Occupational stress and coping strategies of the nursing staff of a Public University Hospital during the COVID-19 pandemic

Background & Aim: Nursing staff are exposed to high levels of stress daily due to the demanding work environment. This study aimed to examine nursing staff occupational stress and coping mechanisms during the COVID-19 pandemic.‎ Methods & Materials: A cross-sectional study with a sample of 108 nursing staff was carried out. The Expanded Nursing Stress Scale (ENSS), the Brief Coping Orientation to Problems Experienced (Brief COPE) Scale, and constructed questions were used for data collection. Data were analyzed using chi-square (χ2), Pearson methods, and Multiple linear regression analysis. Statistical significance was determined at p-value ≤ 0.05. Results:  Overall Occupational stress was assessed with a mean score of 146.8 (SD±35.3). In Brief COPE Scale higher mean was assessed for “social support - information seeking” and lower for “substance use” or “withdrawal” (p<0.001). A significant difference in response distributions was observed regarding their degree of concern or fear about COVID-19 (p<0.01). Increased levels of Overall Occupational Stress (ENSS) were associated with higher levels of BCOPE. Emotional Focus and Venting and Diffusion of Emotions (β=5.15, p=0.026), younger age of the participants (β=-5.78, p=0.033), years of working in the healthcare sector (β=14.46, p=0.004) or the highest fear/concern about being infected and infecting their patients (β=6.22, p=0.032). Conclusion: Nursing staff experienced moderate levels of occupational stress, while challenges raised by the pandemic were handled through seeking social support, positive reframing and acceptance, taking protective measures, and turning to religion. Developing meaningful administrative and educational strategies for staff empowerment and resilience may reduce anxiety and occupational stress for nurses

Happiness around the world: A combined etic-emic approach across 63 countries.

What does it mean to be happy? The vast majority of cross-cultural studies on happiness have employed a Western-origin, or "WEIRD" measure of happiness that conceptualizes it as a self-centered (or "independent"), high-arousal emotion. However, research from Eastern cultures, particularly Japan, conceptualizes happiness as including an interpersonal aspect emphasizing harmony and connectedness to others. Following a combined emic-etic approach (Cheung, van de Vijver & Leong, 2011), we assessed the cross-cultural applicability of a measure of independent happiness developed in the US (Subjective Happiness Scale; Lyubomirsky & Lepper, 1999) and a measure of interdependent happiness developed in Japan (Interdependent Happiness Scale; Hitokoto & Uchida, 2015), with data from 63 countries representing 7 sociocultural regions. Results indicate that the schema of independent happiness was more coherent in more WEIRD countries. In contrast, the coherence of interdependent happiness was unrelated to a country's "WEIRD-ness." Reliabilities of both happiness measures were lowest in African and Middle Eastern countries, suggesting these two conceptualizations of happiness may not be globally comprehensive. Overall, while the two measures had many similar correlates and properties, the self-focused concept of independent happiness is "WEIRD-er" than interdependent happiness, suggesting cross-cultural researchers should attend to both conceptualizations

Comparative research of pragmatic ability of primary school students with typical development, high functioning autism and specific learning difficulties

