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Recently, studies of squirrel-cage induction machines validate the idea that these machines follow the double-cage induction model; however, the manufacturers categorize these machines as single-cage machines. There are many references that use the squirrel-model for squirrel-cage machines, then machine parameters increase from 5 to 7. In the laboratory, parameter determination is performed to estimate 5 parameters; however, 7 parameters have to be determined. Also, the DC test is not an exact test and is used for approximate estimation. Therefore, locked rotor test equations are changed and an overload test is added. After measurements in the laboratory according to the equations of this paper, a MATLAB program is prepared and 7 parameters are determined in a loop until reaching the desired error. This paper demonstrates that laboratory squirrel-cage machines have to be corrected using the 7-parameter model. Furthermore, this paper shows the necessity of new laboratory test equations for squirrel-cage machines. Then a numerical method is used to determine the machine parameters. [ABSTRACT FROM AUTHOR]

In this paper, a decentralized energy management system is presented for intelligent microgrids with the presence of distributed resources using reinforcement learning. Due to the unpredictable nature of renewable energy resources, the variability of load consumption, and the nonlinear model of batteries, the design of a microgrid energy management system is associated with many challenges. In addition, centralized control structures in large-scale systems increase computational volume and complexity in control algorithms. In this paper, a fully decentralized multi-agent structure for a microgrid energy management system is proposed and the Markov decision process is used to model the stochastic behavior of agents in the microgrid. Electrical and thermal distributed resources, batteries, and consumers are considered intelligent and independent agents. They have the learning ability to explore and exploit the environment in a fully decentralized manner and achieve their optimal policies. The proposed method for hourly microgrid management is model-independent and based on learning. The method maximizes the profits of all manufacturers, minimizes consumer costs, and reduces the dependence of the microgrid on the maingrid. Finally, using real data from renewable energy sources and consumers, the accuracy of the proposed method in the Iranian electricity market is simulated and verified. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus disease 2019 (COVID-19) placed unprecedented pressure on the healthcare system. COVID-19 is highly contagious, and the severity of cases varies. For this reason, extensive measures have been taken to prevent the spread of the infection in hospitals. According to the Centers for Disease Control and Prevention (CDC), COVID-19 has greatly affected the incidence of healthcare-associated infections, including surgical site infections (SSIs). Aim: The investigation of the impact of COVID-19 on the incidence of SSI. Methods: A systematic review of the literature was conducted in the international electronic database "PubMed" with the keywords: "COVID-19", "surgical site infection*", "SSI" and in the Greek electronic database "IATROTEK-online" with the keywords: "surgical site infections" and "COVID-19", without time limit for the publication of scientific papers. On PubMed, the keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in English and Greek language, were conducted on animals, and were case studies, editorials, and letters to the editor. Results: Of the 32 scientific papers retrieved, seven were included in the systematic review. In 5 of the participating studies, the incidence of SSIs during the COVID-19 pandemic period was decreased by 30.7% to 100% compared with the period before the pandemic due to the increased use of personal protective equipment and the implementation of site-specific protocols concerning the management of patients preoperatively, intraoperatively and postoperatively. In one of the remaining studies, the incidence of SSIs did not change during the COVID-19 pandemic period, while in the other, the incidence increased. Conclusions: The increased use of personal protective equipment and the implementation of site-specific protocols concerning the management of patients preoperatively, intraoperatively, and postoperatively, due to the COVID-19 pandemic, has led to a reduction in incidence of SSIs. [ABSTRACT FROM AUTHOR]

OBJECTIVE The depiction of the Perceived Organizational Support (POS) of the employees of the National Emergency Aid Center (Emergency Medical System) in the 4th Region of Crete. In addition, the correlation with demographic characteristics, such as sex, age group, family status, but also with professional ones, such as work experience, the area of work per prefecture and the level of education. METHOD One hundred and ninety employees of the National Emergency Aid Center of the 4th Region of Crete participated in the survey. A paper-based questionnaire was developed as a data collection tool. The recording of the demographic data was carried out with close-ended questions. The answers were gradated according to the Likert scale. The research model used was the "Survey of Perceived Organizational Support" (SPOS) in the short version of the eight items. The statistical analysis was carried out using the Statistical Package for Social Sciences (IBM SPSS), version 24.0. RESULTS The scale of POS presented mean value 2.4 (±1.3 standard deviation), while the mean value and the interquartile range was 2.5 (1.5-3.0). In terms of demographic characteristics (sex, age group, family status), no factor gave a statistically satisfactory result to be studied. In terms of professional characteristics, only the area of work per prefecture presented interest (p<0.001), depicting the highest mean value for Lasithi (3.0) and the lowest for Rethymno (1.5). In Heraklion and Chania the rates were roughly the same (2.5 and 2.6, respectively). CONCLUSIONS The majority of the employees at the National Emergency Aid Center of the 4th Region of Crete did not perceive the organization as being supportive towards them. The low rates of POS, especially in the area of work in Rethymno, need further investigation, as a comparison can be made to the area of work in Lasithi, whose employees feel that the organization cares about them and appreciates them. [ABSTRACT FROM AUTHOR]

