The Short Anxiety Screening Test in Greek: translation and validation

BACKGROUND: The aim of the current study was to assess the reliability and validity of the Greek translation of the Short Anxiety Screening Test (SAST), for use in primary care settings. The scale consists of 10 items and is a brief clinician rating scale for the detection of anxiety disorder in older people, particularly, in the presence of depression. METHODS: The study was performed in two rural primary care settings in Crete. The sample consisted of 99 older (76 ± 6.3 years old) people, who fulfilled the participating criteria. The translation and cultural adaptation of the questionnaire was performed according to international standards. Internal consistency using the Cronbach α coefficient and test-retest reliability using the intraclass correlation coefficient (ICC) was used to assess the reliability of the tool. An exploratory factor analysis using Varimax with Kaiser normalisation (rotation method) was used to examine the structure of the instrument, and for the correlation of the items interitem correlation matrix was applied and assessed with Cronbach α. RESULTS: Translation and backtranslation did not reveal any specific problems. The psychometric properties of the Greek version of the SAST scale in primary care were good. Internal consistency of the instrument was good, the Cronbach α was found to be 0.763 (P < 0.001) and ICC (95% CI) for reproducibility was found to be 0.763 (0.686 to 0.827). Factor analysis revealed three factors with eigenvalues >1.0 accounting for 60% of variance, while the Cronbach α was >0.7 for every item. CONCLUSIONS: The Greek translation of the SAST questionnaire is comparable with that of the original version in terms of reliability, and can be used in primary healthcare research. Its use in clinical practice should be primarily as a screening tool only at this stage, with a follow-up consisting of a detailed interview with the patient, in order to confirm the diagnosis

External Jugular Vein Aneurysm Presenting as a Cervical Mass

Venous aneurysms are rare causes of neck mass. Among neck veins, aneurysms of the external jugular vein are extremely uncommon. We present a case of a woman with a history of prior internal jugular vein catheterization who presented at a rural primary health care unit with a nontender progressively enlarging swelling in the right supraclavicular region. B-mode and Doppler ultrasound examination revealed a saccular dilatation of the external jugular vein, suggesting a posttraumatic venous aneurysm. Saccular aneurysms of the external jugular vein are uncommon and only rarely lead to serious complications. Access to ultrasound examination can allow early detection of this entity

Development and evaluation of an appropriate electronic patient records system for primary health care

Introduction: The electronic patient records system (EPR) is a significant tool for the continuity of care in the primary care setting. Several attempts have been made in Greece to establish an EPR for primary health care (PHC), but none of them managed to be widely accepted. Aim: The design, the development and the evaluation of an EPR system based on appropriate classifications and optimized for use in the PHC. Methods: A systematic review was performed in medical literature and the Internet for existing EPR systems in the PHC, to select one as prototype. The perceptions among Greek general practitioners about classifications and EPR systems and the patterns of use of existing EPR systems were analyzed. A new EPR system was developed based on Episode of Care and the classifications ICD10, ATC and ICPC-2. The new EPR system was installed and evaluated in PHC settings in Greece and Cyprus. The evaluation was based on information collected during the implementation process, interviews with the users and the use of questionnaires. Results: Twelve EPR systems were found and an EPR system named Transhis was selected as prototype. The new EPR system we developed was based on minimal data set, optimized for speed, for documenting each consultation through ICPC-2 codes. The functions that were added included: custom forms created by the user, medical information for user assistance, prints through print generator, import images facility from scanner or camera. Problems identified during the implementation were corrected. The use of the new EPR system was accepted by the users, but organizing problems and attitudes identified in the literature as «resistance to computerization» were recorded. The new EPR system’s evaluation by the users was positive and their satisfaction was increased as its use increased in time. Conclusion: The new EPR system is a tool for the PHC in Greece. A wider adoption of this EPR system will provide useful results.Εισαγωγή: Ο ηλεκτρονικός φάκελος ασθενή είναι ένα σημαντικό εργαλείο για την συνέχεια στη παροχή φροντίδας στην πρωτοβάθμια. Στην Ελλάδα έχουν γίνει σημαντικές προσπάθειες στο παρελθόν χωρίς όμως να γίνει γενίκευση κάποιου λογισμικού. Σκοπός: Ο σχεδιασμός, η κατασκευή και η εφαρμογή ενός λογισμικού βασισμένο σε αποδεκτές κωδικοποιήσεις κατάλληλου για χρήση στην πρωτοβάθμια φροντίδα υγείας. Μέθοδος: Έγινε αναζήτηση των υπαρχόντων λογισμικών ΗΦΑ για την ΠΦΥ, στο Medline, στο Internet και σε συνεργαζόμενα πανεπιστήμια και επιλέχθηκε ένα εξ αυτών ως πρότυπο. Καταγράφηκαν οι απόψεις και οι αντιλήψεις γενικών ιατρών με την χρήση ερωτηματολογίου Ένα νέο λογισμικό αναπτύχθηκε στο οποίο χρησιμοποιήθηκαν οι ταξινομήσεις ICD10, ATC και η ICPC-2, η οποία μεταφράστηκε στην Ελληνική γλώσσα. Το νέο λογισμικό εγκαταστάθηκε και έγινε εφαρμογή του σε μονάδες ΠΦΥ σε Ελλάδα και Κύπρο. Η αξιολόγησή του έγινε με καταγραφή της διαδικασίας, συνεντεύξεις με τους χρήστες και συμπλήρωση ερωτηματολόγιων. Αποτελέσματα: Βρέθηκαν δώδεκα λογισμικά και επιλέχθηκε το λογισμικό Transhis ως πρότυπο. Το νέο λογισμικό που δημιουργήθηκε καλύπτει τις λειτουργίες που πρέπει να διαθέτει ένα λογισμικό ηλεκτρονικού φακέλου και επιπλέον διαθέτει ταχύτατη εισαγωγή βασικής πληροφορίας με κωδικούς ICPC-2, φόρμες οριζόμενες από τον χρήστη, ιατρική πληροφορία για φαρμακευτικά σκευάσματα, εκτυπώσεις και εισαγωγή εικόνων από σαρωτή ή φωτογραφική μηχανή. Κατά την εφαρμογή του καταγράφηκαν αρχικά δυσκολίες που σταδιακά επιλύθηκαν. Η χρησιμοποίηση του λογισμικού ήταν αποδεκτή σε όλο το διάστημα της μελέτης. Καταγράφηκαν οργανωτικά προβλήματα και συμπεριφορές όπως η τεκμηριωμένη από την βιβλιογραφία «resistance to computerization». Το λογισμικό αξιολογήθηκε συνολικά θετικά από τους χρήστες, ενώ ο βαθμός ικανοποίησής τους αυξήθηκε με την αύξηση του χρόνου χρήσης του. Συμπεράσματα: Το νέο λογισμικό αποτελεί ένα εργαλείο για την ΠΦΥ στην Ελλάδα. Η ευρύτερη εφαρμογή του αναμένεται να δώσει χρήσιμα αποτελέσματα

