The characteristics of Greek training and experience in pulmonary endoscopic techniques: Is it time for changes?

SUMMARY.OBJECTIVES. This study aimed to report the characteristics of thetraining in pulmonary endoscopy provided in Greece and to evaluatequantitive and qualitive parameters of interventional endoscopyperformance among Greek pneumonologists. METHOD. A speciallydesigned questionnaire was completed by 171 specialists and fellowsin pulmonology and the responses were analyzed. RESULTS. An agedifference in endoscopic skills was observed; 97% of the respondentsaged <50 years had been trained in flexible bronchoscopy, comparedwith 86% of those aged >50 years (p=0.016). In spite of a high rateof training, 65% of respondents reported performing less than 50bronchoscopies per year. In addition, 21% were familiar with thetechnique of transbronchial needle aspiration (ΤΒΝΑ), but only 19%of them performed over 30 procedures per year. Other advanceddiagnostic techniques including endobronchial ultrasound (EBUS),auto-fluorescence and medical thoracoscopy are performed by asmall minority of pulmonologists while therapeutic techniques (i.e.rigid bronchoscopy, electrocautery, cryotherapy and laser therapy)by very few (5-12%). The majority of respondents would welcomeadditional training, not only in advanced interventional techniquesbut also in standard bronchoscopy; 94% agreed that they wouldbenefit from the publication of practice guidelines on endoscopictechniques, and 71% supported the instruction in endoscopy ofall pulmonologists during their fellowship. CONCLUSIONS. Theendoscopic training provided to Greek pneumonologists could beimproved considerably and initiatives should be taken in order toupgrade and unify both the teaching of endoscopic techniques andthe services provided. Pneumon 2011, 24(1):48-55

Co-procurement: making the most of collaborative procurement

While the procurement decision is generally made by individual buyers, this study investigates how a group of buyers can make a shared decision. We call this collaborative approach, co-procurement. A mathematical model is formulated for the decision of procurement from multiple suppliers. The model is solved for individual buyers. The outcome shows the optimal number of items a buyer should buy from different suppliers such that the total cost is minimised for that buyer. Next, it is investigated how a group of buyers could make this decision together. The proposed model takes into account transaction costs of collaboration, to determine the optimal size of the collaboration and the involved parties. The idea is new in the old direction of procurement and it introduces the concept of transaction costs in this area and analyses its impact on the optimal collaboration size and mix. A case study from Dutch Food Valley is provided to investigate the benefits of co-procurement and validate the developed structure. The results indicate that co-procurement can bring considerable cost-savings through consolidation of orders and more efficient transportation schedules. A sensitivity analysis is conducted to determine the impact of changes in the transaction cost in favour of the co-procurement.Transport and LogisticsTransport Engineering and LogisticsTransport and Plannin

The health related quality of life of Greek patients with chronic obstructive pulmonary disease

SUMMARY.Background: Chronic Obstructive Pulmonary Disease (COPD) is an advancing disease, characterized by progressive deterioration of lung function. The impact of the disease on human health is massive and it affects the health related quality of life (HRQoL) of patients in every aspect. This study assessed HRQoL of Greek patients with COPD and its association with demographic and clinical factors, and compared the findings with with those of COPD studies in other countries. In addition, the cost of pharmaceutical treatment of these patients was assessed. Material and methods: The study group consisted of 136 Greek patients with COPD (103 men, mean age 64.7±9.2 years, mean FEV1 59±25.6% predicted).I Information was recorded about their demographic and clinical parameters. Their HRQoL was assessed using the Greek versions of the Medical Outcomes Study Short Form 12 (SF-12) and St George’s Respiratory Questionnaire (SGRQ). Results: The HRQoL of Greek patients with COPD was found to be significantly lower than both that in the general population and that of patients COPD reported in other countries. Almost all the HRQoL scores were shown to be associated with gender, educational and financial status, duration of symptoms, age at onset of symptoms, pack-years of cigarettes smoked, disease stage, degree of dyspnoea, pO2 and pCO2 levels, numbers of medical visits and hospital admissions, participation in rehabilitation programmes, and co-morbidities, such as cardiovascular disease and diabetes mellitus (DM). The average cost of pharmaceutical treatment was assessed at 110 ± 63 € / month and was associated with the stage of the disease, the smoking habit, the degree of dyspnoea, annual numbers of medical visits and admissions and nebulizer usage. Conclusions: The HRQoL of Greek patients with COPD is influenced by multiple parameters, which should all be taken into consideration when their treatment is being planned. Cost-effective studies should be made on populations of Greek patients with COPD and more emphasis should be placed on rehabilitation programmes in Greece. Pneumon 2013, 26(2):139-151

Minimizing waiting times at transitional nodes for public bus transportation in Greece

Scheduling of transit networks is one of the most addressed problems in the mathematical optimization science, due to the increase of public transportation in the last decade. Researchers have introduced various formulations to address the problem of timetabling, using different objectives like bus synchronization and passenger demand. In this paper, we present a mixed-integer linear programming formulation with the objective of minimizing passenger waiting times at transitional transfer nodes, taking also into consideration high passenger demand that occurs at certain times. © 2013, Springer-Verlag Berlin Heidelberg