In this paper, a three-level framework is proposed to determine the optimal scheduling of a Multi-Area Active Distribution Network in the presence of inter-area Soft Open Points (SOPs). In this framework, the uncertainty of renewable generation and forecasted demand is modeled using information gap decision theory in a risk-averse manner. Coordinated scheduling of Controllable Distributed Generators (CDGs) and SOPs, inter-area energy exchanges and energy trading with upstream network considering the uncertainties are the contribution of the presented method. To improve the computational efficiency and to achieve the optimal solution, the scheduling problem is modeled as a second-order conic programming in which the operational and security constraints of the network, CDG limitations, and operational constraints of SOPs are accurately modeled and the problem is solved by executing CPLEX solver in MATLAB environment. A case study on IEEE 33-bus test system showcases the superiority of the proposed model compared to meta-heuristic algorithms such as particle swarm optimization, genetic algorithm, and gravitational search algorithm. [ABSTRACT FROM AUTHOR]

Islanding is one of the important challenges in power networks in the presence of distributed generation which is considered an undesirable incident due to the possibility of damage to operators, network equipment, and consumers. Therefore, it is necessary to quickly detect islanding and make a decision regarding the connection status of local distributed generation units in the network. In this paper, a passive islanding detection method is proposed using adaptive threshold-based instantaneous frequency droop characteristic. The proposed threshold limit is dynamically changed depending on under-studied conditions to discriminate the island from load changes, capacitor bank switching, motor start-up, and short circuit types. Two medium voltage networks of Cigre and 34-bus IEEE are used to evaluate the proposed method. The simulations are performed in Digsilent software and the proposed method is implemented in MATLAB software. The simulation results indicate that the island is correctly detected with appropriate accuracy in a short period of time from other disturbances in the presence of wind, solar and diesel types of distributed generations. [ABSTRACT FROM AUTHOR]

The commutation torque ripple adversely affects the performance of the six-phase inverter of the BLDC motor with trapezoidal back EMF and creates vibration and noise for industrial applications. In this paper, the motor model is obtained in non-commutation times and during the commutation period, and according to that, a suitable method to reduce the torque ripple, by equalizing the slope of the current disconnected from the motor and the slope of the current connected to the motor during commutation, is presented. At low speeds, torque ripple is reduced using predictive pulse width modulation technique. With this method, the duty cycle of the switch involved in the commutation is predicted and applied to the switch during the commutation intervals. At high speeds, this reduction is done using quasi z-source converter and selector circuit. The quasi z-source converter and the selector circuit increase the input voltage of the inverter during commutation intervals and increase its value to four times the back EMF voltage of the motor, thus reducing the torque ripple at high speeds. The theoretical and analytical results are verified using the simulations performed in the PLECS software. [ABSTRACT FROM AUTHOR]

The presence of electric vehicle technology in distribution networks as controllable resources provides advantages such as voltage regulation, power peaking, and loss reduction. This technology has a positive effect on the performance of the distribution network, but the simultaneous presence of electric vehicles and distributed generation sources requires optimal planning because the lack of access to an application reduces the life of these technologies and can cause blackouts in the power network. Therefore, in this study, the dynamic reconfiguration of the distribution network in the simultaneous presence of distributed generation sources and electric vehicles is proposed. Also, the time-of-use mechanism has been proposed as one of the demand response applications to improve the power consumption of subscribers. The objective functions in this study include the reduction of energy loss, operational cost and energy not supplied as the objective function of reliability. In general, the optimization problem of distribution network reconfiguration is complex and non-convex. Also, considering the effect of distributed generation units and electric vehicles makes the problem more complicated than before. Therefore, finding a practical method to solve the optimization problem is one of the main challenges of this paper. For this purpose, a novel hybrid algorithm based on a combination of an improved particle swarm optimization-artificial bee colony is presented to overcome the complexities of the optimization problem. The proposed method has [ABSTRACT FROM AUTHOR]

Magnetic Induction Tomography (MIT) is a promising modality for noninvasive imaging due to its contactless and nonionizing technology. In this imaging method, a primary magnetic field is applied by excitation coils to induce eddy currents in the material to be studied, and a secondary magnetic field is detected from these eddy currents using sensing coils. The image (spatial distribution of electrical conductivity) is then reconstructed using measurement data, the initial estimation of electrical conductivity, and the iterative solution of forward and inverse problems. The inverse problem can be solved using one-step linear, iterative nonlinear, and special methods. In general, the MIT inverse problem can be solved by Gauss-Newton iterative method with acceptable accuracy. In this paper, this algorithm is extended and the zoning technique is employed for the reduction of unknown coefficients. The simulation results obtained by the proposed method are compared with the real conductivity coefficients and the mean relative error rate is reduced to 24.22%. On the other hand, Gauss-Newton iterative method is extended for solving the inverse problem of the MIT, and sensitivity measurement matrices are extracted in different experimental and normalization conditions. [ABSTRACT FROM AUTHOR]

Low-frequency noise modeling and estimation is a critical issue in the design of analog and digital circuits, especially for short-channel CMOS technologies. The conventional noise models do not fit the experimental results adequately at frequencies close to DC for amplifiers and close to the carrier frequency for oscillators. Furthermore, measuring this noise necessitates the use of specialized and expensive equipment. In this paper, the bound of carrier trapping and releasing are extracted while examining the characteristics of low-frequency noise using the EMD method, and an innovative model based on carrier number fluctuations is proposed. The method introduces a low-cost measurement system for low=frequency noise. The performance accuracy of this measurement system and the proposed model is evaluated and compared with conventional noise modeling methods. The evaluation results demonstrate the success of the proposed measurement setup and model in estimating near-DC noise. [ABSTRACT FROM AUTHOR]