The aim of the present thesis is to investigate the pragmatic ability in the area of figurative language (Idioms & Proverbs), and its association with linguistic (Receptive Vocabulary, Morphology-Syntax) and non-linguistic variables (Chronological Age, Non Verbal Ability), as well as with Reading Comprehension in typical (TD) and atypical [High-Functioning Autism (HFA) & Specific Learning Difficulties (SLD)] developing children. The sample consists of 372 participants attending 4th, 5th and 6th grade of primary school (286 TD, 37 with HFA and 49 with SLD). Measures ofPragmatic and Morphosyntactic Ability, Vocabulary (Peabody Picture Vocabulary Test-4) (Dunn & Dunn, 2007), Reading ability (Reading Test-A) (Padeliadou & Antoniou, 2008), and non-verbal reasoning ability (Raven΄ s Colored Progressive Matrices) (Sideridis, Antoniou, Mouzaki, & Simos, 2015) were administered. The study was divided in two phases: (a) the pilot study, with the aim of constructing measures of pragmatic and morphosyntactic ability and (b) the main study, which wasdivided into 3 studies. According to the results of the 1st study, as far as TD participants are concerned: (a) Pragmatic ability was hierarchically predicted by MorphologySyntax, Reading Comprehension and Receptive Vocabulary for the 286 TD participants, in addition to non-linguistic variables; (b) there has been a gradual improvement in figurative competence as age increases, as well as a correlation between pragmatic ability and different factors, depending on the school grade; (c) Reading Comprehension was predicted by pragmatic ability at grade 4 and byMorphology-Syntax at grades 5 & 6. In the 2nd study, 35 HFA & 45 SLD children were matched for gender, chronological age and non-verbal reasoning ability with participants in the control group (TD). Both HFA and SLD groups performed poorly, showing slower rate of development in figurative language compared with the TD group. For both experimental groups pragmatic ability was predicted by MorphologySyntax. In the 3rd study, the profile of 19 HFA & 19 SLD participants in the examined variables was outlined, after both groups were matched with the control group (TD) for gender, chronological age, non-verbal reasoning ability and receptive vocabulary. The results revealed that the TD group performed significantly better than both experimental groups in pragmatic ability measure. There was no statistically significant difference between HFA and SLD participants in pragmatic ability, nor in the other examined variables. Data from scatter plots show more qualitative rather than quantitative differences between the two experimental groups, compared to the TD sample. Findings of the present thesis highlight the importance of language ability for the development of pragmatic skills of students with typical and atypical developmentat the late stages of primary school. Implications for research and educational purposes are discussed.Σκοπός της παρούσας διδακτορικής διατριβής είναι η διερεύνηση της πραγματολογικής ικανότητας στην περιοχή του μεταφορικού λόγου (Ιδιωματισμοί & Παροιμίες) σε πληθυσμό τυπικής (ΤΑ) και μη τυπικής ανάπτυξης [με Διαταραχή Αυτιστικού Φάσματος Υψηλής Λειτουργικότητας (ΔΑΦΥΛ) & Ειδικές Μαθησιακές Δυσκολίες (ΕΜΔ)] και η σύνδεσή της με γλωσσικούς (Προσληπτικό Λεξιλόγιο,Μορφολογία-Σύνταξη) και μη γλωσσικούς παράγοντες (Χρονολογική Ηλικία, Μη Λεκτική Ικανότητα), καθώς και με την Αναγνωστική Κατανόηση. Στην έρευνα συμμετείχαν 372 μαθητές των τριών τελευταίων τάξεων του Δημοτικού (286 ΤΑ, 37 με ΔΑΦΥΛ και 49 με ΕΜΔ). Στο συνολικό δείγμα χορηγήθηκαν δοκιμασίες μέτρησης: της Ικανότητας στον Μεταφορικό Λόγο και της Μορφοσυντακτικής Ικανότητας, του Λεξιλογίου (Peabody Picture Vocabulary Test-4) (Dunn & Dunn, 2007), της Αναγνωστικής ικανότητας (Τεστ Ανάγνωσης-Α) (Παντελιάδου & Αντωνίου, 2008) καιτης Μη Λεκτικής Ικανότητας (Raven΄ s Colored Progressive Matrices) (Σιδερίδης, Αντωνίου, Μουζάκη, & Σίμος, 2015). Η ερευνητική διαδικασία χωρίστηκε σε δύο φάσεις: την πιλοτική έρευνα, με σκοπό την αρχική διαμόρφωση των εργαλείων μέτρησης της πραγματολογικής και μορφοσυντακτικής ικανότητας και την κυρίως έρευνα, που χωρίστηκε σε τρείς μελέτες. Στην 1η μελέτη, που αφορούσε στην ΤΑ, βάσει των δεδομένων: (α) ως παράγοντες πρόβλεψης της πραγματολογικής ικανότητας, εκτός από τις μη γλωσσικές μεταβλητές, αναδείχθηκαν ιεραρχικά ηΜορφολογία-Σύνταξη, η Αναγνωστική Κατανόηση και το Προσληπτικό Λεξιλόγιο για τους 286 συμμετέχοντες ΤΑ· (β) διαπιστώθηκε σταδιακή βελτίωση της μεταφορικής ικανότητας παράλληλα με την αύξηση της ηλικίας, καθώς και σύνδεση της πραγματολογικής ικανότητας με διαφορετικούς παράγοντες, ανάλογα με την τάξη φοίτησης· και (γ) ως παράγοντες πρόβλεψης της Αναγνωστικής Κατανόησης, αναδείχθηκαν η πραγματολογική ικανότητα για την 4η Δημοτικού και η Μορφολογία Σύνταξη για την 5η και 6η Δημοτικού. Στη 2 η μελέτη, εξισώθηκαν κατά ζεύγη 35 συμμετέχοντες με ΔΑΦΥΛ και 45 συμμετέχοντες με ΕΜΔ με αντίστοιχες ομάδες ελέγχου ΤΑ ως προς το Φύλο, τη Χρονολογική Ηλικία και τη Μη Λεκτική Ικανότητα. Και οι δύο πειραματικές ομάδες είχαν χαμηλότερες επιδόσεις και πιο αργούς ρυθμούς ανάπτυξης στον μεταφορικό λόγο, συγκριτικά με την ομάδα ελέγχου ΤΑ. Ως παράγοντας πρόβλεψης της πραγματολογικής ικανότητας για την ομάδα με ΔΑΦΥΛκαι ΕΜΔ αναδείχθηκε η Μορφολογία-Σύνταξη. Στην 3η μελέτη, σκιαγραφήθηκε το προφίλ 19 συμμετεχόντων με ΔΑΦΥΛ και 19 με ΕΜΔ στις υπό εξέταση μεταβλητές, αφού εξισώθηκαν με ομάδα ελέγχου ΤΑ ως προς το Φύλο, τη Χρονολογική Ηλικία, τη Μη Λεκτική Ικανότητα και το Προσληπτικό Λεξιλόγιο. Οι αναλύσεις έδειξαν ότι το δείγμα ΤΑ είχε καλύτερες επιδόσεις στην πραγματολογική ικανότητα, συγκριτικά με τις δύο πειραματικές ομάδες. Οι ομάδες με ΔΑΦΥΛ και ΕΜΔ δεν διαφοροποιούνταν στατιστικώς σημαντικά στην πραγματολογική ικανότητα, αλλά και στις υπόλοιπεςεξεταζόμενες μεταβλητές. Τα δεδομένα των διαγραμμάτων διασποράς φανέρωσαν περισσότερο ποιοτικές, παρά ποσοτικές διαφορές ανάμεσα στις δύο πειραματικές ομάδες, συγκριτικά με το δείγμα ΤΑ. Τα ευρήματα της παρούσας διδακτορικής διατριβής αναδεικνύουν τη σπουδαιότητα των γλωσσικών ικανοτήτων για την ανάπτυξη πραγματολογικών δεξιοτήτων μαθητών τυπικής και μη τυπικής ανάπτυξης στο τέλος του Δημοτικού, στοιχείο που δύναται να αξιοποιηθεί για ερευνητικούς και εκπαιδευτικούς σκοπούς

