Inequalities between migrants and non-migrants in accessing and using health services in Greece during an era of economic hardship

A cross-sectional study was conducted from April 2013 until March 2014 to explore the existence of inequalities in access to and utilization of health services by migrants compared to non-migrants in Greece and to test the influence of various factors on these disparities. Also, we investigated the influence of several socioeconomic and demographic characteristics. Study population included 1,152 migrants and 702 non-migrants. Migrants, participants suffering from a chronic disease, those without health insurance, and patients who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in getting their medication. Uninsured participants, females, those unemployed or without a permanent occupational status, and those who assessed their health status as not at all good/a little good/moderate were statistically more likely to report unmet needs in access to health services during the last year. Regarding the use of health services, those with health coverage, non-migrants, and females were statistically more likely to go for a blood test as a hospital outpatient. Greece, despite administrative delays and barriers, provided full coverage to the uninsured, asylum seekers, and migrants, even many groups of undocumented migrants

Instruments for Patient Education: Psychometric Evaluation of the Expected Knowledge (EKhp) and the Received Knowledge of Hospital Patients (RKhp)

Purpose: In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients' expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial).Patients and methods: The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009-2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development.Results: Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care.Conclusion: EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.</p

Knowledge expectations of surgical orthopaedic patients: a European survey

Ageing population entails a growing international problem of osteoarthritis. Best practices for education of these patients are lacking. This study focused on empowering education in Northern (Finland, Iceland, Lithuania and Sweden) and Southern Europe (Cyprus, Greece and Spain). The aim was to analyse associations between expected knowledge and background factors. The data were collected from European arthroplasty patients with the Knowledge Expectations of hospital patients- scale, (KE(hp) - scale), including bio-physiological, functional, experiential, ethical, social and financial dimensions. Patients had essential bio-physiological and functional knowledge expectations. Women expected more than men, employed less than retired, unemployed or who worked at home. Generally, patients in Northern countries expected more than in Southern countries. However, highest expectations were found in Sweden and Greece, lowest in Spain and Cyprus. There are differences in knowledge expectations based on patients' backgrounds. Development of common standards in European patient education needs further research

Hypertension and Exposure to Noise Near Airports: the HYENA Study

We compare two approaches for high-level power estimation of DSP components implemented in FPGAs for different sets of data streams from real-world applications. The first model is a power macro-model based on the Hamming distance of input signals. The second model is an analytical high-level power model based on switching activity computation and knowledge about the component’s internal structure, which has been improved to also consider additional information on the signal distribution of two consecutive input vectors. The results show that the accuracy of both models is, in most cases, within 10% of the low-level power estimates given by the tool XPower when cycle-bycycle input signal distributions are taken into account, and that the difference between the model accuracies depends significantly on the nature of the signals. Additionally, the effort required for the characterization and construction of the models for different component structures is discussed in detail

Attitudes and knowledge of the Greek nursing students towards older people

The proportion of older people has increased worldwide and so are the health problems related with ageing, such as cardiovascular diseases and cancer that often need long-term nursing care. Nurses therefore, have a pivotal role in the care of older people. AIM: To evaluate the effects of education on nursing students' knowledge and attitudes towards older people in Greece. METHOD: Two hundred and twenty seven first and final year nursing students at a university and 191 first and final year nursing students at a Technological Education Institute completed a questionnaire, including demographic questions, the Kogan's Old People Scale and the Palmore's Facts on Aging Quiz I. RESULTS: Attitudes towards older people were more positive in final year students in comparison to first year ones in both schools. Knowledge was found better only in relation to physical health in the final year students, in both schools. Age and female gender were found to influence both attitudes and knowledge positively. CONCLUSIONS: Nursing education in Greece seems to influence the attitudes and knowledge of nursing students towards older people. However, revisions and improvements in curricula are needed if nursing students are to gain a more holistic perspective of older people

Effectiveness of heart failure management programmes with nurse-led discharge planning in reducing re-admissions: A systematic review and meta-analysis

Background: Heart failure (HF) is a clinical condition with major socioeconomic burden. Scientists are trying to find effective solutions to eliminate the effects of the disease and the current innovations in research address the introduction of HF management programmes (HF-MPs). Objectives: A meta-analysis was undertaken to estimate the effect of HF-MP with a nurse-driven pre-discharge phase on the outcomes of HF and all-cause re-admission. Data sources: A systematic search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library (reviews and clinical trials) was performed to locate randomised controlled trials (RCTs), published in English language, which implemented any HF-MP with discharge planning carried out by a nurse. Identified articles were further screened for additional studies. Study selection: Two reviewers independently screened relevant abstracts or titles using a standardised predefined check list. Pilot studies, studies additionally assessing other conditions and studies that evolved technology utilities or included medication management beyond optimisation of therapy, were excluded. Data extraction: Selected articles were thoroughly screened and data of interest (characteristics and outcomes) were obtained. Quality assessment was done by two reviewers separately. Data synthesis: Nineteen RCTs were selected for the meta-analysis. The overall pooled effect (relative risk, RR) of the intervention group compared with the control group was estimated by using a random effects analysis (95% confidence interval (CI)) for the outcomes of HF-related re-admission and all-cause re-admission. The overall RR of HF re-admissions was 0.68, 95% CI (0.53, 0.86), . p<. 0.05 and of all-cause re-admission was 0.85, 95% CI (0.76, 0.94), . p<. 0.05 favouring the intervention. Metaregression analysis was performed while trying to explain the observed heterogeneity but none of the factors (environment, duration of follow-up, origin and complexity) were significantly related with the RR.No significant publication bias was observed regarding both HF and all-cause re-admission. Conclusions: The results of the current meta-analysis highlight the potential of HF-MPs with nurse-driven pre-discharge interventions to reduce hospital re-admissions. Essential characteristics or components of a successful HF-MP are still to be determined, thus more studies are required to solve this issue. 2011 Elsevier Ltd