Attitudes towards euthanasia in severely ill and dementia patients and cremation in Cyprus: a population-based survey

Background: Population studies on end-of-life decisions have not been conducted in Cyprus. Our study aim was to evaluate the beliefs and attitudes of Greek Cypriots towards end-of-life issues regarding euthanasia and cremation. Methods: A population-based telephone survey was conducted in Cyprus. One thousand randomly selected individuals from the population of Cyprus age 20 years or older were invited to participate. Beliefs and attitudes on end-of-life decisions were collected using an anonymous and validated questionnaire. Statistical analyses included cross-tabulations, Pearson’s chi-square tests and multivariable-adjusted logistic regression models. Results: A total of 308 males and 689 females participated in the survey. About 70% of the respondents did not support euthanasia for people with incurable illness and/or elders with dementia when requested by them and 77% did not support euthanasia for people with incurable illness and/or elders with dementia when requested by relatives. Regarding cremation, 78% were against and only 14% reported being in favor. Further statistical analyses showed that male gender, being single and having reached higher educational level were factors positively associated with support for euthanasia in a statistically significant fashion. On the contrary, the more religiosity expressed by study participants, the less support they reported for euthanasia or cremation. Conclusions: The vast majority of Greek Cypriots does not support euthanasia for people with incurable illness and/or elders with dementia and also do not support cremation. Certain demographic characteristics such as age and education have a positive influence towards attitudes for euthanasia and cremation, while religiosity exerts a strong negative influence on the above. Family bonding as well as social and cultural traditions may also play a role although not comprehensively evaluated in the current study

Interna revizija u javnim bolnicama: slučaj Grčke

Internal control is of utmost importance for effective corporate governance, particularly in public hospitals aiming for modernization in the Greek framework. Internal audit functions enhance transparency, enforce accountability, and ensure compliance with societal values, bolstering public trust. This study delves into the implementation of internal control in Greek public hospitals, considering factors like size, structure, and operational intricacies. We explore the regulatory framework, procedures, scope, and objectives, while interviewing auditing experts for insights into challenges and opportunities. Findings reveal procedural dominance in current implementation of the Law. Focus on accounting neglects crucial functional departments. The audit committee\u27s role and composition raise independence concerns. Understaffing further hampers operations. A significant weakness appears in the independence of the audit. Internal auditors report to the hospital administrator and participate in the audit committee. The appointment and remuneration of auditors is not based on the auditor\u27s competence and suitability, but on a cost basis. The question therefore arises as to whether the auditor performs the duties objectively and impartially in accordance with the International Institute of Internal Auditors\u27 standards. Furthermore, regarding the research question on the role of the internal auditor and the treatment by auditees, there has been a significant improvement as evident by the respondents’ answers.Unutarnja kontrola od iznimne je važnosti za učinkovito korporativno upravljanje, posebno u javnim bolnicama koje teže modernizaciji u grčkom okviru. Funkcije interne revizije povećavaju transparentnost, provode odgovornost i osiguravaju usklađenost s društvenim vrijednostima, jačajući povjerenje javnosti. Ova rad bavi se provedbom interne kontrole u grčkim javnim bolnicama, uzimajući u obzir čimbenike poput veličine, strukture i složenosti rada. Istražujemo regulatorni okvir, postupke, opseg i ciljeve, te intervjuiramo revizorske stručnjake radi uvida u izazove i prilike. Nalazi otkrivaju proceduralnu dominaciju u trenutnoj provedbi Zakona. Usredotočenost na računovodstvo zanemaruje ključne funkcionalne odjele. Uloga i sastav odbora za reviziju izaziva zabrinutost glede neovisnosti. Nedostatak osoblja dodatno otežava rad. Značajna slabost javlja se u neovisnosti revizije. Unutarnji revizori odgovaraju upravitelju bolnice i sudjeluju u revizijskom odboru. Imenovanje i nagrađivanje revizora ne temelji se na stručnosti i podobnosti revizora, već na osnovi troškova. Stoga se postavlja pitanje obavlja li revizor svoju dužnost objektivno i nepristrano u skladu sa standardima Međunarodnog instituta internih revizora. Nadalje, kada je riječ o istraživačkom pitanju o ulozi internog revizora i pristupu reviziji, došlo je do značajnog poboljšanja što je vidljivo iz odgovora ispitanika

Support for smoke-free policies in the Cyprus hospitality industry

Objectives The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. Methods A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Results Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predicted by SHS exposure, perceived prevalence of smoker clients, and smoke-free policy attitudes. Conclusions SHS exposure and related health beliefs, and normative factors should be targeted by interventions aiming to promote policy support in the hospitality industry in Cyprus

