Prevalence and associated factors of anxiety and depression in students at a Greek university during COVID-19 lockdown

Background: Restrictions on movement and lockdown are measures taken in many nations, in response to the COVID-19 pandemic. University students are additionally burdened by the transition to distance e-learning. The aims of the study were to investigate the prevalence of anxiety and depression in university students and to identify associated risk factors.Design and Methods: An online questionnaire was administered to 2,009 students in the University of Patras, Greece, during the national lockdown. Socio-demographic, academic data, and the forced disruption of daily life were assessed along with the Greek version of the Hospital Anxiety and Depression Scale.Results: Anxiety and depression prevalence was 35.8% and 51.2% respectively. Age, school of study, financial status, self-perceived health status, level of satisfaction with the state's and university's response and specific aspects in the daily routine were associated with both anxiety and depression scores. At higher odds of both depression and anxiety were students with low income, bad health status, annoyed at staying home and those who encountered difficulties with the online education system. Additional risk factors for depression were studies in humanities and social sciences, and low satisfaction with the university's response, while for anxiety were studies in agricultural sciences and absence of information about COVID-19.Conclusions: The proportion of Greek students showing depression and anxiety, during the restrictive measures, is alarming. Mental health in university students should be monitored. Mitigation strategies should focus on specific personal, academic and social variables that have been identified as protective factors

Efficacy and acceptability of selective serotonin reuptake inhibitors for the treatment of depression in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for the treatment of depression in patients with Parkinson's Disease (PD) but data on their efficacy are controversial.</p> <p>Methods</p> <p>We conducted a systematic review and meta-analysis of randomized controlled trials to investigate the efficacy and acceptability of SSRIs in the treatment of depression in PD.</p> <p>Results</p> <p>Ten studies were included. In the comparison between SSRIs and Placebo (n = 6 studies), the combined risk ratio (random effects) was 1.08 (95% confidence interval: 0.77 - 1.55, p = 0.67). In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37). An acceptability analysis showed that SSRIs were generally well tolerated.</p> <p>Conclusions</p> <p>These results suggest that there is insufficient evidence to reject the null hypothesis of no differences in efficacy between SSRIs and placebo in the treatment of depression in PD. Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded. The comparison between SSRIs and TCAs is based on only three studies and further trials with more pragmatic design are needed.</p

The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

Abstract Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF. Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding). Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77). Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability

Investigation musculoskeletal disorders in perioperative nurses and the effectiveness of educational intervention to prevent and treat them