Does individual - level social capital affect patient satisfaction in oncology settings?

Background: Social capital is a term used to reflect the belief that social context and social relations have important consequences on people’s everyday life. It has many different conceptualizations but most authors agree that it refers to civic participation, density of social networks, information channels, shared values, trust, mutual support, and reciprocity among people. Its central idea is that social interactions and engagement in community activities are investments that promote individual and collective well?being. Social capital is important because it brings a new emphasis in understanding health outcomes and incorporates contextual perspectives in medical diagnos es and assessments. Patient satisfaction has emerged as a powerful determinant and outcome of health care quality: satisfied patients have better compliance with their therapy, cooperation with the health staff, health outcomes and quality of life. Financial reasons intervene as well: in a competitive environment, satisfied patients tend both to re?use the same hospital/services and to recommend it to others. Patient satisfaction is influenced by major sociodemographic characteristics (sex, age, education, e.t.c.) but it as not been associated with social capital yet. h Aim: The main aim of the thesis is to examine the effect social capital may have on patient satisfaction ratings in oncology settings. Secondary objectives are to validate the Social Capital Questionnaire (SCQ) and the Comprehensive Assessment of Satisfaction ith Care (CASC) in Greece. w Description of the questionnaires: SCQ was developed in Australia by Onyx & Bullen (2000). It has 36 questions in eight factors to measure different social capital dimensions, including: Participation in the Local Community, Social Agency or Proactivity in a Social Context, Feelings of Trust & Safety, Neighborhood Connections, Family & Friends Connections, Tolerance to Diversity, Value of Life, and Work Connections. Higher scores on a 4?point Likert?type scale indicate more social capital. υπηρεσιών υγείας από τις υπηρεσίες υγείας CASC was developed by Bredart et al. (1998, 1999). It comprises 60 questions that evaluate both inpatient and outpatient dimensions of cancer care i.e. medical, nursing, and administrative. The rating of the responses is in a 5?point Likert scale. 1 represents the worst experience of care while a rating of 5 reveals excellent satisfaction. Translation Process: For both scales, we followed the translation guidelines of the European Social Survey. The translation process was divided into four phases. First, three translators made independent parallel translations of the English version of the questionnaires. In the second stage, the translators and one reviewer agreed on a final version. Third, although it is not part of the ESS guidelines, a back?translation from Greek to English by an independent translator was also performed. In the fourth phase, using all the information from the first three phases and after thorough discussions with translators and reviewers, the doctoral student, acting as adjudicator, approved the final version of the two scales. Psychometric and cognitive validation of the Social Capital Questionnaire: The validation of