Traditionally, photovoltaic power plants use Maximum Power Point Tracking (MPPT) algorithms to produce maximum electrical energy. However, with the increase of grid-installed photovoltaic power plants, power system operators have faced new challenges such as overload, overvoltage, and proper performance during grid voltage disturbances. As a result, network standards and codes have been updated in the direction of photovoltaic systems that are more controllable and compatible with the network. To provide various grid support functions, such as frequency response and voltage support, the Constant Power Generation (CPG) control algorithm is established by grid codes. For this purpose, MPPT algorithms have been replaced by flexible power point tracking (FPPT) algorithms. This paper proposes an algorithm to control photovoltaic systems based on a multi-level cascaded full-bridge (CHB) inverter to achieve constant power generation control by the FPPT method. The required power reference is distributed among the sub-modules of the CHB converter according to the available power of each sub-module in such a way that, as much as possible, each sub-module is loaded equally. Then, the FPPT algorithm with an adaptive voltage step is used to set the power of each submodule in its reference value. The voltage step is calculated adaptively based on the observed condition (transient or steady state) so that the tracking performance has fast dynamics. The effectiveness of the proposed algorithm is evaluated by simulating a 500-kW photovoltaic system directly connected to a 4.7 kV grid. [ABSTRACT FROM AUTHOR]

Islanding is one of the important challenges in power networks in the presence of distributed generation which is considered an undesirable incident due to the possibility of damage to operators, network equipment, and consumers. Therefore, it is necessary to quickly detect islanding and make a decision regarding the connection status of local distributed generation units in the network. In this paper, a passive islanding detection method is proposed using adaptive threshold-based instantaneous frequency droop characteristic. The proposed threshold limit is dynamically changed depending on under-studied conditions to discriminate the island from load changes, capacitor bank switching, motor start-up, and short circuit types. Two medium voltage networks of Cigre and 34-bus IEEE are used to evaluate the proposed method. The simulations are performed in Digsilent software and the proposed method is implemented in MATLAB software. The simulation results indicate that the island is correctly detected with appropriate accuracy in a short period of time from other disturbances in the presence of wind, solar and diesel types of distributed generations. [ABSTRACT FROM AUTHOR]

OBJECTIVE The depiction of the Perceived Organizational Support (POS) of the employees of the National Emergency Aid Center (Emergency Medical System) in the 4th Region of Crete. In addition, the correlation with demographic characteristics, such as sex, age group, family status, but also with professional ones, such as work experience, the area of work per prefecture and the level of education. METHOD One hundred and ninety employees of the National Emergency Aid Center of the 4th Region of Crete participated in the survey. A paper-based questionnaire was developed as a data collection tool. The recording of the demographic data was carried out with close-ended questions. The answers were gradated according to the Likert scale. The research model used was the "Survey of Perceived Organizational Support" (SPOS) in the short version of the eight items. The statistical analysis was carried out using the Statistical Package for Social Sciences (IBM SPSS), version 24.0. RESULTS The scale of POS presented mean value 2.4 (±1.3 standard deviation), while the mean value and the interquartile range was 2.5 (1.5-3.0). In terms of demographic characteristics (sex, age group, family status), no factor gave a statistically satisfactory result to be studied. In terms of professional characteristics, only the area of work per prefecture presented interest (p<0.001), depicting the highest mean value for Lasithi (3.0) and the lowest for Rethymno (1.5). In Heraklion and Chania the rates were roughly the same (2.5 and 2.6, respectively). CONCLUSIONS The majority of the employees at the National Emergency Aid Center of the 4th Region of Crete did not perceive the organization as being supportive towards them. The low rates of POS, especially in the area of work in Rethymno, need further investigation, as a comparison can be made to the area of work in Lasithi, whose employees feel that the organization cares about them and appreciates them. [ABSTRACT FROM AUTHOR]

Background: The prevention of Central Line-Associated Bloodstream Infections (CLABSIs) can be achieved through systematic surveillance and intervention through the implementation of care bundles. An integral component of the care bundles is the central line insertion and maintenance checklists. Aim: The aim of this literature review was to investigate the compliance rate of the nursing staff with the central line insertion and maintenance care checklists as well as the factors affecting it. Material and Methods: Search was performed on PubMed (April 05, 2021) with the keywords: "nurse*", "nursing staff", "compliance", "central line insertion checklist" and "central line maintenance checklist", without time limit for the publication of scientific papers. Keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in the English language, were conducted on animals, and were case studies, editorials, and letters to the editor. Results: Of the scientific papers retrieved, 5 were included in the systematic review. The compliance rate of nursing staff with central line insertion and maintenance checklists ranged from 8.4% to 74.3% and from 11.4% to 77.3%, respectively. Regarding the factors affecting the compliance of nursing staff with both types of checklists, these were the nurse-to-patient ratio and the number of beds of nursing wards. Conclusions: Compliance rates with the central line insertion and maintenance checklists are moderate and low. Interventions are required that will increase compliance rates leading to lower CLABSI rates. [ABSTRACT FROM AUTHOR]

