist attempts to restrict it. It is important that these conclusions are taken into account in any systematic attempt to limit smoking within mental health settings.

Introduction: Numerous countries have launched campaigns regarding sun protection in the last decades. Aim: The aim of the present study was to assess an intervention program aimed at higher knowledge and healthier attitudes regarding sun protection. Materials and Methods: The sample consisted of 4,133 students aged 8-12 years from a single Greek province. Results: In most items, knowledge levels after the intervention were found to be higher than those before (2.8±0.9 vs 3.3±0.9), while knowledge about sun protection factors seems to have had the highest improvement (27.1% vs 56.6%). However, student attitudes did not appear to improve, with the exception of applying sunscreen with a higher SPF (29.7% vs 54.8%). Girls seemed to have healthier attitudes compared to boys, but gender played no role with regard to knowledge levels. Also, place of residence did not play any role regarding knowledge levels, although those living in semi-urban areas seemed to have more unhealthy attitudes. Logistic regression by correlating knowledge and attitudes established that higher knowledge levels are usually accompanied by healthier attitudes, albeit marginally. Conclusions: The intervention had a positive contribution to the student knowledge level regarding sun protection and also led to small improvements regarding some attitudes. Continuous similar interventions could lead to better results and the adoption of healthier attitudes.

Background: Considerable studies directly connect the complications in diabetic patients, and especially peripheral neuropathy, with the emergence of depression. Neuropathetic pain may deteriorate the general health status of the diabetic patient and glycaemic regulation. Purpose: The purpose of this study was to investigate the appearance and degree of diabetic peripheral neuropathy and its correlation with depression, with other parameters of the disease and also duration. Methods: 57 diabetic patients participated with diagnosed diabetic peripheral neuropathy (male n=27, female n= 30, mean of age 72.7±6.35 years). The first part of Michigan Neuropathy Screening Instrument and the Zung Depression Rating Scale were used as tools for our study. Data was analysed with the SPSS 18.0 statistic program. Results: 57.9% of the patients were overweight, 35.1% were obese and only 7% were within normal weight range. The BMI findings between the two genders indicate that male participants are more often obese than females. Women surpassed men in the category of overweight patients (p

Introduction: The stigma of mental illness and the ensuing social exclusion are due to the lack of knowledge on the causality of mental illness. Aim: The purpose of this study was to record the stigmatic attitudes of health professionals towards depression, patients suffering from it and the available therapeutic approaches. Material and Methods: The sample of the study included 609 health professionals working in the General Hospital of Corinth. The collection of the empirical material was performed using an anonymous questionnaire. The statistical analysis was performed with the statistical program SPSS 17.0. Results: Although the health professionals showed more optimistic attitudes towards the abilities of the mentally ill, they seem to maintain stereotypes, proving that stigmatization of the mentally ill and prejudice around mental illness continue to exist. Participants identified psychosocial and psychotherapeutic interventions as the most effective forms of therapy, such as supportive social destination (74.4%), healthy eating and physical activity (67.9%), psychoanalysis (60.6%), relaxation techniques (60.5%) and counselling (53.2%), recording ambivalent attitudes towards psychiatric medicines, questioning their effectiveness. The economic crisis has had a direct impact on health professionals as well burdened their psyche (78.3%) and created problems in everyday work (86.7%). Conclusion: Health professionals must be protagonists, free from the stigma attached to mental illness as only in this way will they be able to transmit optimism and feelings of acceptance.

Background: Diabetes mellitus (DM) represents a continuously growing worldwide threat with major financial impact on the healthcare systems. The importance of tight glycaemic control in patients with DM type II is well established and is most effectively accomplished with the proper cooperation of both the treating physicians aswell as the treated subjects.Aims: The aim of our study was to evaluate the level of awareness of patients with DM type II about the various aspects of DM, including the nature of the disease, its precipitating factors and complications, as well as its treatment.Methodology: The patients were asked to complete anonymously a questionnaire concerning their knowledge about diabetes, its basic pathophysiology and complications, the treatment options and possible side-effects. Data were analyzed using STATA statistical software (Version 9.0).Results: Eighty patients were on oral hypoglycaemic agents (OHA), 34 on insulin while 4 were under a hybrid treatment. Among patients on OHA, 40 patients (50%) were taking a combination of them. 13.4% of the sample was aware of what DM stands for, 84.9% did not know the type of DM they were suffering from, while (85.7%) considered that obesity plays a major role in the pathogenesis of DM. Concerning the therapy of DM, only 54.83% of the patients were aware of the brand names of their antidiabetic medication, 88.2% did not know theirway of action, while 60.5% did not know the possible side effects. The majority of the sample, 60.5%, assumed that blood glucose should be measured only before meals.Conclusions: The knowledge of the subjects visiting the center for the first time was found to be inadequate. This is probably due to inadequate information, non-availability of educational material and improper guidance.