SCQ was conducted in two phases: First, cognitive validation interviews with 25 adults in Athens were performed by concurrent interviewing. They explored people’s understandings in complex and multi?dimensional terms relevant to social capital such as multiculturalism, trust, community, active participation e.t.c. They also revealed issues of multiple questions within one for Greek people’s attitudes towards the immrs igant. At the second stage, the psychometric properties of the Greek version of the Social Capital Questionnaire (SCQ?G) were evaluated in a sample of 521 adults drawn from th ree different urban areas in Greece (Athens, Korinthos, Iraklio?Crete). Exploratory factor analysis followed by multi?trait scaling yielded six factors: Participation in the Local Community, Feelings of Safety, Family/Friends Connections, Value of Life and Social Agency, Tolerance of Diversity, and Work Connections. Variations in the factor solution suggest that social capital does not share the same structure in different countries. Cronbach’s alpha for the entire SCQ?G was .83 and between .68 and .77 for the factors. The Family and Friends Connections factor did not perform well, with a Cronbach’s alpha of .33. Πανεπιστήμιο Κρήτης Τμήμα Ιατρικής Τομέας Κοινωνικής Ιατρικής xii Μελέτη Two limitations of the study must be recognized: The sample consisted only of people from urban settings and criterion validity, how two different scales that measure the same concept relate to each other, was not tested. Sample of oncology patients: 84 cancer inpatients in a department of Medical oncology in Athens for a period of ten weeks met the inclusion criteria: they are 18–79 years old, they are communicative and mentally healthy (with no extensive brain metastases and no previous psychiatric history), able to understand and speak Greek, stay at least two nights in the hospital. Of them, 32 (38%) refused to participate leading to a 62% response rate. Interview?based administration was chosen in order to yield more reliable results in terms of time of assessment, response rate and data omission. Ethical approval was granted by the hospital’s ethical committee....ΣΚΟΠΟΣ: Σκοπός της διδακτορικής διατριβής είναι η διερεύνηση της επίδρασης του ατομικού κοινωνικού κεφαλαίου στην ικανοποίηση των ογκολογικών ασθενών από τη νοσηλεία τους. Επιμέρους στόχοι είναι η στάθμιση της ‘Κλίμακας για την Ποσοτική Εκτίμηση του Κοινωνικού Κεφαλαίου’ (SCQ) και του ερωτηματολογίου για τη ‘Συνολική Εκτίμηση της Ικανοποίησης από τη Νοσηλεία’ (CASC) στην Ελλάδα. ΨΥΧΟΜΕΤΡΙΚΗ ΣΤΑΘΜΙΣΗ ΤΟΥ SCQ: ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΙ: Πραγματοποιήθηκε Διερευνητική Παραγοντική Ανάλυση και Συσχετίσεις Πολλαπλών Κλιμακώσεων σε δείγμα ευκολίας 5 21 ενηλίκων από 3 αστικά κέντρα (Αθήνα, Κόρινθο, Ηράκλειο). ΑΠΟΤΕΛΕΣΜΑΤΑ: Η ελληνική έκδοση του SCQ περιλαμβάνει 6, από τους αρχικούς 8, παράγοντες: Συμμετοχή στην Κοινότητα, Αισθήματα Ασφάλειας, Επαφές με Συγγενείς & Φίλους, Κοινωνική Συμπεριφορά & Εκτίμηση της Ζωής, Σχέσεις στην Εργασία, και Ανοχή στη Διαφορετικότητα. Η αξιοπιστία εσωτερικής συνέπειας (συντελεστής a του Cronbach) στο ελληνικό δείγμα ήταν .83 για το σύνολο της κλίμακας και μεταξύ .68 και .77 για τις υ ποκλίμακες. ΣΥΖΗΤΗΣΗ: Το ερωτηματολόγιο είναι επαρκές για τη μέτρηση του κοινωνικού κεφαλαίου στην Ελλάδα. Η στάθμιση, σε