Disease severity determines health-seeking behaviour amongst individuals with influenza-like illness in an internet-based cohort.

BACKGROUND: Seasonal influenza epidemics place considerable strain on health services. Robust systems of surveillance are therefore required to ensure preparedness. Sentinel surveillance does not accurately capture the community burden of epidemics as it misses cases that do not present to health services. In this study, Flusurvey (an internet-based community surveillance tool) was used to examine how severity of disease influences health-seeking behaviour in the UK. METHODS: Logistic regression with random effects was used to investigate the association between health-seeking and symptom severity, duration of illness and reduction in self-reported health-score over four flu seasons between 2011 and 2015. RESULTS: The majority of individuals did not seek care. In general, there was very strong evidence for an association between all severity indicators and visiting a health service (p < 0.0001). Being female (OR 1.62, 95% CI 1.23-2.14, p = 0.0003) and a self-diagnosis of the flu (OR 3.39, 95% CI 2.38-4.83, p < 0.0001) were also associated with increased likelihood of visiting a health service. During the 2012-13 and 2014-15 flu seasons, there was a significantly larger proportion of individuals with more severe sets of symptoms and a longer duration of illness. Despite this, the proportion of individuals with particular sets of symptoms visiting a health service showed only very slight variation across years. CONCLUSIONS: Traditional surveillance systems capture only the more severe episodes of illness. However, in spite of variation in flu activity, the proportion of individuals visiting a health service remains relatively stable within specific sets of symptoms across years. These data could be used in combination with data on consultation rates to provide better estimates of community burden

Morphology-based landslide monitoring with an unmanned aerial vehicle

PhD ThesisLandslides represent major natural phenomena with often disastrous consequences. Monitoring landslides with time-series surface observations can help mitigate such hazards. Unmanned aerial vehicles (UAVs) employing compact digital cameras, and in conjunction with Structure-from-Motion (SfM) and modern Multi-View Stereo (MVS) image matching approaches, have become commonplace in the geoscience research community. These methods offer a relatively low-cost and flexible solution for many geomorphological applications. The SfM-MVS pipeline has expedited the generation of digital elevation models at high spatio-temporal resolution. Conventionally ground control points (GCPs) are required for co-registration. This task is often expensive and impracticable considering hazardous terrain. This research has developed a strategy for processing UAV visible wavelength imagery that can provide multi-temporal surface morphological information for landslide monitoring, in an attempt to overcome the reliance on GCPs. This morphological-based strategy applies the attribute of curvature in combination with the scale-invariant feature transform algorithm, to generate pseudo GCPs. Openness is applied to extract relatively stable regions whereby pseudo GCPs are selected. Image cross-correlation functions integrated with openness and slope are employed to track landslide motion with subsequent elevation differences and planimetric surface displacements produced. Accuracy assessment evaluates unresolved biases with the aid of benchmark datasets. This approach was tested in the UK, in two sites, first in Sandford with artificial surface change and then in an active landslide at Hollin Hill. In Sandford, the strategy detected a ±0.120 m 3D surface change from three-epoch SfM-MVS products derived from a consumer-grade UAV. For the Hollin Hill landslide six-epoch datasets spanning an eighteen-month duration period were used, providing a ± 0.221 m minimum change. Annual displacement rates of dm-level were estimated with optimal results over winter periods. Levels of accuracy and spatial resolution comparable to previous studies demonstrated the potential of the morphology-based strategy for a time-efficient and cost-effective monitoring at inaccessible areas

Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review

Corticosteroids constitute an ideal treatment for various inflammatory and autoimmune disorders due to their anti-inflammatory and immunomodulatory actions. However, corticosteroids have a considerable number of side effects, including hypertension, diabetes, lipid disorders, sleep apnea, osteoporosis, myopathy, and disorders of coagulation and fibrinolysis, which are components of Cushing’s syndrome (CS). Corticosteroid-induced side effects are dependent on the formulation, route, dose, and time of exposure. However, the underlying pathogenetic mechanisms have not been clearly defined. A large body of evidence supports the role of an imbalance between vasoconstriction and vasodilation with possible links to nitric oxide, prostanoids, angiotensin II, arginine vasopressin, endothelins, catecholamines, neuropeptide Y, and atrial natriuretic peptide. Increased oxidative stress, renin–angiotensin system activation, increased pressor response, metabolic syndrome, and sleep apnea appear to be pathogenetically involved as well. The ideal treatment is the withdrawal of corticosteroids, which is most often impossible due to the exacerbation of the underlying disease. Alternatively, a careful plan, including the proper selection of the formulation, time, and route, should be made, and each side effect should be treated properly. The focus of the research should be to develop synthetic corticosteroids with anti-inflammatory effects but fewer metabolic effects, which so far has been unsuccessful

How the Strength of the Internal Audit can affect the Performance of the company

Αφορά έρευνα η οποία διεξάχθηκε σε ελληνικές εισηγμένες επιχειρήσεις ανεξαρτήτου κλάδου. Ερωτήθηκαν οι εσωτερικοί ελεγκτές των επιχειρήσεων πάνω σε τρεις τομείς που επηρεάζουν τον εσωτερικό έλεγχο και σε σύγκριση με τα χρηματοικονομικά στοιχεία των εταιρειών αυτών φτάσαμε στην απάντηση της αρχικής μας υπόθεσης, αν ο εσωτερικός έλεγχος μπορεί να προσθέσει αξία στην επιχείρηση.This study examines how the financial performance of a company can be affected by the quality of its internal audit department. We solely focused on internal auditors of Greek organizations and the data were collected via questionnaires on internal auditors and financial reports of the companies. The response rate was 51% and the variables used to determine the quality of the internal audit department, were Objectivity &amp; Independence, Knowledge &amp; Competence and Work Performance &amp; Monitoring and Controls. The Spearman’s correlation method was used to test our hypothesis, and findings showed that Internal Audit’s strength has a positive correlation on the Financial Performance of a company. Concluding that, Internal Audit does add value to a company

Εφαρμογή μεθόδων εντροπίας στην διαγνωστική βλαβών

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Συστήματα Αυτοματισμού

Birth prevalence of anorectal malformations in England and 5-year survival: a national birth cohort study

OBJECTIVE: To determine the birth prevalence, maternal risk factors and 5-year survival for isolated and complex anorectal malformations. DESIGN: National birth cohort using hospital admission data and death records. SETTING: All National Health Service England hospitals. PATIENTS: Live-born singletons delivered from 2002 through 2018, with evidence in the first year of life of a diagnosis of an anorectal malformation and repair during a hospital admission, or anorectal malformation recorded on the death certificate. Cases were further classified as isolated or complex depending on the presence of additional anomalies. MAIN OUTCOME MEASURES: Birth prevalence of anorectal malformations per 10 000 live births, risk ratios for isolated and complex anorectal malformation by maternal, infant and birth characteristics, and 5-year survival. RESULTS: We identified 3325 infants with anorectal malformations among 9 474 147 live-born singletons; 61.7% (n=2050) of cases were complex. Birth prevalence was 3.5 per 10 000 live births (95% CI 3.4 to 3.6). Complex anorectal malformations were associated with maternal age extremes after accounting for other sociodemographic factors. Compared with maternal ages 25-34 years, the risk of complex anorectal malformations was 31% higher for ≥35 years (95% CI 17 to 48) and 13% higher for ≤24 years (95% CI 0 to 27). Among 2376 anorectal malformation cases (n=1450 complex) born from 2002 through 2014, 5-year survival was lower for complex (86.9%; 95% CI 85.1% to 88.5%) than isolated anorectal malformations (98.2%; 95% CI 97.1% to 98.9%). Preterm infants with complex anorectal malformations had the lowest survival (73.4%; 95% CI 68.1% to 78.0%). CONCLUSIONS: Differences in maternal risk factors for isolated and complex anorectal malformations may reflect different underlying mechanisms for occurrence. Five-year survival is high but lowest for preterm children with complex anorectal malformations