Monitoring Reasons for Encounter via an Electronic Patient Record System: the Case of a Rural Practice Initiative

The objective of this brief communication was to tabulate common reasons for encounter in a Greek rural general practice, as result of a recently adopted electronic patient record (EPR) application. Twenty encounter reasons accounted for 3,797 visits (61% of all patient encounters), whereas 565 other reasons accounted for the remaining 2,429 visits (39%). Number one reason for encounter was health maintenance or disease prevention seeking services, including screening examinations for malignancies, immunization and provision of medical opinion reports. Hypertension, lipid disorder and ischemic heart disease without angina were among the most common reasons for seeking care. A strengths/weaknesses/opportunities/threats (SWOT) analysis on the key role of an EPR system in collecting data from rural and remote primary health care settings is also presented.</p

The Short Anxiety Screening Test in Greek: translation and validation

Abstract Background The aim of the current study was to assess the reliability and validity of the Greek translation of the Short Anxiety Screening Test (SAST), for use in primary care settings. The scale consists of 10 items and is a brief clinician rating scale for the detection of anxiety disorder in older people, particularly, in the presence of depression. Methods The study was performed in two rural primary care settings in Crete. The sample consisted of 99 older (76 ± 6.3 years old) people, who fulfilled the participating criteria. The translation and cultural adaptation of the questionnaire was performed according to international standards. Internal consistency using the Cronbach α coefficient and test-retest reliability using the intraclass correlation coefficient (ICC) was used to assess the reliability of the tool. An exploratory factor analysis using Varimax with Kaiser normalisation (rotation method) was used to examine the structure of the instrument, and for the correlation of the items interitem correlation matrix was applied and assessed with Cronbach α. Results Translation and backtranslation did not reveal any specific problems. The psychometric properties of the Greek version of the SAST scale in primary care were good. Internal consistency of the instrument was good, the Cronbach α was found to be 0.763 (P 1.0 accounting for 60% of variance, while the Cronbach α was >0.7 for every item. Conclusions The Greek translation of the SAST questionnaire is comparable with that of the original version in terms of reliability, and can be used in primary healthcare research. Its use in clinical practice should be primarily as a screening tool only at this stage, with a follow-up consisting of a detailed interview with the patient, in order to confirm the diagnosis.</p

The Effect of Wet Conditions and Surface Combat Swimming on Shooting.

INTRODUCTION: Shooting ability is an important aspect of performance in some sports and is vital during a military operation. Load carriage, clothing, and equipment normally associated with fatigue and reduced field of vision or lack of stability at a specific point are important factors that affect the ability to aim when shooting. Additionally, gun support and equipment appear to differentially affect shooting ability with varying shooting positions. All of the studies examining these factors have taken place on dry land and not in water. However, up to date, no study has examined the effect of wet conditions, especially after surface combat swimming (sCS), on shooting ability in different shooting positions. The purpose of this study was to determine the effect of fatigue, produced by prolonged sCS, on a fighter&apos;s shooting ability. In addition, we investigated whether the effect of fatigue and wet conditions differed between the shooting positions. MATERIALS AND METHODS: Forty-five participants performed 10 shots in a shooting simulator while standing (ST) and 10 shots while kneeling (KN). This was performed twice and in three conditions: dry, wet, and after 1,000 m of sCS. RESULTS: Wet conditions did not significantly affect shooting abilities. Surface combat swimming negatively affected shooting ability when both ST and KN. The reduction in the center of gravity (COG) of the shots after sCS was 3.7 ± 2.5\% for ST and 3.5 ± 0.8\% for KN (P {\textless} .01). This was accompanied by the increase in horizontal and vertical movement of the gun after the sCS (P {\textless} .01). Kneeling was more stable, as shown by a higher percentage of COG of the shots by 3.3 ± 0.1\% (P {\textless} .01) and by fewer gun movements in both axes (P {\textless} .01). CONCLUSIONS: In conclusion, combat swimming affects shooting ability, both in ST and in KN positions. The KN position provides better stability and improved shooting ability