Emotions and Online-Distance Education: The Case of Cyprus

Η παρούσα έρευνα μελετά το ρόλο των συναισθημάτων των συμμετεχόντων φοιτητών σε δύο μεταπτυχιακά προγράμματα σπουδών του Ανοικτού Πανεπιστημίου Κύπρου κατά τον πρώτο χρόνο λειτουργίας τους. Ειδικότερα, αξιολογείται η εμπειρία της εξ αποστάσεως εκπαίδευσης μέσα από τα συναισθήματα των φοιτητών, όπως αυτά αποτυπώνονται σε συνεντεύξεις, μηνιαία ημερολόγια συναισθημάτων και ηλεκτρονικά μηνύματα. Τα αποτελέσματα της έρευνας επισημαίνουν την πολλαπλότητα των πεδίων στα οποία μπορούν τα συναισθήματα να εκταθούν, καθώς και τη σπουδαιότητα των ερμηνειών που αποδίδουν οι φοιτητές σε σχέση με τη συγκεκριμένη μεθοδολογία μάθησης. Τα ζητήματα κοινωνικής και συναισθηματικής επικοινωνίας και επαφής αναδεικνύονται ως κρίσιμης σημασίας στη διερεύνηση των συναισθημάτων για την εμπειρία της εξ αποστάσεως μάθησης. Γενικά, τα ευρήματα της έρευνας αυτής υποστηρίζουν ότι η όσον το δυνατό συντομότερη εξοικείωση των σπουδαστών με την εξ αποστάσεως μεθοδολογία, η ενίσχυση της ποιοτικής επικοινωνίας με τους συμφοιτητές και τους καθηγητές και ο κατάλληλος προγραμματισμός και σωστή διαχείριση του χρόνου, είναι παράγοντες που συντελούν στη μείωση των αρνητικών συναισθημάτων.This article examines the origin and impact of adult learners’ emotions in the context of a distance learning program at the Open University of Cyprus. A range of methods for accessing emotions related to online learning is used, such as emotion diaries, semi-structured interviews, and email messages. The study highlights the multiple directions adult learners’ emotions can take and the significance of learners’ interpretations of their emotions in relation to the learning methodology. The issues of social and emotional communication and contact emerge as critical in the exploration of adult learners’ emotions in the context of online learning. In particular, the study shows how adult learners’ emotions in online learning are manifest and expressed in ambivalent ways, that is, how both positive and negative emotions co-exist and form particular emotional climates that influence adults’ learning experiences throughout the course. Analyzing the data from this study confirms findings from other recent research that in order to decrease negative emotions associated with online – distance learning methodology, the learners must familiarise themselves with the technology at hand, enhance quality communication with fellow learners and instructors as well as become well-organised and manage their time effectively. In addition, the programme must be well-organised and the instructors must facilitate the learners’ needs in a timely and organised manner. All in all, the current study shows that there is a lot to be gained from further considering how adult learners talk about their emotions as they learn how to become online learners

Physicians’ Perceptions and Adherence to Guidelines for the Management of Hypertension: A National, Multicentre, Prospective Study

Background. The aim of the current study was to investigate physicians’ perceptions and adherence to the European guidelines for the management of hypertension. Methods. This is a national, multicentre, prospective, observational study, conducted between November 2007 and June 2008, in Cyprus. Consecutive hypertensive patients have been recruited by a random sample of physicians. The physicians’ recommendations for every single patient have been recorded and compared with the 2007 ESH/ESC guidelines. Results. Of the total of 654 patients, 477 (72.9%) were correctly advised by their physician to receive antihypertensive treatment to control their blood pressure, while 396 (60.5%) correctly got advices to adopt only lifestyle changes. The overall adherence of physicians to the European guidelines (overall agreement rate) was 70.4% (k=0.258, P<0.001). Of the total of 68 physicians, 65 (95.6%) reported that they were aware of some guidelines. There was no statistically significant effect of specific physicians’ characteristics on the overall adherence to guidelines, but there was in the percentage of patients achieving medication guidelines. Conclusions. The study demonstrated that although Cypriot physicians declared that they were aware of the clinical guidelines for the management of hypertension, more than one-fourth of high risk hypertensive patients remained untreated and 40% of low risk patients received inappropriate medication