Trends in survival of children with severe congenital heart defects by gestational age at birth: A population‐based study using administrative hospital data for England

BACKGROUND: Children with congenital heart defects (CHD) are twice as likely as their peers to be born preterm (<37 weeks' gestation), yet descriptions of recent trends in long-term survival by gestational age at birth (GA) are lacking. OBJECTIVES: To quantify changes in survival to age 5 years of children in England with severe CHD by GA. METHODS: We estimated changes in survival to age five of children with severe CHD and all other children born in England between April 2004 and March 2016, overall and by GA-group using linked hospital and mortality records. RESULTS: Of 5,953,598 livebirths, 5.7% (339,080 of 5,953,598) were born preterm, 0.35% (20,648 of 5,953,598) died before age five and 3.6 per 1000 (21,291 of 5,953,598) had severe CHD. Adjusting for GA, under-five mortality rates fell at a similar rate between 2004-2008 and 2012-2016 for children with severe CHD (adjusted hazard ratio [HR] 0.79, 95% CI 0.71, 0.88) and all other children (HR 0.78, 95% CI 0.76, 0.81). For children with severe CHD, overall survival to age five increased from 87.5% (95% CI 86.6, 88.4) in 2004-2008 to 89.6% (95% CI 88.9, 90.3) in 2012-2016. There was strong evidence for better survival in the ≥39-week group (90.2%, 95% CI 89.1, 91.2 to 93%, 95% CI 92.4, 93.9), weaker evidence at 24-31 and 37-38 weeks and no evidence at 32-36 weeks. We estimate that 51 deaths (95% CI 24, 77) per year in children with severe CHD were averted in 2012-2016 compared to what would have been the case had 2004-2008 mortality rates persisted. CONCLUSIONS: Nine out of 10 children with severe CHD in 2012-2016 survived to age five. The small improvement in survival over the study period was driven by increased survival in term children. Most children with severe CHD are reaching school age and may require additional support by schools and healthcare services

Οι κοινωνικοπολιτικές διαστάσεις της ροκ μουσικής της δεκαετίας του 1960

Η εργασία πραγματεύεται την αξία της μουσικής στη κοινωνία και τη πολιτική. Συγκεκριμένα, αναλύει τη περίοδο των 60s όπου ιστορικά και κοινωνικά σημειώνονταν μεγάλες εξελίξεις οι οποίες φαίνεται να επηρέασαν και τη μουσική.The thesis deals with the value of music in society and politics. Specifically, it analyzes the period of the 60s where historically and socially there were great developments which seem to have influenced the music as well

Methods and introductory results of the Greek national health and nutrition survey - HYDRIA

Background: &nbsp;According to a large prospective cohort study (with baseline examination in the 1990s) and smaller studies that followed, the population in Greece has been gradually deprived of the favorable morbidity and mortality indices recorded in the 1960s. The HYDRIA survey conducted in 2013-14 is the first nationally representative survey, which collected data related to the health and nutrition of the population in Greece. Methods: The survey sample consists of 4011 males (47%) and females aged 18 years and over. Data collection included interviewer-administered questionnaires on personal characteristics, lifestyle choices, dietary habits and medical history; measurements of somatometry and blood pressure; and, blood drawing. Weighting factors were applied to ensure national representativeness of results. Results: Three out of five adults in Greece reported suffering of a chronic disease, with diabetes mellitus and chronic depression being the more frequent ones among older individuals. The population is also experiencing an overweight/obesity epidemic, since seven out of 10 adults are either overweight or obese. In addition, 40% of the population bears indications of hypertension. Smoking is still common and among women the prevalence was higher in younger age groups. Social disparities were observed in the prevalence of chronic diseases and mortality risk factors (hypertension, obesity, impaired lipid profile and high blood glucose levels). Conclusion: Excess body weight, hypertension, the smoking habit and the population’s limited physical activity are the predominant challenges that public health officials have to deal with in formulating policies and designing actions for the population in Greece