Maria Polydouri (1902-1930): the Greek poète maudit who died of tuberculosis.

Maria Polydouri was a notable Greek poet. Often likened to the French poètes maudits, her poetry reflected a lyrical charisma and her unsettled life an untimely ending. The passing of both her parents within less than two months when she was aged 18 and her incomplete, desperate affair with the syphilitic poet Kostas Karyotakis, defined her existence. She took up many uncompleted occupations and remained socially committed. It seems that in 1923 she caught tuberculosis that was diagnosed ultimately in 1927 and led to her hospitalization at first in Paris and later in Athens. A progressive and restless spirit until the end, she wrote her best poems while in hospital. Polydouri's final years and death received national attention and marked her out as a Greek literary legend

The earliest mention of a black bag.

A black bag, needed especially for home visits, has been used since the time of Hippocrates who, in his treatise "On good manners", gave the first detailed description of a medical bag with guidelines for the required equipment and structure. Ancient Egyptian and Palestinian references also date back at least two millenniums

The 1889-90 flu pandemic in Greece: a social, cultural and economic history with lessons for the 21^st century.

The 1889-1892 influenza pandemic is the first flu outbreak that can be demonstrated to have been truly worldwide in scope. Its initial spread, along with the successive waves, coincided with an uneasy period of economic and political instability in Greece. Greek historians have largely ignored this outbreak in a national setting and have exclusively focused on the economic crisis and social unrest of that era. As in other countries, it seems that in Greece, too, the case fatality ratio was low, but morbidity and public health issues gained importance. Culturally, it triggered the creation of a new terminology around disease and proved an inspiration for satirical magazines. The economic distress of large parts of the population contributed to the design of health measures of only limited impact, with the press being the main source for dissemination of new health information. Despite being separated by 130 years, the 1889 influenza pandemic and the COVID-19 pandemic share some striking similarities. They both spread across transport lines and were followed by spotty and multifocal subsequent waves, disproportionately affected the poorest and most vulnerable, and led to neologisms, strong public health debates, and shifts in employment habits and measures. As we move forward into the 21st century, it is essential that we are able to reflect on such shared trends over decades, which are true because of common and interactive co-determinants of infectious disease outbreak emergence and spread and our responses to them

Alexandre Yersin's explorations (1892-1894) in French Indochina before the discovery of the plague bacillus.

Alexandre Yersin, the great French discoverer of yersinia pestis, was a keen explorer of unknown lands. At the age of 30, a member of the French Colonial Health service, he set off to fulfil his intimate dream and explore other continents. For almost two years and three long expeditions, he journeyed through widely unknown regions in the province of the French Indochina, in southeast Asia, territories of Vietnam, Cambodia and Laos. This article presents vignettes from his explorations. During his difficult travels, he carefully planned and noted his itineraries; designed new routes, but also observed and recorded sociodemographic and environmental data and unidentified diseases. The immature science of late 19th century geography had the strength to allure such an influential medical figure and place him among the early medical geographers. His journeys, observations and recordings brought to Yersin great experience, and he made his most important scientific contributions after he had concluded his explorations

Infection, contagion and causality in Colonial Britain: the 1889-90 influenza pandemic and the British Medical Journal.

The influenza pandemic of 1889 was the first truly global flu outbreak in scope. Characterised by high morbidity and low mortality, it spread rapidly across Europe and the rest of the world along trading routes. It reached mainland Britain in December 1889. The responses of medical practitioners in Britain and the British colonies to the pandemic were heavily featured in the British Medical Journal and reveal a confusing picture around causality, contagion and infection. Cases from the colonies (Cape Town, India, Australia, Samoan Islands, Hong Kong) as presented in the journal are explored in an attempt to reconstruct the mainstream medical belief of the time. The evidence sadly shows a lack of confidence in contagionism, almost complete absence of monocausalism and a vague picture of the epidemic constitution. Original case studies from colonial medical officers as well as editorials triggered a debate in the pages of the BMJ. In this context, the journal succeeded in playing a key role in recording the first thoroughly documented attack of influenza. In a world that was only learning to be interconnected, the BMJ became the point of reference for the British medical establishment, which ranged from London to Scotland and from Africa and India to Oceania

Multiculturalism and Compassion: Responding to Mental Health Needs Among Refugees and Asylum Seekers Comment on "A Crisis of Humanitarianism: Refugees at the Gates of Europe".

As Fotaki (2019) argues, the current political climate in Europe is threatening principles of humanitarianism, particularly among refugees and asylum seekers. This commentary builds on that argument, with a spotlight on mental health and culturally relevant service design. By addressing some of the barriers faced by refugees and asylum seekers in accessing mental healthcare, we can address inequalities and develop compassionate societies

Implementing a system to evaluate quality assurance in rehabilitation in Greece.

BACKGROUND: Use of a widely accepted quality assurance tool is an essential procedure of effective and result-oriented quality management in the rehabilitation sector, and generally in health care and social services, but is still lacking in Greece. OBJECTIVE: This study aims to explore to what extent a Quality Assurance System in Rehabilitation (QASR) in the Greek setting could respond to the needs for quality evaluation of the facilities for people with a disability and to discuss possibilities of its use in rehabilitation organizations, sites and hospitals. METHODS: The European Quality in Social Services (EQUASS) Assurance self-assessment questionnaire was officially translated and used as the basis for the new tool, which consisted of 110 questions in 11 sections on development and 6 questions on its evaluation. This tool was tested in 15 specialized centers. RESULTS: The study received a high (93.75%) response rate. Overall score ranged from 11% to one perfect 100%; 53.3% of the facilities fell short of the preset qualification standards, while 4 (26.7%) were qualified for level-1 accreditation. Evaluation of the QASR questionnaire for the function of the rehabilitation facilities for the disabled was extremely positive. CONCLUSIONS: The EQUASS assurance-based Greek QASR has received proper attention in its first implementation and it was shown promising to assess the needs of sites that would like to improve their services. The next steps are to establish its validity and reliability so that it can significantly emerge as the standard system for guiding policy in the rehabilitation sector in Greece

Is real world evidence influencing practice? A systematic review of CPRD research in NICE guidances.

BACKGROUND: There is currently limited evidence regarding the extent Real World Evidence (RWE) has directly impacted the health and social care systems. The aim of this review is to identify national guidelines or guidances published in England from 2000 onwards which have referenced studies using the governmental primary care data provider the Clinical Practice Research Datalink (CPRD). METHODS: The methodology recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. Four databases were searched and documents of interest were identified through a search algorithm containing keywords relevant to CPRD. A search diary was maintained with the inclusion/exclusion decisions which were performed by two independent reviewers. RESULTS: Twenty-five guidance documents were included in the final review (following screening and assessment for eligibility), referencing 43 different CPRD/GPRD studies, all published since 2007. The documents covered 12 disease areas, with the majority (N =7) relevant to diseases of the Central Nervous system (CNS). The 43 studies provided evidence of disease epidemiology, incidence/prevalence, pharmacoepidemiology, pharmacovigilance and health utilisation. CONCLUSIONS: A slow uptake of RWE in clinical and therapeutic guidelines (as provided by UK governmental structures) was noticed. However, there seems to be an increasing trend in the use of healthcare system data to inform clinical practice, especially as the real world validity of clinical trials is being questioned. In order to accommodate this increasing demand and meet the paradigm shift expected, organisations need to work together to enable or improve data access, undertake translational and relevant research and establish sources of reliable evidence