Introduction. The characteristics of the COVID-19 pandemic (speed of transmission, uncertainty in knowledge and management, intensive work demands, severity of illness, death of patients and colleagues) along with the necessary rapid adjustments in healthcare systems affect the mental and physical well-being of health professionals. Purpose. The present paper provides a descriptive literature review of the most recent scientific papers regarding the impact of the COVID-19 pandemic on the quality of life of health professionals. Twenty three articles published in international scientific journals were retrieved and studied. Results. The studies cover many geographical areas of the planet. Regardless of the venue, the individual characteristics and the specialties of the participants, all of them demonstrate a significant degree of burden on the Health-Related Quality of Life (HRQoL) of health professionals. Health professionals experience anxiety, depression, post-traumatic stress, headache, sleep disturbances and worsening of pre-existing diseases. The incidence of "moral fatigue" and burnout syndrome is unprecedented. Conclusions. The COVID-19 pandemic is causing a severe health, social and economic crisis throughout the population, with "silent" victims the people working in health care facilities. Healthcare policy designers need to take this fact into account and develop prevention and response strategies. Throughout the world, the relevant studies should be thoroughly analyzed, in order to compile documented programs of mental and physical empowerment for healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Ventilator-Associated Pneumonia (VAP) is one of the most common hospital-acquired infections, related with increased morbidity indicators. The implementation of care bundles can significantly reduce the incidence of VAP leading to higher quality of care provided. Aim: The investigation of the compliance rate of nursing staff with VAP prevention bundle. Methods: Search was performed on PubMed (April 06,2021) with the keywords: "nurse*", "nursing staff", "compliance", "ventilator-associated pneumonia" and "VAP", without time limit for the publication of scientific papers. Keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor. Results: Of the scientific papers retrieved, 6 were included in the systematic review. In the majority of studies, the following care bundle for VAP prevention was implemented: 1) elevation of the head of the bed to 30°-45°, 2) performance of spontaneous breathing trials with sedatives turned off, 3) stress ulcer prophylaxis, 4) thromboembolism prophylaxis and 5) regular oral care with chlorhexidine. The compliance rate of nursing staff with VAP prevention bundle ranged from 5% to 87%. Conclusions: There is a great variability in compliance rate of nursing staff with the VAP prevention bundle. Low compliance with VAP prevention bundles can lead to increased healthcare costs and low quality of healthcare. [ABSTRACT FROM AUTHOR]

Introduction. The characteristics of the COVID-19 pandemic (speed of transmission, uncertainty in knowledge and management, intensive work demands, severity of illness, death of patients and colleagues) along with the necessary rapid adjustments in healthcare systems affect the mental and physical well-being of health professionals. Purpose. The present paper provides a descriptive literature review of the most recent scientific papers regarding the impact of the COVID-19 pandemic on the quality of life of health professionals. Twenty three articles published in international scientific journals were retrieved and studied. Results. The studies cover many geographical areas of the planet. Regardless of the venue, the individual characteristics and the specialties of the participants, all of them demonstrate a significant degree of burden on the Health-Related Quality of Life (HRQoL) of health professionals. Health professionals experience anxiety, depression, post-traumatic stress, headache, sleep disturbances and worsening of pre-existing diseases. The incidence of "moral fatigue" and burnout syndrome is unprecedented. Conclusions. The COVID-19 pandemic is causing a severe health, social and economic crisis throughout the population, with "silent" victims the people working in health care facilities. Healthcare policy designers need to take this fact into account and develop prevention and response strategies. Throughout the world, the relevant studies should be thoroughly analyzed, in order to compile documented programs of mental and physical empowerment for healthcare professionals. [ABSTRACT FROM AUTHOR]

Major pelvic injuries are quite common in the setting of high-energy blunt trauma and in combination with other injuries and hemodynamic instability lead to high mortality rates, ranging from 40 to 60%. The main cause of death in the first 24 hours in these cases is acute bleeding. The purpose of this paper is the presentation of an interesting case, of a 21-year old trauma patient with pelvic and retroperitoneal bleeding, in order to highlight the pelvic packing in combination with arterial embolization and stabilization of the pelvis as a useful method of treating the hemodynamically unstable trauma patient with major pelvic injuries. [ABSTRACT FROM AUTHOR]

Originally, the word "eunuch" meant "the keeper of the bed." Over time, the term "eunuch" had the meaning of one who could not have intercourse or procreate, because either his genitals or his gonads have been removed. In the Church, the phenomenon of castration is evident in monastic circles. Of course, there is no shortage of reactions and restrictions on when a eunuch can or cannot join the clergy. The words of Jesus in Matthew's Gospel 19,12 caused a lot to be written and said by the Fathers of the Church regarding castration. The condemnation of voluntary castration is first found in the canons of the Holy Apostles. Subsequently, many Fathers and Ecumenical Councils referred to the phenomenon of castration in relation to the clergy and monasticism. In this paper, we will examine the phenomenon of castration in the Christian teaching on the clergy and monasticism. [ABSTRACT FROM AUTHOR]