Introduction: The surgery unit is a particularly labor-intensive environment in thehospital. Studies reflect the correlation of labor risk factors for musculoskeletalinjuries among nurses but few have investigated the relationship to perioperativenurses and this scientific gap covered this thesis.Purpose: The purpose of this thesis was to investigate in our country the prevalenceof musculoskeletal disorders in perioperative nurses, to assess occupational riskfactors as well as to explore the knowledge and perceptions of musculoskeletalproblems and how they improved after an educational intervention.Material and Methods: Four hundred and two Greek perioperating nurses workingin regional hospitals participated and 134 who constituted the sample of educationalintervention. For the data collection anonymous self-administered questionnaire wasused one to investigate the prevalence and the aggravating factors of musculoskeletaldisorders in the operating room, which consisted of three parts (investigatingmusculoskeletal symptoms, description of work, psychometric evaluation) and one forthe exploration of knowledge. The answers from the questionnaires were recorded ona personal computer in the statistical package on social sciences (SPSS, version 19).For the statistical analysis of the data, the following tests were used:Wilcoxonsignedtest, McNemartest, Pearson's x2test or Fisher'sexacttest, Mann-Whitneytest, Pairedt-test, Student'st test, Bonferroni correction, Spearman correlationcoefficient, and multiple step linear regression. The significance level was set at 0.05.Results: The mean age of perioperative nurses in the sample was 42.3 years (SD =7.8 years), with a high percentage (78.7%) being women. The 88.0% worked as scrubnurses and 88.4% as circulating nurses. Most common reported problems wereworking in the same position for long time periods (73.8%), moving and lifting heavyobjects and equipment (71.0%), keeping working while they are in pain (70.8%),working in weird/uncomfortable position (63.8%) and working for many hours or inshifts (63.3%).Additionally, 61.0% of the participants reported musculoskeletal symptoms in theirlow back in the last year, 54.6% in their neck, 41.0% in their shoulder, 34.4% in theirknee and 33.1% in their wrist/hands. Regarding the last 7 days, 43.0% of the participants reported musculoskeletal symptoms in their low back, 33.3% in theirneck, 24.2% in their shoulder, 18.0% in their knee and 17.4% in their upper back.“Environment” and “Personal preferences” subscales had higher values in bothranking and scoring scales, indicating that they were of greater importance, while“Equipment and media” and “Surgery procedures” subscales had lower values,indicating that they were of lower importance. Regarding “Enviroment” subscale,“Temperature” and “Group work” had similar rankings, “Surgery arrangement” wasranked as the most important and “Administration delay” was ranked as the leastimportant. Regarding “Personal preferences” subscale, “Sitting/ Standing” was rankedas the most important.Furthermore 134 perioperative nurses took part in an educational intervention. Afterthe end of all the factors most affect the work of the participants. The exceptions wereaccelerated work, psychosocial factors and the lack of staff who had no changebecause they were identified as important from the beginning. After the interventionthe perioperative nurses claimed that they knew more about MSDs, ergonomics andmanual handling, than they knew before. The percentage of correct responses rangedbefore the interference from 10.5% to 95.55 and after from 61.4% to 100%.Women had significantly greater increase in knowledge scores that gainedsignificantly