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

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

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

A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: sorafenib for second line renal cell cancer

BACKGROUND: The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure. AIM: To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework. METHODS: A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed. RESULTS: Sorafenib value based price was found to be significantly lower compared to its current reference price. CONCLUSION: Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme

Performance characteristics of automated clinical chemistry analyzers using commercial assay reagents contributing to quality assurance and clinical decision in a hospital laboratory

Background: Clinical laboratories provide essential diagnostic services that are essential in clinical decision making, contributing to the quality of healthcare. The performance of two Siemens ADVIA 1800 analyzers was characterized in a hospital Biochemistry laboratory in order to evaluate the analytical characteristics of such automated analyzer systems using nonoriginal assay reagents attempting to support laboratory quality service and crucial clinical decision making. Methods: We independently completed performance validation studies including trueness, precision, sensitivity as well as measurement of uncertainty and sigma metrics calculation for 25 biochemical parameters. Results: Trueness expressed as bias was less than 20% for both ADVIA 1800 analyzers. Within run and total precisions expressed as CV% were ≤9.85% on both analyzers for most parameters studied with few exceptions (Mg, TB, DB, Cl, HDL and UA) observed either in low or in high level samples and between the two analyzers. LoB, LoD and LoQ values produced by the two analyzers were comparable except Cl. Uncertainty values produced by the two analyzers were comparable with no significant differences. Quality performance of reagent assays was studied using the sigma metrics system. The sigma values were plotted on normalized method decision charts for graphical representation of assay performances for each analyzer. Conclusions: The two ADVIA systems, independently evaluated, showed consistent performance characteristics with certain discrepancies by several reagents. Sigma analysis was helpful for revealing the quality performance of non-original reagents supporting the need for strict assessment of quality assurance and in some instances optimization/improvement of assay methods

Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis

In this article, we present the data related to motivational factors given by the medical (n=118) and nursing (n=217) staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015) [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial). The data contains 4 parts: (1) demographics, (2) assessment of the degree to which this hospital provided such incentives-rewards, (3) personal assessment of the participants about the significance of these incentive-rewards and (4) to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses) for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models

Inhibitory control, cognitive flexibility, and the production of disfluencies in children who do and do not stutter

Purpose: Differences in inhibitory control and cognitive flexibility between children who stutter (CWS) and children who do not stutter (CWNS) have been previously demonstrated. The aim of the current study was to investigate whether the previously reported inhibitory control– and cognitive flexibility–related performance costs for CWS are associated with the number of speech disfluencies that they produce. Method: Participants were 19 CWS (Mage = 7.58 years, range: 6.08–9.17) and 19 CWNS matched on age and gender (Mage = 7.58 years, range: 6.08–9.33). Gamma regression models were used to investigate possible associations between performance costs in speed and accuracy measured during a computer task evaluating inhibitory control and cognitive flexibility and the number of speech disfluencies during video-recorded speech samples (story retelling and casual conversation). Results: Two significant interactions were observed. For both inhibitory control and cognitive flexibility, we identified a significant group and inhibitory control/cognitive flexibility performance–cost interaction in stuttering-like disfluencies (SLDs), indicating that the performance–cost effects on SLD production were significantly higher in the CWS group, compared to the CWNS group. Conclusions: CWS with reduced inhibitory control or cognitive flexibility produce more SLDs, but not other disfluencies. These results are partly in line with some previous findings in nonstuttering and stuttering populations linking inhibitory control and cognitive flexibility weaknesses to the production of speech disfluencies

Development and Validation of a Knowledge Management Questionnaire for Hospitals and Other Healthcare Organizations

Sustainable societies need to consider the connection between knowledge management (KM) and healthcare as a critical issue for social development. They need to investigate how to create knowledge and identify possible predictors of knowledge-sharing behavior that can support a hospital’s sustainable knowledge-management strategy. KM strategies could help managers to increase the performance of hospitals and other healthcare organizations. The purpose of this paper is to present a valid and reliable questionnaire about KM in healthcare organizations. We develop a new knowledge-management questionnaire based on the use of an extensive literature review and health professionals’ consensus. The Applied Knowledge Management Instrument (AKMI) questionnaire was pilot tested and retested on a small group of employees of healthcare organizations (n = 31). After the pilot process, a larger group of health professionals (n = 261) completed the questionnaire. Further investigation resulted in item reduction and verification of the dimensions of AKMI. Finally, we explore the psychometric properties of the developed tool. The developed questionnaire seems to be reliable, valid, and suitable to be used for studying the suggested nine dimensions of KM: perceptions of KM, intrinsic and extrinsic motivations, knowledge synthesis and sharing, cooperation, leadership, organizational culture, and barriers. The developed questionnaire can help policymakers and hospital administrators collect information about KM processes in healthcare organizations and this can result in higher performance of health organizations

Goal Orientation Profiles, Academic Achievement and Well-Being of Adolescents in Greece

Adolescents differ in the way they motivate themselves, and the way they choose, perceive, and approach their goals. Goal orientations have been proposed to be a significant aspect of individual differences. In general, some students aim at gaining a higher level of skills, whereas other students aim at showing a high level of performance in relation to their classmates. This chapter aimed at exploring the links between goal orientation profiles and psychological well-being in adolescent students in Greece. Using a sample of 576 high-school students (Mage = 15.2, 44% girls), person-centered analyses were performed on goal orientations scales whereas GPA, self-esteem and symptoms were used to measure adaptation and psychological well-being. Four profiles emerged, on the basis of the scores on the four goal orientation dimensions. Statistically significant mean differences were found between the four groups on all measures of adaptation. Mastery-oriented students were found to show the best adaptation, overall. The results support the notion that approaching learning tasks for the sake of learning and the resulting personal development is a strong indicator of positive adaptation