συνδυασμό με άλλα ευρήματα, αποτελεί νδειξη ότι το κοινωνικό κεφάλαιο δεν έχει κοινά χαρακτηριστικά σε όλες τις χώρες. έ ΓΝΩΣΙΑΚΗ ΣΤΑΘΜΙΣΗ ΤΟΥ SCQ: ΘΕΩΡΗΤΙΚΟ ΥΠΟΒΑΘΡΟ: Το νόημα των λέξεων που χρησιμοποιούνται στη ρητορική του κοινωνικού κεφαλαίου διαφοροποιείται μεταξύ των χωρών υπονομεύοντας την ερμηνεία των αποτελεσμάτων. Η γνωσιακή στάθμιση διερευνά το τι αντιπροσωπεύουν οι απαντήσεις του ελληνικού πληθυσμού επιτρέπον τας τις συγκρίσεις μεταξύ της Ελλάδας και άλλων χωρών. ΜΕΘΟΔΟΙ: Πραγματοποιήθηκαν ημιδομημένες συνεντεύξεις με 25 ενήλικα άτομα στην Αθήνα. Η ανάλυση των αποτελεσμάτων αντλεί τον ευρύτερο θεωρητικό και μεθοδολογικό τηςπ α ροσανατολισμόπό την ‘ανάλυση του λόγου’. ΑΠΟΤΕΛΕΣΜΑΤΑ: Λέξεις όπως κοινότητα, κουλτούρα, πολιτισμικότητα κ.ά., χρησιμοποιήθηκαν σπάνια από τους συμμετέχοντες, χωρίς να υπάρχει κοινός ορισμός από αυτούς που τις χρησιμοποίησαν. Παράλληλα, αναγνωρίστηκαν πολλαπλές Μελέτη συσχέτισης του κοινωνικού κεφαλαίου με την ικανοποίηση των χρηστών ix ερωτήσεις σε μία μόνο ερώτηση (multiple questions within one) για τον παράγοντα Ανοχή στη Δι αφορετικότητα. ΣΥΖΗΤΗΣΗ: Η γνωσιακή στάθμιση των ερωτηματολογίων χρειάζεται, επιπλέον της ψυχομετρικής, προκειμένου να μπορούν να ερμηνευτούν αξιόπιστα τα αποτελέσματα των σχετικών ερευνών. ΨΥΧΟΜΕΤΡΙΚΗ ΣΤΑΘΜΙΣΗ ΤΟΥ CASC: ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΙ: Η επάρκεια του CASC για χρήση στην Ελλάδα ελέγχθηκε μέσω Συσχετίσεων Πολλαπλών Κλιμακώσεων και άλλων στατιστικών δοκιμασιών, χρησιμοποιώντας τα στοιχεία που συλλέχθηκαν για τη συσχέτιση του κοινωνικού κεφαλαίου με την ικανοποίηση των ασθενών. ΑΠΟΤΕΛΕΣΜΑΤΑ: Ο συντελεστής a του Cronbach ήταν πάνω από .85 για όλες τις υποκλίμακες και .97 για το σύνολο του ερωτηματολογίου. Οι υποκλίμακες για το νοσηλευτικό προσωπικό παρουσιάζουν ορισμένες διαφοροποιήσεις σε σχέση με την αρχική δομή . ΣΥΖΗΤΗΣΗ: Η ικανοποίηση των ογκολογικών ασθενών στην Ελλάδα μπορεί να καταγραφεί αξιόπιστα από το CASC. ΣΥΣΧΕΤΙΣΗ ΤΟΥ ΚΟΙΝΩΝΙΚΟΥ ΚΕΦΑΛΑΙΟΥ ΜΕ ΤΗΝ ΙΚΑΝΟΠΟΙΗΣΗ ΤΩΝ ΑΣΘΕΝΩΝ ΑΠΟ ΤΗ ΝΟΣΗΛΕΙΑ ΤΟΥΣ: ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΙ: Ογδόντα τέσσερις ασθενείς πληρούσαν τα κριτήρια εισαγωγής στη μελέτη σε περίοδο 10 διαδοχικών εβδομάδων, σε μία παθολογική ογκολογική κλινική (νοσοκομείο Ευαγγελισμός): να είναι από 18 έως 79 ετών, να μην έχουν ψυχιατρικό ιστορικό, να μπορούν να επικοινωνήσουν (για παράδειγμα, να μην έχουν εκτενείς εγκεφαλικές μεταστάσεις), να μπορούν να καταλάβουν και να μιλήσουν ελληνικά, να έχουν μείνει στο νοσοκομείο τουλάχ ιστον για 2 βράδια. Οι ασθενείς συμπλήρωσαν ταυτόχρονα μέσω ατομικής συνέντευξης και τα 2 ερωτηματολόγια για λόγους αξιοπιστίας και εγκυρότητας των αποτελεσμάτων (τα ερωτηματολόγια συμπληρωνόταν από τους ίδιους τους ασθενείς και όχι από συγγενείς τους, δι ερευνούταν γιατί οι ασθενείς δεν απαντούν ορισμένες ερωτήσεις). Η συσχέτιση του κοινωνικού κεφαλαίου με την ικανοποίηση των ασθενών ελέγχθηκε με μονοπαραγοντική (simple) και πολυπαραγοντική (multiple) γραμμική παλινδρόμηση (linear regression) μεταξύ παραγόντων του κοινωνικού κεφαλαίου και 13 παραμέτρων ικανοποίησης. ΑΠΟΤΕΛΕΣΜΑΤΑ: Ο ‘γενικός βαθμός ικανοποίησης σε 10βάθμια κλίμακα’ εμφανίζει τους υψηλότερους συντελεστές συσχέτισης r με το σύνολο του κοινωνικού κεφαλαίου (r = .570, p < .001) και με την Κοινωνική Συμπεριφορά & Εκτίμηση της Ζωής (r = .532, p < .001). ..