This paper examines the implementation of action research that investigates the use of film art as a teaching and learning instrument in school classrooms. It selects the concept of "refugee" and investigates whether and how cinema can adequately address sensitive social issues, foster empathy, and contribute to a better understanding of the situation that affects us. As a result of the continuous influx of refugees to the island of Rhodes in previous years, numerous students have repeatedly expressed concern regarding the arrival, motivations, and temporary settlement of these individuals in their place of residence. To reduce the prejudices that children had uncritically assimilated and reproduced, it was deemed imperative to implement the current research action. The negative predisposition towards the topic to be investigated, however, necessitated the use of a modern teaching instrument capable of attracting and retaining the interest of young students. Utilising the capabilities of new technologies, we aimed to improve the educational process while simultaneously addressing the refugee issue's knowledge gaps. Since modern society resides in a "culture of the image," film education was singled out. The findings of the study demonstrated that cinematic art is a magnet for students, who, through the screening of a film or their direct participation in a film shoot, have the opportunity to enjoy new learning dimensions while also strengthening their critical thinking regarding intercultural issues. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy treatment in certain medical and health conditions has been consistently found to reduce health care costs and improving the quality of life of the patients. A rising strand of the literature underlines the need for socioeconomic evaluations in occupational therapy interventions. Aim: The present study is about the occupational therapy department of a Greek General Hospital, the one of Syros island. Materials and Methods: The paper has a two-fold research goal: to examine the economic costs and revenues of the occupational therapy department and to evaluate the health-related quality of life of the patients of the department, before and after the first lockdown in Greece due to COVID-19, that lead to a three-month shutdown of all occupational therapy sessions. Results: Regarding the economic evaluation part, there seems to be a downward trend in the department's expenditure, mainly due to the nationwide decrease in wages. However, there is noted a large discrepancy between costs and revenues of the department, due to the insufficient public reimbursement and the low pricing imposed on occupational therapy sessions. On the other hand, health-related quality of life scores of the patients treated, just before the lockdown (in February 2020), differentiate between age groups. Conclusions: For adult patients, there does not seem to be any significant differences in their health-related quality of life due to the disruption of their treatment. Still, for children-patients, a significant number of them seems to have lower health-related quality of life scores after the three-month disruption in their sessions. The results should be viewed with caution due to the limitations in the sample size and information. Still, due to the scarcity of studies in this area, we hope the study can provide some initial research insights on the research topics addressed. [ABSTRACT FROM AUTHOR]

The active participation of patients in decision-making can play an important role in improving the safety and, consequently, the quality of health care. In this context, patient-centered care and joint decision-making are interrelated concepts. In this paper the literature on participatory care, and the factors that affect it, is reviewed. This systematic review demonstrates the importance of the relationship between patients and health care providers in improving the care management. Studies show that the attitude of the patients is influenced by their age, socio-economic status, gender, nationality and education. Previous care experience and illnesses affect the desire to participate, either positively or negatively, and the patients' level of information, and the presence or absence of trust in the person of the treating physician also play a role. The communication and behavior of health professionals, and their personal characteristics may facilitate or hinder the participation of patients in decision-making. This review shows that patient participation depends on a complex interaction of factors related to the patients, their knowledge and beliefs, demographics, health status, the health professionals and communication skills. It is important to promote a collaborative relationship between patients and health professionals and patient involvement needs to be perceived by all as beneficial to health care, and not as provocative behavior directed towards challenging staff skills and abilities. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is the most common genetically transmitted deadly disease of the Caucasian race. The clinical picture of CF is highly variable and it can present from early infancy to several years later. Untoward events that may arise from the disease, and from its treatment, can challenge the patient and his(her) parents-caregivers, both emotionally and physically, resulting in a variety of psychosocial disturbances. A chronic illness, such as CF, can disrupt the life of a sick child and his or her family. As ways of dealing with this, the children, in order to avoid being harmed by the various stressors, may adopt a variety behaviors, thoughts and feelings, some positive and some negative, that serve to prevent, avoid or control the emotional distress. A corresponding psychosocial impact is observed in the other family members. This paper summarizes the various psychosocial characteristics associated with CF and the coping strategies of the affected children and their families, based on the age group, as they grow and develop throughout during the course of the disease. [ABSTRACT FROM AUTHOR]

Biological systems, and their comprehension, constitute one of the greatest challenges for current research. Studies have shown that biological systems have complex dynamics, and that cell proliferation is a phenomenon that follows chaotic dynamics. The question arises regarding the necessity for such studies, linking the tools and theories of chaotic mechanics with biological systems, and in particular with the theories of carcinogenesis and cancer ontogeny. We understand that if there were a way to describe such a system, and in particular a biological system, with a series of equations, we would be able to describe the course of biological phenomena, such as the transformation of a cell to a malignant phenotype, the course of inflammatory response of a tissue after a stimulus, etc. It is apparent that we are not yet in a position to describe such phenomena, not even approximately. This is the subject of the present paper, in which we describe the methods and theories that could probably be the key to a deeper understanding of these biological phenomena. One of the most complex phenomena and greatest challenges in current biological research is the biology of cancer, to which we will refer specifically. Despite the complexity of the subject, we have attempted to use the minimum of mathematical formulations, and their comprehension is not required to understand the context of the present work; our aim is to introduce a link between chaos mechanics, including its ideas and tools, and biological systems. [ABSTRACT FROM AUTHOR]

Wnt signaling has been shown to be an important regulatory pathway in the osteogenetic differentiation of mesenchymal stem cells. Induction of the Wnt signaling pathway promotes bone formation, bone renewal and differentiation of osteoblasts and osteoclasts, while inactivation of the Wnt pathway leads to osteopenia. Activation and inactivation of Wnt signaling deviations during osteogenesis lead to sclerosis and osteoporosis, respectively. Study of the Wnt signaling mechanism and its interactions with other signaling pathways in bones provides potential therapeutic targets for the treatment of bone diseases. Although modification of the Wnt signal pathway has a variety of therapeutic possibilities, careful handling is required, because of the risk of oncogenesis. This paper reports on the role of Wnt signaling in bone metabolism, the potential therapeutic targets, and the risks arising from intervention in Wnt signaling. [ABSTRACT FROM AUTHOR]