Cost-Sharing Rates Increase During Deep Recession: Preliminary Data From Greece

Background: Measures taken over the past four years in Greece to reduce pharmaceutical expenditure have led to significant price reductions for medicines, but have also changed patient cost-sharing rates for prescription drugs. This study attempts to capture the resulting increase in patients’ out-of-pocket (OOP) expenses for prescription drugs during the 2011-2014 period. Methods: The authors conducted a retrospective review of financial data derived from 39 883 prescriptions, dispensed at three randomly chosen pharmacies located in Lamia, central Greece. Results: The study recorded an average contribution rate per prescription as follows: 11.28% for 2011 (95% CI: 10.76-11.80), 14.10% for 2012, 19.97% for 2013, and 29.08% for 2014. Correspondingly, the mean patient charge per prescription for 2011 was €6.58 (95% CI: 6.22-6.94), €8.28 for 2012, €8.35 for 2013, and €10.87 for 2014. During the 2011-2014 period, mean percentage rate of patient contribution increased by 157.75%, while average patient charge per prescription in current prices increased by 65.22%. The use of a newly introduced internal reference price (IRP) system increased the level of prescription charge at a rate of 2.41% for 2012 (100% surcharge on patients), 26.24% for 2013 (49.95% on patients and 50.04% on the appropriate health insurance funds), and 47.72% for 2014 (85.06% on patients and 14.94% on funds). Conclusion: Increased cost-sharing rates for prescription drugs can reduce public pharmaceutical expenditure, but international experience shows that rising OOP expenses can compromise patients’ ability to pay, particularly when it comes to chronic diseases and vulnerable populations. Various suggestions could be effective in refining the costsharing approach by giving greater consideration to chronic patients, and to the poor and elderly

Same pandemic yet different COVID-19 vaccination roll-out rates in two small European islands : a comparison between Cyprus and Malta

A mass vaccination strategy is estimated to be the long-term solution to control COVID-19. Different European countries have committed to vaccination strategies with variable population inoculation rates. We sought to investigate the extent to which the COVID-19 vaccination strategies, inoculation rate, and COVID-19 outcome differ between Cyprus and Malta. Data were obtained from the Ministry of Health websites and COVID-19 dashboards, while vaccination data were obtained from the European Centre for Disease Prevention and Control until mid-June, 2021. Comparative assessments were performed between the two countries using Microsoft® Excel for Mac, Version 16.54. Both islands took part in the European Union’s advanced purchase agreement and received their first batch of vaccines on 27 December 2020. The positivity rate and mortality between December and June differs between the two countries (average positivity rate Cyprus 1.34, Malta 3.37 p ≤ 0.01; average mortality Cyprus 7.29, Malta 9.68 p ≤ 0.01). Both the positivity rate and mortality for Cyprus declined due to strict public health measures and vaccination roll-out in early January (positivity rate by 95% and mortality by 58%). In contrast, for Malta, there was a sharp increase (64% p ≤ 0.01) with almost no public health restrictions in place and soaring cases during the Christmas and Carnival period until March, when lockdown measures were re-introduced. A distinctive difference between Cyprus and Malta in positivity rate (14 per 100,000 population; p ≤ 0.01) can also be observed between January and mid-April 2021. However, from April onwards it is evident that the positivity rate and mortality decline (positivity rate Cyprus by 82%, Malta by 95%; mortality Cyprus by 90%, Malta by 95%, p ≤ 0.01, respectively) in both countries as the vaccination roll-outs progressed, covering about 58.93% of the Maltese population, while Cyprus had fully inoculated about 38.03% of its population. The vaccine strategies and vaccination rates were similar for both countries; yet Malta had the fastest vaccine roll-out. Reluctancy to get vaccinated, significant differences in the vaccination appointment scheduling system, and the freedom of vaccination choice for the citizens in Cyprus may have contributed to a delayed vaccination roll-out. These potential contributing factors should be acknowledged and considered for future vaccination programs and potential COVID-19 boosters.peer-reviewe

Assessing Patient Participation in Health Policy DecisionMaking in Cyprus

Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cypru

Re-engineering the Cypriot general healthcare system for syndemics

To date in Cyprus, there is no dedicated “Quality Improvement” body or Public Health authority. The long-awaited general healthcare system (known as GeSy or GHS) has been completed, mid-stream of the COVID-19 pandemic. A recently proposed resilience plan in response to the lessons learnt from the pandemic was put forward by the Government of the Republic of Cyprus to strengthen the capacity of the GHS and support public health defense. The negotiator of GeSy and Health Minister 2015–2018 also provided his view that the health system needs a holistic transformation of service provision. Recognizing failures and thinking from a syndemogenesis perspective how the envisioned patient-centric healthcare delivery can be achieved, we propose that the public health response could also be linked to a politico-economic one in shielding GeSy. We make such case for a syndemic strategy (simultaneous management of COVID-19 and pre-existing epidemics on the island) and the development of the five-district model where each main district hospital is to complement the activities of the GHS through developing: 1. A training Center for training and sharing of best practices for COVID-19 and other public emergencies. 2. A public health body. 3. A quality improvement institute. 4. A commissioning center on planning and streamlining healthcare services. 5. A clinical trial platform. The rationale is based on the management literature and use of existing resources and capabilities for transforming the GeSy and generating value