Repeated Transradial Catheterization: Feasibility, Efficacy, and Safety

Transradial access is an alternative to the transfemoral approach in coronary interventions. It results in less access-site bleeding, shorter hospital stays, lower costs, and less pain for the patient. However, some authors have suggested that the transradial approach might lead to radial artery occlusion, which precludes repeated same-artery catheterizations. Using data from our center, we evaluated the feasibility, safety, and efficacy of repeated transradial catheterization. We reviewed the 3,006 transradial catheterizations performed at our center from 2006 through 2009. Patients who had undergone at least one repeated transradial catheterization were identified, their cases monitored through 2012, and their baseline characteristics and other factors, including procedural sequelae, were analyzed. Seventy-nine patients underwent repeated right radial artery catheterizations, for a total of 92 repeated procedures. Repeated access to the right radial artery was not achieved in 4 attempts (failure rate, 4.3%), because of poor pulses or the operator\u27s inability to advance the wire. No major sequelae were noted. The average times between the 1st to 2nd, 2nd to 3rd, and 3rd to 4th catheterizations were 406, 595, and 401 days, respectively. Our procedural success rate of 95.7% in performing repeated transradial catheterizations with no major sequelae provides support for the efficacy and safety of such procedures

'Big-5' Personality Traits and Revisit Intentions: The Mediating Effect of Memorable Tourism Experiences

Purpose: This study aims to investigate the influence of the 'Big Five' personality traits on memorable tourism experiences (MTE) and revisit intentions. It explores the interrelationships among these three constructs. Methods: A sample of 239 outbound tourists at Larnaca and Paphos international airports in Cyprus was utilized. The research employed a combination of exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and mediation analysis to assess the mediating role of MTE dimensions between personality traits and revisit intentions. Results: The results indicate that most associations between the Big Five personality traits and the seven MTE dimensions were not statistically significant, with the exception of two relationships: neuroticism with novelty, and openness with refreshment. All seven MTE dimensions were found to have a positive and significant impact on revisit intentions. However, the direct effects of personality traits on revisit intentions were not significant. Mediation analysis showed partial mediation for all seven MTE dimensions in the relationship between agreeableness and revisit intentions. Implications: Given the limited predictive power of the Big Five personality traits and the seven-dimensional MTE scale in this context, future research should consider employing alternative or expanded measures for both personality and MTE. Researchers are encouraged to refine and broaden these constructs to better capture their potential influence on tourist behavior

Navigating through the maze of pricing and affordability of branded pharmaceuticals in the midst of the financial crisis: a comparative study among five European recession countries, from a Cyprus perspective

BACKGROUND: Financial recession mandated the introduction of harsh austerity measures. Health, and particularly pharmaceuticals, constitute a significant part of public expenditure and as such they have been subject to significant budget reduction and stringent policies. As a consequence of these measures, an increasing percentage of patients resort to private sector for acquisition of their prescribed pharmaceuticals, due to exclusion of public health care beneficiary status, reduction of breadth of national formularies, delays in reimbursement and excessive waiting times. Affordability for pharmaceuticals in the private sector is of paramount importance since household disposable income plummets and more people are prone to impoverishment. This is critical for branded products, whose active substance and trademark are under patent protection, since no alternative options exist while their monopoly status imply that their prices are high. The impact on affordability regarding access of patient to necessary pharmaceutical care has not been documented in developed countries. METHODS: A laspeyer index was constructed to compare prices of branded pharmaceuticals and assess affordability, by adjusting price index with Gross Domestic Product Purchase Power Parity per capita. Laspeyer index compares prices based on weights, which in our study are the corresponding sales of products in Cyprus. Moreover, we define the percentage of population that will face catastrophic pharmaceutical expenditure after acquisition of one product from eight major and common therapeutic categories. We used data from five European recession countries: Italy, Portugal, Spain, Greece and Cyprus, for 48 products which were selected based on sales. RESULTS: Cyprus displays the highest prices for pharmaceuticals. By adjusting for Gross Domestic Product Purchase Power Parity per capita, affordability is worst for Cyprus and Portugal. CONCLUSIONS: As more patients have to resort to private sector for provision of adequate and timely healthcare, health agencies must reassess affordability of medicines and minimise catastrophic expenditure impact. Health agencies should primarily try to enhance efficiency of the system and reduce waste, instead of resorting to blunt budget reduction, which can demonstrate unpredictable consequences in public health