more knowledge after the intervention compared with men. Also,increasing the score was significantly higher among nurses who is under 30 years ofage compared to nurses who were over 40 years (p = 0,004). The increase ofknowledge was significantly higher among nurses who had no second degree and theincrease in score was significantly higher among nurses working in this area no morethan 4 years compared with nurses who worked over 10 years (p = 0,039). In contrast,significantly less was to increase knowledge score nurses who recognize all riskfactors at work for musculoskeletal disorders and those who understood that it is veryimportant to take appropriate preventive measures.Conclusions: The study captured the prevalence of musculoskeletal disorders in theGreek perioperative nurses. It confirmed that the work environment in the operatingroom and the activities performed by perioperative nurses such as working in thesame position for long periods of time, moving and lifting heavy objects andequipment, the inconvenient working position and working of many hours or in shifts, are the major problems that contribute daily in the creation and deterioration ofmusculoskeletal disorders.This dissertation has shown that an educational intervention can significantly improvethe knowledge and skills of perioperative nurses and be an important factor in theprevention and treatment of musculoskeletal disorders.Key-words: Musculoskeletal disorders, perioperative nurses, educationalintervention, hospital, surgery, musculoskeletal symptoms.Εισαγωγή: Το χειρουργείο αποτελεί ένα ιδιαίτερο περιβάλλον έντασης εργασίας στοχώρο του νοσοκομείου. Μελέτες έχουν αποτυπώσει τη συσχέτιση των εργασιακώνπαραγόντων κινδύνου για μυοσκελετικές κακώσεις στο νοσηλευτικό προσωπικό,όμως ελάχιστες έχουν διερευνήσει τη σχέση τους με τους περιεγχειρητικούςνοσηλευτές και το επιστημονικό αυτό κενό κάλυψε η παρούσα διατριβή.Σκοπός: Σκοπός της παρούσας διδακτορικής διατριβής ήταν να διερευνηθεί και στηχώρα μας ο επιπολασμός των μυοσκελετικών παθήσεων στους περιεγχειρητικούςνοσηλευτές, να εκτιμηθούν οι επαγγελματικοί παράγοντες κινδύνου, καθώς επίσης ναδιερευνηθούν οι γνώσεις και αντιλήψεις τους για τα μυοσκελετικά προβλήματα καιπόσο αυτές βελτιώνονται έπειτα από μια εκπαιδευτική παρέμβαση.Υλικό και Μέθοδος: Στην έρευνα συμμετείχαν 402 περιεγχειρητικοί νοσηλευτές,που εργάζονταν σε δημόσια νοσοκομεία της Ελλάδας και 134 οι οποίοι αποτέλεσαντο δείγμα της εκπαιδευτικής παρέμβασης. Για τη συλλογή των δεδομένωνχρησιμοποιήθηκαν ανώνυμα αυτοσυμπληρούμενα ερωτηματολόγια, ένα για τηνδιερεύνηση του επιπολασμού και των επιβαρυντικών παραγόντων τωνμυοσκελετικών παθήσεων στο χώρο του χειρουργείου το οποίο αποτελούνταν απότρία μέρη (διερεύνηση μυοσκελετικών συμπτωμάτων, περιγραφή της εργασίας,ψυχομετρική αξιολόγηση) και ένα για τη διερεύνηση γνώσεων. Οι απαντήσεις από ταερωτηματολόγια καταχωρήθηκαν σε προσωπικό υπολογιστή στο στατιστικό πακέτογια τις κοινωνικές επιστήμες (SPSS, έκδοση 19). Για τη στατιστική ανάλυση τωνδεδομένων χρησιμοποιήθηκαν οι εξής δοκιμασίες: το το Wilcoxonsignedtest, τοMcNemartest, το Pearson’sχ2test ή το Fisher'sexacttest, το Mann-Whitneytest, τοPairedt-test, το Student’st-test, η ανάλυσης διασποράς και η διόρθωση Bonferroni, οσυντελεστής συσχέτισης του Spearman και η πολλαπλή βηματική γραμμικήπαλινδρόμηση. Το επίπεδο σημαντικότητας τέθηκε στο 0,05.Αποτελέσματα: Η μέση ηλικία των περιεγχειρητικών νοσηλευτών του δείγματοςήταν 42,3 έτη (SD=7,8 έτη), με υψηλό ποσοστό (78,7%) να είναι γυναίκες. Το 88%ήταν εργαλειοδότες και το 88,4% νοσηλευτές κίνησης. Τα πιο συνηθισμέναπροβλήματα που αναφέρθηκαν ήταν η εργασία στην ίδια θέση για μεγάλες χρονικέςπεριόδους (73,8%), η μετακίνηση και ανύψωση βαρέων αντικειμένων και εξοπλισμού (71,0%), η παραμονή τους στην εργασία, ενώ αισθάνονταν πόνο (70,8%), η εργασίασε περίεργη άβολη θέση (63,8%) και η εργασιακή απασχόληση για πολλές ώρες ή σεβάρδιες (63,3%).