A longitudinal study of multiple lifestyle health risk behaviours among nursing students and non-nursing peers

Aim: The aim of this paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students. Background: Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. Design: Longitudinal comparative study. Measurements: We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self-administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed. Results: There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake. Conclusion: Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health-promoting role. We need strategies to safeguard the professional nursing practice

Intention, Motivation, and Empowerment: Factors Associated with Seasonal Influenza Vaccination among Healthcare Workers (HCWs)

Background: Vaccination against seasonal influenza has proven effective in preventing nosocomial influenza outbreaks among hospital patients and healthcare workers (HCWs). This study aims to explore the intention, motivation, and empowerment toward vaccination and vaccination advocacy as contributing factors for seasonal influenza vaccination in HCWs. Methods: A cross-sectional study in eight secondary hospitals in Greece was conducted from March to May 2022. An anonymous questionnaire was enclosed in an envelope and distributed to all participants, including questions on vaccine behavior and the MoVac-flu and MoVad scales. Results: A total of 296 participants completed the questionnaire. In multivariate logistic regression models adjusted for potential confounders, increased age, intention score, MoVac-flu scale score, and the presence of chronic diseases were significant predictors of influenza vaccination this year, while increased age, intention score, and presence of chronic diseases were predictors of vaccination every year. Conclusion: Vaccination uptake is simultaneously affected by logical cognitive processes (intention), together with factors related to motivation and empowerment in distinct self-regulatory domains such as value, impact, knowledge, and autonomy. Interventions focused on these identified predictors may be used as a guide to increase HCWs’ vaccination rates