Introduction: The phenomenon of mobbing in hospitals is an important inhibitor both for the psychospiritual balance of clinical nurses and for the proper functioning of hospitals as organizations. Aim: The investigation of the frequency of mobbing in clinical nurses and its impact on them. Methods: Search was performed on PubMed on March 13, 2020 with the key-words: "mobbing" and "nurse*", without time limit for the publication of scientific papers. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor. Results: Of the scientific papers retrieved, 14 were included in the systematic review. The prevalence of mobbing in clinical nurses ranged from 4.6% to 86.5%. This large variation is due to the characteristics of the health system of each country. Finally, the results of the studies showed that mobbing reduces the productivity of clinical nurses and the climate of cooperation and solidarity between them, increases anxiety, depression and stress levels, reduces the feeling of satisfaction and safety of the working environment and increases the number of absences from work. Conclusions: Mobbing is a common form of work-related violence experienced by clinical nurses. Hospital administrations are invited to acquire the knowledge to identify this phenomenon in the workplace in order to develop policies to prevent and address it. Mobbing is a common form of work-related violence experienced by clinical nurses. Hospital administrations are called to acquire the knowledge to identify this phenomenon in the workplace in order to develop policies to prevent and address it. [ABSTRACT FROM AUTHOR]

This paper focuses on the system for handling the complaints of patients in the Greek National Health System, especially with regard to the protection of patients’ rights. The focus of the analysis was the way in which the complaints process is implemented by the authorities, based on the relevant legislation, in order to identify its key features and weaknesses, and the opportunities for improvement. Suggestions for improvement result from the examination of good practices, based on international experience, according to which a coherent patient complaints handling system can be formulated and implemented, with clear responsibilities, and coordination and cooperation between the responsible bodies operating in the complaints handling field. A concerted approach to address the current dysfunctions in the complaints handling system is a key factor for improving the quality of the health services and patient satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is a chronic disease associated with serious complications such as diabetic foot syndrome. The main purpose of this study was to investigate the relationship between the existence of diabetic foot syndrome and the social life of patients, their quality of life and stress / depression. Methodology: The systematic review was considered as the most appropriate type for the answer of the set goals. For its implementation, a thorough search was conducted in the Pubmed and Google Scholar databases, using specific keywords: "diabetic foot", "social isolation", "anxiety", "depression" in all possible combinations. The selected papers were published in English, and should have been published after 2015, and all surveys and meta-analyzes were rejected. Of the 689 surveys that met the initial criteria, only 11 were used. Results: 4 studies were found and analyzed related to social isolation, 4 related to quality of life, and 3 related to stress and depression. Patients with diabetes develop numerous serious complications due to their disease. Also, people with higher levels of social isolation are significantly more likely to develop foot ulcers, while ulcer development and social isolation are associated with a higher mortality rate, especially among patients with type 2 diabetes. Conclusions: Diabetic foot syndrome is a serious complication of diabetes with impending low quality of life, increased levels of anxiety and depression, and increased long-term mortality. At the same time, social isolation seems to be an independent predictor of long-term mortality and diabetic foot syndrome. [ABSTRACT FROM AUTHOR]

Introduction: The Chronic Obstructive Pulmonary Disease (COPD) can affect patients' quality of life (QOL). Aim: The aim of this systematic review was to investigate the association between exercise and QOL of patients with COPD following a respiratory rehabilitation program in organized centers of respiratory rehabilitation of hospital units. Material and Methods: A systematic review of papers published up until June 2018 was conducted. Search was performed on PubMed with the key-words: "COPD", "Chronic Obstructive Pulmonary Disease", "physical activity", "exercise", "quality of life" and "QOL" as well as on IATROTEK-online with the key-words: "Chronic Obstructive Pulmonary Disease", "COPD", "quality of life" and "exercise". The criteria for inclusion in this review were: the QOL assessment has been done with the Saint George's Respiratory Questionnaire (SGRQ) and the content of the studies concerns the evaluation of the QOL of COPD patients following respiratory rehabilitation programs in organized centers of respiratory rehabilitation of hospital units. Results: Only 9 of the scientific papers retrieved met the criteria for inclusion in this review. The exercise was found to affect the QOL of COPD patients positively. Although, the degree of improvement in both the overall score and the scores of the three subscales of the SGRQ was not the same in all studies but varied significantly depending on the type of exercise and the limitations of each study. Conclusions: The QOL of patients with COPD was improved after the integration of rehabilitation programs that were performed in specialized respiratory centers of hospital units. [ABSTRACT FROM AUTHOR]

Emergency and crisis communication management has been documented in the literature as a significant dimension of operational preparedness, particularly in the case of public health crises. Amid the recent Covid-19 pandemic, therefore, the psychological effects of the crisis have prompted international organizations, such as the World Health Organization (WHO), to issue recommendations and guidelines on more effective risk and crisis communication. This paper examines the ways in which the Greek authorities handled the communication aspect of the first Covid-19 pandemic wave in the light of its impact on the mental health of Greeks. Emphasis is placed on the importance of operational planning, and an early assessment of the management experience as a whole is attempted, along with estimation of the impact of communication management in the medium term. The multilevel effect of communication in crisis management has been shown to have such a degree of added value that the development of national communication plans is now deemed necessary. [ABSTRACT FROM AUTHOR]