Επιπλέον 61,0% των συμμετεχόντων ανέφερε κατά το τελευταίο έτος μυοσκελετικάσυμπτώματα στην οσφυϊκή μοίρα, 54,6% στην αυχενική, 41,0% στον ώμο, 34,4% στογόνατο και 33,1% στον καρπό. Όσον αφορά τις τελευταίες 7 ημέρες το 43,0% τωνσυμμετεχόντων ανέφερε μυοσκελετικά συμπτώματα στην οσφυϊκή μοίρα, 33,3%στην αυχενική, 24,2% στον ώμο, 18,0% στο γόνατο και 17,4% στην πλάτη.Οι υποκλίμακες «Περιβάλλον» και «Προσωπικές προτιμήσεις» είχαν υψηλότερεςτιμές και στις δύο κλίμακες κατάταξης και βαθμολόγησης, αναφέροντας ότι είχανμεγαλύτερη σημασία. Οι υποκλίμακες «Εργαλεία και μέσα» και «Πολιτικές καιδιαδικασίες χειρουργείου» είχαν χαμηλότερη βαθμολογία υποδεικνύοντας ότι ήτανμικρότερης σημασίας. Όσον αφορά τις υποκλίμακες «Περιβάλλον», «Θερμοκρασία»και «Ομάδα εργασίας» είχαν παρόμοια κατάταξη. Η «Διαρρύθμιση τουχειρουργείου» κατετάγη ως σημαντική και η «Διοικητική καθυστέρηση» ως λιγότεροσημαντική. Όσον αφορά την υποκλίμακα «Προσωπικές προτιμήσεις» το«Καθιστός/Όρθιος» κατετάγη ως το πιο σημαντικό.Επιπροσθέτως 134 περιεγχειρητικοί νοσηλευτές έλαβαν μέρος σε μια εκπαιδευτικήπαρέμβαση. Μετά τη λήξη της όλοι οι παράγοντες επηρέαζαν περισσότερο τηνεργασία των συμμετεχόντων. Εξαίρεση αποτέλεσαν η ταχύρυθμη εργασία, οιψυχοκοινωνικοί παράγοντες και η έλλειψη προσωπικού που δεν είχαν καμία αλλαγήγιατί αναγνωρίστηκαν ως σημαντικοί από την αρχή. Μετά την παρέμβαση οιπεριεγχειρητικοί νοσηλευτές υποστήριξαν ότι γνώριζαν περισσότερα για τιςμυοσκελετικές παθήσεις, την εργονομία και τη χειρωνακτική διακίνηση φορτίων, απόότι γνώριζαν πριν. Τα ποσοστά των σωστών απαντήσεων κυμαίνονταν πριν τηνπαρέμβαση από 10,5% έως 95,55 και μετά από 61,4% έως 100%.Οι γυναίκες είχαν σημαντικά μεγαλύτερη αύξηση στη βαθμολογία γνώσεων, δηλαδήαπέκτησαν σημαντικά περισσότερες γνώσεις μετά την παρέμβαση, σε σύγκριση μετους άντρες. Επίσης, η αύξηση της βαθμολογίας ήταν σημαντικά μεγαλύτερη στουςνοσηλευτές που ήταν κάτω από 30 ετών, σε σύγκριση με τους νοσηλευτές που ήτανάνω των 40 ετών (p=0,004). Η αύξηση των γνώσεων ήταν σημαντικά μεγαλύτερηστους νοσηλευτές που δεν είχαν δεύτερο πτυχίο και η αύξηση της βαθμολογίας ήταν σημαντικά μεγαλύτερη στους νοσηλευτές που εργάζονταν στον παρόντα χώρο τοπολύ 4 έτη, σε σύγκριση με τους νοσηλευτές που εργάζονταν πάνω από 10 έτη(p=0,039). Αντίθετα, σημαντικά μικρότερη ήταν η αύξηση της βαθμολογίας γνώσεωνστους νοσηλευτές που αναγνώριζαν όλους τους παράγοντες κινδύνου στη δουλειάτους για μυοσκελετικές παθήσεις, καθώς και σε αυτούς που κατανοούσαν ότι είναιπολύ σημαντικό να λαμβάνουν τα κατάλληλα μέτρα πρόληψης.Συμπεράσματα: Η μελέτη αποτύπωσε έναν υψηλό επιπολασμό μυοσκελετικώνπαθήσεων στους Έλληνες περιεγχειρητικούς νοσηλευτές. Επιβεβαίωσε ότι τοπεριβάλλον εργασίας στο χειρουργείο και οι δραστηριότητες που εκτελούνται απότους περιεγχειρητικούς νοσηλευτές, όπως η παρατεταμένη εργασία από την ίδια θέσηγια μεγάλο χρονικό διάστημα, η μετακίνηση και ανύψωση βαρέων αντικειμένων καιεξοπλισμού, η άβολη θέση εργασίας και η για πολλές ώρες εργασιακή απασχόληση ήσε βάρδιες, είναι τα κύρια προβλήματα που συμβάλλουν καθημερινά στηνδημιουργία και την επικράτηση των μυοσκελετικών παθήσεων.Η παρούσα διατριβή κατέδειξε ότι μία εκπαιδευτική παρέμβαση μπορεί να βελτιώσεισημαντικά τις γνώσεις και δεξιότητες των περιεγχειρητικών νοσηλευτών και νααποτελέσει σημαντικό παράγοντα στην πρόληψη και αντιμετώπιση τωνμυοσκελετικών παθήσεων.Λέξεις κλειδιά: Μυοσκελετικές παθήσεις, περιεγχειρητικοί νοσηλευτές,εκπαιδευτική παρέμβαση, νοσοκομείο, χειρουργείο, μυοσκελετικά συμπτώματα

