Alien Registration- Prezerakos, Louis J. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/31364/thumbnail.jp

Measuring intra-hospital clinic efficiency and productivity : an application to a Greek university general hospital

In this paper we use Data Envelopment Analysis and the Malmquist Productivity Index and its decompositions to assess the productive efficiency and productivity of the in-patient clinics of a large Greek University General Hospital. Clinics are represented by means of a simple model whereby they use inputs (labor and capital) to produce outputs (in-patient days and patient discharges). The efficiency model is input oriented and assumes constant returns to scale. Model validation analyses showed that this model appears to be externally valid. The framework proposed here is a simple and useful tool for informing intra-hospital management decisions.peer-reviewe

Health care services performance measurement : theory, methods and empirical evidence

Despite the growing international literature in the field of efficiency and productivity measurement there are very limited Greek applications partly due to inadequate and incomplete datasets. The aim of this article is to illustrate the main methodologies for health care services efficiency and productivity measurement, to present their strengths and weaknesses and to discuss the existing evidence from applications in other countries. Notwithstanding the fact that the related methodologies have been recently developed these methods may help practitioners and health care decisions makers in improving health care management in Greece.peer-reviewe

Measuring across hospital efficiency and productivity : the case of second regional health authority of Attica

The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998 - 2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998- 2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.peer-reviewe

Trait Emotional Intelligence Questionnaire-Adolescent Short Form: A Psychometric Investigation in Greek Context

This article aims to investigate the reliability and validity of the Trait Emotional Intelligence Questionnaire–Adolescent Short Form (TEIQue-ASF) score in a sample of 440 Greek adolescents. The instrument’s score demonstrated good internal consistency and was significantly correlated with core self-evaluations as well with somatic complaints, self-report psychopathology, and personal strengths. It also explained a statistically significant increase in the prediction of outcome variables beyond core self-evaluations. It is concluded that the findings of the present study provide evidence that support the interpretation and use of the TEIQue-ASF score to assess the emotional self-perceptions of Greek adolescents

The surgical management of dysphagia secondary to diffuse idiopathic skeletal hyperostosis

OBJECTIVE: This study reviews the management pathway and surgical outcomes of patients referred to and operated on at a tertiary neurosurgical centre, for dysphagia associated with anterolateral cervical hyperostosis (ACH) in diffuse idiopathic skeletal hyperostosis (DISH). PATIENTS & METHODS: Electronic patient records for 6 patients who had undergone anterior cervical osteophytectomy for dysphagia secondary to ACH were reviewed. ACH diagnosis was made by an Ear, Nose and Throat (ENT) specialist and patients were referred to a neurosurgical-led multidisciplinary team (MDT) for review. A senior radiologist performed imaging measurements and vertebral level localization was confirmed via barium-swallow video-fluoroscopy. Speech and language therapists (SLTs) determined the suitability of pre-operative conservative management. Patients were followed-up post-operatively with clinical and radiological assessments. RESULTS: 6 patients (Male to female ratio, 6:0; mean age, 59 years) were referred to a tertiary neurosurgical centre with DISH related dysphagia, an average of 25 months after ENT review (range, 14-36 months) between 2005 and 2016. The vertebral levels implicated in dysphagia ranged from C2 to T1 with a median of 4 vertebral levels involved. The most frequently affected vertebral levels were C4-6 (all 6 patients). The average antero-posterior height (as measured on axial images) of the most prominent osteophyte was 15.9 mm (range 12.0-20.0 mm). Patients underwent elective cervical osteophytectomy on average 10.8 months after neurosurgical review (range, 3-36 months). One patient had a post-operative haematoma needing evacuation and prolonged hospital stay. The average duration of follow-up was 42.3 months. All our patients maintained good symptomatic resolution without osteophyte recurrence. CONCLUSIONS: All our patients experienced significant and sustained clinical improvement. Anterior cervical osteophytectomy consistently leads to improvement in symptomatic ACH patients without recurrence. Early referral to a neurosurgical multi-disciplinary team (MDT) is indicated in ACH related dysphagia, once conservative management has failed

SARS-CoV-2 sero-surveillance in Greece: evolution over time and epidemiological attributes during the pre-vaccination pandemic era

BACKGROUND: Nation-wide SARS-CoV-2 seroprevalence surveys provide valuable insights into the course of the pandemic, including information often not captured by routine surveillance of reported cases. METHODS: A serosurvey of IgG antibodies against SARS-CoV-2 was conducted in Greece between March and December 2020. It was designed as a cross-sectional survey repeated at monthly intervals. The leftover sampling methodology was used and a geographically stratified sampling plan was applied. RESULTS: Of 55,947 serum samples collected, 705 (1.26%) were found positive for anti-SARS-CoV-2 antibodies, with higher seroprevalence (9.09%) observed in December 2020. Highest seropositivity levels were observed in the "0-29" and "30-49" year age groups. Seroprevalence increased with age in the "0-29" age group. Highly populated metropolitan areas were characterized with elevated seroprevalence levels (11.92% in Attica, 12.76% in Thessaloniki) compared to the rest of the country (5.90%). The infection fatality rate (IFR) was estimated at 0.451% (95% CI: 0.382-0.549%) using aggregate data until December 2020, and the ratio of actual to reported cases was 9.59 (7.88-11.33). CONCLUSIONS: The evolution of seroprevalence estimates aligned with the course of the pandemic and varied widely by region and age group. Young and middle-aged adults appeared to be drivers of the pandemic during a severe epidemic wave under strict policy measures

Mediterranean cyclones and windstorms in a changing climate

Changes in the frequency and intensity of cyclones and associated windstorms affecting the Medi-terranean region simulated under enhanced Greenhouse Gas forcing conditions are investigated. The analysis is based on 7 climate model integrations performed with two coupled global models (ECHAM5 MPIOM and INGV CMCC), comparing the end of the twentieth century and at least the first half of the twenty-first century. As one of the models has a considerably enhanced resolution of the atmosphere and the ocean, it is also investigated whether the climate change signals are influenced by the model resolution. While the higher resolved simulation is closer to reanalysis climatology, both in terms of cyclones and windstorm distributions, there is no evidence for an influence of the resolution on the sign of the climate change signal. All model simulations show a reduction in the total number of cyclones crossing the Mediterranean region under climate change conditions. Exceptions are Morocco and the Levant region, where the models predict an increase in the number of cyclones. The reduction is especially strong for intense cyclones in terms of their Laplacian of pressure. The influence of the simulated positive shift in the NAO Index on the cyclone decrease is restricted to the Western Mediterranean region, where it explains 10–50 % of the simulated trend, depending on the individual simulation. With respect to windstorms, decreases are simulated over most of the Mediterranean basin. This overall reduction is due to a decrease in the number of events associated with local cyclones, while the number of events associated with cyclones outside of the Mediterranean region slightly increases. These systems are, however, less intense in terms of their integrated severity over the Mediterranean area, as they mostly affect the fringes of the region. In spite of the general reduction in total numbers, several cyclones and windstorms of intensity unknown under current climate conditions are identified for the scenario simulations. For these events, no common trend exists in the individual simulations. Thus, they may rather be attributed to long-term (e.g. decadal) variability than to the Greenhouse Gas forcing. Nevertheless, the result indicates that high-impact weather systems will remain an important risk in the Mediterranean Basin

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them