The 1978 Alma-Ata Declaration placed Primary Health Care (PHC) at the centre of health services and at the forefront of overall social policy, and 40 years later, the Astana Declaration confirmed the principles of PHC and renewed its content. PHC has been influenced by events and writings that date from the early 20th century. The 1920 "Dawson Report" in the UK, which was not implemented, was the first to propose the organization of Primary and Secondary Health Centres, to be supported by teaching hospitals and other services. In the 1940s, Community Oriented Primary Care (COPC) in poor districts of South Africa combined the methodologies of public health and PHC with active community participation to achieve substantial improvements in the health of the population. In 1961, the "ecology of health" or the pyramid of health care utilization, showed how frequently the adult population makes use of health services, and provided the basis for the development of the three levels of health care. A new paper, 40 years later, showed that, in terms of "order of magnitude", the original findings remain valid. With the Declaration of Alma-Ata, the member states of the World Health Organization (WHO) and UNICEF affirmed their commitment to reduce health inequalities through the development of horizontal, integrated and comprehensive PHC with community participation. The disparity between words and deeds, however, and "selective PHC" limited its success. In the developed countries, PHC was identified with the services provided by general practice/family medicine. The revival of interest in PHC in the 2000s is demonstrated by the World Health Report of 2008 "PHC: now more than ever". In 2018, the Astana Declaration revitalized the vision of PHC, but uncertainties are still expressed about its prospects. The uncertainties are augmented by the current Covid-19 pandemic and its unforeseen effects on society, the economy and politics and, by extension, on the health care services. [ABSTRACT FROM AUTHOR]

Hyponatremia is a pathophysiologic process indicating water excess. It is the commonest electrolyte disturbance in hospitalized patients and among the commonest in elderly community dwellers. Many cases are mild and asymptomatic but the more serious ones are clinically important because they are related to increased morbidity and mortality. The usual mechanism of hyponatremia is inappropriate antidiuretic hormone secretion (SIADH) but SIADH-related diagnosis of hyponatremia in psychiatric patients may delay due to the fact that its symptoms may be identical to those of primary psychiatric disorders or sideeffects of many psychotropic drugs. Almost all psychotropic drugs may cause hyponatremia and clinicians should bear this fact in mind. Nevertheless, based both on clinical experience and research data, antidepressants (more specifically, venlafaxine and selective serotonin-reuptake inhibitors), antipsychotics (particularly the older ones) and, among antiepileptics used in psychiatry, carbamazepine and oxcarbazepine seem to be mostly implicated. Among drugs of abuse, ecstasy must raise increased clinical suspicion. Apart from SIADH, other causative mechanisms of hyponatremia may include decreased threshold of antidiuretic hormone secretion and the enhancement of its effects in renal collecting ducts. Psychogenic polydipsia, usually observed in patients with schizophrenia spectrum disorders, may also cause hyponatremia even though increased water intake per se is seldom of such an extent that could lead to hyponatremia if renal function is normal. In this paper, we briefly review the pathophysiologic mechanisms of hyponatremia and the psychotropic drugs that are more commonly implicated without mentioning epidemiological data or describing treatment methods. Our aim is to increase clinical vigilance of health care professionals and sensitize them to understand this side effect of many psychotropic drugs. Except for these drugs, we give data concerning drugs of abuse that may cause hyponatremia. [ABSTRACT FROM AUTHOR]

High Flow Nasal Oxygen (HFNO) is a non-invasive form of respiratory support that is indicated for the treatment of both type I (hypoxemic) and type II (hypoxemic/hypercapnic) acute respiratory failure. After some initial hesitation due to the fear-which was not confirmed in practice-of spread of SARS-COV-2 to healthcare professionals, HFNO has been widely used in COVID-19 patients and given encouraging results in regards to reducing intubations and increasing ventilator-free days. In this paper, we review its mechanisms of action, refer to the clinical studies that support its use, present its advantages, disadvantages and contraindications, and give instructions for its application in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has been a major issue for health care delivery structures, which have been under constant pressure since its commencement. Health professionals, particularly front-line nurses, face extremely difficult working conditions, which have been documented in many studies internationally. Aim: The main objective of this paper is to explore nurses' knowledge, attitudes and perceptions of the current pandemic, with a particular focus on issues that concerned their professional lives. Material - Methods. A systematic critical search of the international literature was conducted in 2020-2021. The search terms used were: "nursing", "coronavirus", "pandemic", "knowledge", "attitudes", "perceptions", and their derivatives, synonyms and combinations in Pubmed. Once relevant studies were identified, a data extraction process Results: After careful perusal of 1277 original literature references, the analysis ultimately included 38 research studies on nurses' knowledge attitudes and perceptions during the COVID-19 pandemic. These were categorized under five themes, i.e. 'nurses expressed problems of understaffing and increased workload', 'strong psychological effects' (discomfort, fear, symptoms of anxiety and depression), 'concerns about resource adequacy' (mainly lack of personal protective equipment) and 'difficulties in communication and seeking further information and education'. Conclusions: During the pandemic, nurses, especially those on the front-line, reported multiple problems and concerns, both on a professional and personal level. The recognition of these problems can be useful and taken into account in central planning for possible future crises. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the ethical dilemmas presented in the decision for abortion after rape. In the case of rape, the woman is forced to suffer further psychological harm by carrying the 'product' of violence rather than consent. However, in the event of rape, any subsequent abortion essentially punishes the unborn child who has committed no crime. Instead, the perpetrator should be punished, not the foetus. In the case of incest, the woman who becomes pregnant by her relative is very likely to deliver a monstrous fetus, which will suffer throughout its life. Abortion is therefore suggested as a 'therapeutic solution'. Yet, there is a risk (to a lesser extent) of genetic abnormalities even for consensual pregnancies. So by the same token, should all fetuses with genetic abnormalities be killed? In conclusion, in the case of rape, the fetus or the child, it is not the symbol of an act of love, but the aftermath of a violent act, a living reminder of the inhumane event and a hindrance to the victim's mental redemption. The option of abortion seems to be the way that the victim can continue with her life. But from an ethical point of view, abortion after rape is not justified because the innocent victim is actually 'punished' and not the perpetrator. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) is a global health and societal emergency respiratory disease that is caused by SARS-CoV-2. A poor understanding of the disease among Healthcare Workers (HCWs) can result in delayed identification and treatment leading to rapid spread of infections. Aim: The investigation of the knowledge, attitude and practices (KAP) of HCWs toward COVID-19. Material and Methods: Search was performed on PubMed for studies published from January 1, 2020 to June 30, 2020 with the key-words: "knowledge", "attitude», "practice", "COVID19", "healthcare workers" and "HCW", which were searched in the title and abstract of the studies. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials, and letters to the editor. Results: Of the scientific papers retrieved, 5 were included in the systematic review. Regarding the rate of knowledge of HCWs toward COVID-19, it ranged from 62.6 % to 89%. The rate of HCWs that had good practices and positive attitudes toward COVID-19 ranged from 74% to 89.7% and from 21% to 88.5%, respectively. The factors that positively affected (increase the rate) in statistically significant level the knowledge, attitudes and practices were the age of 40 years old and more, the higher level of education (possession of Master of Science Degree and/or Doctor of Philosophy), the medical profession and the more years of experience. Conclusions: Continuing professional education is advised among HCWs to improve knowledge of HCWs hence averting negative attitudes and promoting positive preventive and therapeutic practices. [ABSTRACT FROM AUTHOR]