Background: Ghrelin and adiponectin are recently discovered peptides. Ghrelin has a crucial role in the regulation of food intake and energy homeostasis, and adiponectin is secreted by adipocytes, andit has been proposed to mediate obesity-related insulin resistance. Both they are playing a critical role in a variety of physiological processes including endocrine, metabolic, cardiovascular, and other actions. Furthermore, other potential clinical applications of ghrelin include the treatment of patients with diabetes mellitus and infections, likewise adiponectin plays an important role in diagnosis of cardiovascular disease.Conclusions: Further studies need to specify the accurate results and the action mechanisms of adiponectin in order to facilitate the clinical practice; as well as to clarify the role of these adding a new knowledge in international scientific community.

The aim of this study was to investigate the use of alcohol in health professionals during the economic crisis in Greece. The sample included 579 health professionals. Despite the fact that alcohol consumption was low and women held more negative views on the effectiveness of its use compared to men, they consumed more than men both in quantity (mean 1.57 vs 1.46, p=0.291) and in frequency (mean 1.98 vs 1.73, p=0.132). Employees with a higher level of education expressed more opposition to the use of alcohol than those with a basic level of education (93.5% vs 66.7%, p=0.004). There was a significant positive correlation between the amount of alcohol consumed after a stressful event and the frequency with which this amount of alcohol consumption occurred in workers.

Introduction: Due to a variety of circumstances and world-wide research findings, patient safety andquality care during hospitalization have emerged as major issues. Patient safety deficits may burdenhealth systems as well as allocated resources. The international community has examined severalproposals covering general and systemic aspects in order to improve patient safety; several long-termprograms and strategies have also been implemented promoting the participation of health-relatedagents, and also government agencies and non-governmental organizations.Aim: Those factors that have negative correlations with patient safety and quality healthcare weredetermined; WHO and EU programs as well as the Greek health policy were also reviewed.Method: Local and international literature was reviewed, including EU and WHO official publications,by using the appropriate keywords.Conclusions: International cooperation on patient safety is necessary in order to improvehospitalization and healthcare quality standards. Such incentives depend heavily on establishing worldwideviable and effective health programs and planning. These improvements also require further stepson safe work procedures, environment safety, hazard management, infection control, safe use ofequipment and medication, and sufficient healthcare staff.

Introduction: The kidney disease is a common situation, it is accompanied by a significantmorbidity/mortality and despite the development of substitution renal functions methods (SRFM) and transplantation, the prognosis is unfavorable.Aim: The aim of the present review is the assessment of the necessity for sending to theNephrology Team (NT) in the early stage of RF.Results: Lately, it has been documented that the timely sending to the NT, can significantlyimprove the survival of patient with kidney disease. On the contrary, the delayed sending has asa result not only the non timely measure uptake for the delay of the loss of renal function, butalso the later therapy for the uremic complications.According to Eadington (1996) the sending is considered as a delayed, when the provision ofhealthcare services could be improved with the timely contact with the Nephrology Services.Both in Europe and North America, the delayed sending comes up to the 30-40% of people whoare inducted in dialysis.The benefit from the early sending to the NT, it is important and consists of the regimens forthe delay of the kidney disease development,, timely information for the patient about theSRFM, timely vascular preparation or other kind of accessibility, non-urgent dialysis initiation,patients’ training, lower financial cost, less hospitalization days, transplantation preparation andlower mortality.Conclusions: Optimal sending is the timely sending since it makes possible the diagnosis, thedelay of the development of KD and the prevention of the complications. Furthermore, givestime for the appropriate medical and psychological preparation of the patient and the initiation ofdialysis in the appropriate time.The measures which should be adopted include the improvement training and communication ofhealthcare workers and services interference, as well as the enactment of guidelines.