Reliability and validity of the Greek translation of the patient assessment of chronic illness care + (PACIC-PLUS GR) survey

The article was funded by the “CUT Open Access Author Fund”This study aimed to investigate the Patient Assessment of Chronic Illness Care+ (PACIC+) which is a tool to assess care for Chronic Conditions combining PACIC items with an overall 5As score derived from the '5As' model (ask, advise, agree, assist, and arrange), and is congruent with the Chronic Care Model. In addition, the study at hand aimed to translate the PACIC+ tool into Greek and test its psychometric properties to the Greek patients

Use of Long-Acting Injectable Antipsychotics in a Clinical Sample of Community-Dwelling Patients with Schizophrenia-Spectrum Disorders in Rural Greece

Data on the use of long-acting injectable antipsychotics (LAIs) in rural community mental healthcare settings are scarce. This study aimed to investigate the prescription patterns of LAIs in a clinical sample of patients with schizophrenia-spectrum disorders in rural Greece. All patients with schizophrenia-spectrum disorders who regularly attend the Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia (MMHU I-T) in northwestern Greece were included in the study. The sample consists of 87 patients (59 males and 28 females) with a mean age of 54.4 years and a mean illness duration of 28 years. Most patients (72.4%) received antipsychotic monotherapy, and nearly 30% received an LAI formulation, mostly a second-generation LAI (20 of 26 patients, 76.9%). The treatment regimen comprised benzodiazepines in one-third of the patients and antidepressants in one-quarter. There was no statistically significant association between treatment regimen and the clinical and demographic variables studied, except for biological sex (female). The percentage of patients treated with LAIs in this study was almost three times higher than the rate previously reported in Greece and is higher than the rates reported in other countries. Patients with schizophrenia-spectrum disorders in rural Greece may have adequate access to innovative treatment with second-generation LAIs. Further research is needed to demonstrate the cost-effectiveness of LAI treatment in rural communities and to elucidate the factors associated with such treatment

Clinical Outcome in Persons with Severe Mental Disorders Attending a Mental Health Day Center during the COVID-19 Pandemic

Background: Studies assessing the psychological impact of the COVID-19 pandemic on populations highlight the emergence of mental health difficulties, especially if a mental health disorder is already present. Patients with severe mental illnesses (SMIs) may be even more vulnerable to the psychosocial effects of the pandemic. However, little is known regarding the possible impact of the pandemic on SMI patients supported by community-based mental health day centers. Methods: A two-year prospective study comprising 29 individuals with SMI was conducted by the Skitali Mental Health Day Center in Ioannina, Northwest Greece. The described group of examined patients consisted mainly of psychotic patients (65.5%). Patients were assessed using the Health of Nations Outcome Scale and the Global Assessment of Functioning scale, and scores prior to and after the onset of the pandemic were compared. Results: The results indicated that participants did not present any significant decline in their overall clinical status during the COVID-19 pandemic and the national lockdown measures. Conclusions: This finding is relevant because previous research has shown that the pandemic may negatively impact adherence to treatment and service attendance and that the symptomatology of patients with SMIs may further deteriorate. It is suggested that the operation of mental health day centers during collective stressful events should be preserved, but further research is needed to evaluate their role in maintaining continuity of care during such events

Biomimetic and biodegradable cellulose acetate scaffolds loaded with dexamethasone for bone implants

There is, as a matter of fact, an ever increasing number of patients requiring total hip replacement (Pabinger, C.; Geissler, A. Osteoarthritis Cartilage 2014, 22, 734–741). Implant-associated acute inflammations after an invasive orthopedic surgery are one of the major causes of implant failure. In addition, there are instability, aseptic loosening, infection, metallosis and fracture (Melvin, J. S.; Karthikeyan, T.; Cope, R.; Fehring, T. K. J. Arthroplasty 2014, 29, 1285–1288). In this work, a drug-delivery nanoplatform system consisting of polymeric celluloce acetate (CA) scaffolds loaded with dexamethasone was fabricated through electrospinning. Atomic force microscopy (AFM) and scanning electron microscopy (SEM) indicated the successful fabrication of these structures. Cytotoxicity studies were performed by using MTT assay, methylene-blue staining and SEM fixation and showed very good cell adhesion and proliferation, indicating the cytocompatibility of these fibrous scaffolds. Drug-release kinetics was measured for the evaluation of a controllable and sustained release of anti-inflammatory drug onto the engineered implants and degradation study was conducted in order to assess the mass loss of polymers. This drug-delivery nanoplatform as coating on titanium implants may be a promising approach not only to alleviate but also to prevent implant-associated acute inflammations along with a simultaneous controlled release of the drug

Guillain-Barré syndrome and fulminant encephalomyelitis following Ad26.COV2.S vaccination: double jeopardy.

This correspondence comments on a published article presenting a case of rhombencephalitis following SARS-CoV-2-vaccination with the mRNA vaccine BNT162b2 (Pfizer/BioNTech). We also present the case of a 47-year-old man who developed Guillain-Barré-syndrome and a fulminant encephalomyelitis 28 days after immunization with Ad26.COV2.S (Janssen/Johnson &amp; Johnson). Based on the presented cases, we underscore the importance of clinical awareness for early recognition of overlapping neuroimmunological syndromes following vaccination against SARS-CoV-2. Additionally, we propose that that role of autoantibodies against angiotensin-converting enzyme 2 (ACE2) and the cell-surface receptor neuropilin-1, which mediate neurological manifestations of SARS-CoV-2, merit further investigation in patients presenting with neurological disorders following vaccination against SARS-CoV-2