Burnout syndrome in Cypriot physiotherapists: a national survey

Background. Burnout in the healthcare workers is formally defined as a state of physical, emotional and mental exhaustion caused by long-term involvement in situations that are emotionally demanding. Methods. Using a random stratified sampling method and taking into account geographical location, specialty and type of employment, 172 physiotherapists working both in the private and public sectors completed an anonymous questionnaire that included several aspects related to burnout; the MBI scale, questions related to occupational stress, and questions pertaining to self image. Results. Almost half (46%) of the 172 participants believed that their job is stressful. Approximately 57% of the physiotherapists who worked in the public sector and 40% of those who worked in the private sector (p = 0.038) reported that their job is stressful. In total, 21.1% of participants met Maslach's criteria for burnout. The point prevalence of burnout was as follows: (1) 13.8% of those who worked in the public sector and 25.5% of those in the private sector (2) 22.2% of males and 20% of females (3) 21.6% who were married, 18% who were single and 33.3% who were separated. Gender was found to be associated with the level of personal accomplishment (chi-squared test; p = 0.049), as 17.8% of men compared with 24.3% of women reported high personal accomplishment. The number of years of working as a physiotherapist correlated negatively (r = -0.229, p = 0.004) with the total depersonalization score. Regression analysis showed that the perception that the job is stressful (p < 0.001) and the low salary (p = 0.016) were significant predictors of high emotional exhaustion scores, while age group (p = 0.027) predicted high scores of depersonalization and the employment sector (p = 0.050) as well as the low salary predicted high personal accomplishment scores. Conclusions. Burnout levels in physiotherapists in Cyprus ranged from low to moderate

Factors influencing prescribing behaviour of physicians in Greece and Cyprus: results from a questionnaire based survey

<p>Abstract</p> <p>Background</p> <p>Over the past few decades, drug and overall healthcare expenditure have risen rapidly in most countries. The present study investigates the attitudes and the factors which influence physician prescribing decisions and practice in Greece and Cyprus.</p> <p>Methods</p> <p>A postal questionnaire was developed by researchers at the Department of Health Economics at the National School of Public Health in Greece, specifically for the purposes of the study. This was then administered to a sample of 1,463 physicians in Greece and 240 physicians in Cyprus, stratified by sex, specialty and geographic region.</p> <p>Results</p> <p>The response rate was 82.3% in Greece and 80.4% in Cyprus. There were similarities but also many differences between the countries. Clinical effectiveness is the most important factor considered in drug prescription choice in both countries. Greek physicians were significantly more likely to take additional criteria under consideration, such as the drug form and recommended daily dose and the individual patient preferences. The list of main sources of information for physicians includes: peer-reviewed medical journals, medical textbooks, proceedings of conferences and pharmaceutical sales representatives. Only half of prescribers considered the cost carried by their patients. The majority of doctors in both countries agreed that the effectiveness, safety and efficacy of generic drugs may not be excellent but it is acceptable. However, only Cypriot physicians actually prescribe them. Physicians believe that new drugs are not always better and their higher prices are not necessarily justified. Finally, doctors get information regarding adverse drug reactions primarily from the National Organisation for Medicines. However, it is notable that the majority of them do not inform the authorities on such reactions.</p> <p>Conclusion</p> <p>The present study highlights the attitudes and the factors influencing physician behaviour in the two countries and may be used for developing policies to improve their choices and hence to increase clinical and economic effectiveness and efficiency.</p

In Cyprus, the Troika should be promoting health reforms towards universal coverage, not derailing them

Last November, the Troika agreed a Memorandum of Understanding with Cyprus, which also made special reference to the country’s health sector. Ahead of Presidential elections in Cyprus on Sunday, Jonathan Cylus, Irene Papanicolas and Mamas Theodorou argue that some of the key recommendations of the Memorandum, such as eliminating access to healthcare at reduced rates, and increasing some fees, threaten to undermine efforts towards Cyprus’s goal of universal health coverage