Application of an in-hospital, surgeon-led anti-osteoporotic medication algorithm in patients with hip fractures improves persistence to medication and can prevent the second fragility fracture.

INTRODUCTION Secondary fracture prevention is an essential part of hip fracture treatment. Despite this, many patients are discharged without the appropriate anti-osteoporotic medication. The aim of this study is to report the outcomes of the application of an in-hospital, surgeon-led anti-osteoporotic medication algorithm to patients with hip fractures. MATERIALS AND METHODS This prospective cohort study followed patients with hip fractures who were treated at a tertiary referral hospital between 2020 and 2022. At discharge, anti-osteoporotic medication according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Foundation algorithm was prescribed to all patients. Multivariate Cox regression analysis was used to investigate the risks of non-persistence to medication and of secondary fracture. RESULTS Two hundred thirteen consecutive patients were prospectively followed. Mean follow-up was 17.2 ± 7.1 months. Persistence to medication at 2 years was 58% (95%CI 51-65%). A secondary osteoporotic fracture occurred in 1/126 (0.8%) persistent patients and 9/87 (11.4%) non-persistent patients. Multivariable Cox regression analysis confirmed that persistence to medication was significantly associated with a lower risk of secondary fracture (cause-specific hazard ratio [csHR] 0.05; 95%CI 0.01-0.45; p = 0.007). CONCLUSION The application of the surgeon-led AO Foundation algorithm enables the in-hospital initiation of anti-osteoporotic treatment, leading to better persistence to medication and decreased incidence of secondary osteoporotic fractures

Innovative methodology for the prioritization of the Program of Measures for integrated water resources management of the Region of Crete, Greece

Summarization: An innovative multi-criteria methodology was proposed for the prioritization of the Program of Measures (PoM) in the Water Region of Crete, and applied specifically to the basin of Geropotamos river according to the requirements of the Water Framework Directive. This study relied on the four pillars of sustainability and the EU cross-compliance legislative objective for the minimization of the climate change impact. The multi-criteria evaluation methodology was based on the results of four different types of analyses: a DPSIR analysis, a SWOT analysis, a Cost-Benefit Analysis and a climate change impacts analysis. Public participation on the results of the study with local stakeholders was used at every stage of the multi-criteria evaluation process, from the selection and weighing of the criteria to the final ranking and measures' prioritization. The PoM contains two types of measures: basic measures which deal with the implementation of existing legislation and are the same for all regions of Greece and additional measures which are specified for the Region of Crete. The results of the prioritization process in Geropotamos Basin suggests that improving the water quality and ecological status of available water resources do not always require significant financial resources and can have a high impact in terms of achieving “good” quality status.Παρουσιάστηκε στο: Science of the Total Environmen

Climate change impact on the hydrological budget of a large Mediterranean island

Summarization: Crete is a Mediterranean, karst-dominated island, characterized by long drought periods. The Karst-SWAT model, combined with 11 climate change scenarios, was run to assess climate change impacts on the island under two set-ups, both using the auto-irrigation function of the model: (1) with water drawn from the shallow or deep aquifer, and (2) with irrigated water derived from an unlimited outside source. The first set-up provided insight into the fluctuation of future irrigation needs, and when compared to the second set-up, enabled quantification of the future water deficit. The Water Exploitation Index was used to describe the spatial variability of future water stress on Crete. A decrease in both surface and karstic spring flows is foreseen, especially after 2060 (24.2 and 16.5%, respectively). Simulated irrigation water demand and water deficit show continuous increase throughout the projection period (2020–2098).Παρουσιάστηκε στο: Hydrological Sciences Journa