Psychotic disorders are not uncommon. They are characterized by a constellation of symptoms which affect the patients significantly, and are associated with moderate outcome and high rates of disability. For many patients with psychosis the primary health care system may be their only pathway to care, because of their symptomatology and various other adversities. This paper addresses some of the challenges that primary health care physicians face in the management of patients with psychotic disorders. The issues of physical morbidity and the high mortality of these patients are highlighted, as well as the diagnostic challenges, the phenomenon of poor compliance with treatment and the stigmatization and discrimination against them in the health care setting. Specific medical emergencies involving patients with psychotic disorders that primary care physicians may have to treat, such as hyponatremia and the neuroleptic malignant syndrome, are briefly presented. Finally, the paper contains practical suggestions for primary care physicians and other professionals with regard to the early suspicion and recognition of a psychotic episode, evaluation of relapses in patients with chronic psychotic illness, and co-operation with mental health professionals. Primary care staff can contribute significantly to the management of psychotic disorders in the community, but for them to be more effective, further training in mental health is needed, along with supervision by specialized mental health services. [ABSTRACT FROM AUTHOR]

The accelerated rate of pharmaceutical innovation and the resulting increase in pharmaceutical spending constitute a challenging problem for the health administration and its policy, and for the scientific community. In Greece, in particular, since budgetary surveillance was imposed on Greece, because of the absence of an appropriate infrastructure for negotiations on reimbursed prices (a structure that would have the ability to control and restrict pharmaceutical spending), an upper obligatory budget limit on pharmaceutical public spending has been legally established. The legally established upper limit has been implemented through two obligatory infrastructures, the volume discounts (rebate) in the first place, and ultimately the automatic returns adjustments (claw back). It is a common, publicly declared estimate that the level of the legally established upper limit to public pharmaceutical spending is quite low, given the needs of the Greek population. Hence, the resulting level of automatic returns has been quite high for the pharmaceutical industry. The main aim of this paper is to contribute to a much-needed public debate about the adequate level of the upper limit of public pharmaceutical spending, adjusted to the population needs, along with fairer distribution of the claw back, while the need for an upper limit is present, with breakdown of this upper limit into an ATC4 multi-level, and with population needs defined more accurately. [ABSTRACT FROM AUTHOR]

Cysts are abnormal epithelial cavities containing fluid, usually serous or serous-hemorrhagic, or even pus, and they can be found in both the soft tissue and the bone of the jaws. Large bone cysts, with a diameter of 4.5 cm or larger, are the subject of this report. This paper presents 5 of the 22 cases of large jaw cysts treated in the last five years in the Department of Oral and Maxillofacial Surgery of the General Hospital of Tripoli. The diagnostic approach is described, and the treatment of these cysts, with or without the use of bone grafts and titanium reconstruction plates, is evaluated. The technique with good results is that of enucleation and extensive surgical debridement, with or without the use of bone grafts and reconstruction plates, decided on a case-by-case basis. [ABSTRACT FROM AUTHOR]

The purpose of this paper is a brief literature review to investigate the potential relationship between DNA damage and atherosclerosis. The study material included articles on the subject, found in international databases, such as Google Scholar and PubMed, using the appropriate keywords: DNA damage, atherosclerosis, oxidative stress, and a combination of these. Human atherosclerotic plaques appear to show increased levels of DNA damage. However, additional well-designed studies are needed to further clarify this relationship and identify potential therapeutic targets. [ABSTRACT FROM AUTHOR]

Introduction: The disease caused by the SARS-CoV-2 infection since its outbreak in China in the end of 2019, turned into a pandemic after having reached over 7,834 confirmed cases and 170 deaths worldwide by the end of January 2020. Purpose: The purpose of the current article is to present how SARS (Severe Acute Respiratory Syndrome), MERS (Middle East syndrome) and COVID-19 pandemics affected the mental health of different population subgroups and also to present the determinants of mental illness, in an attempt to understand their negative psychological effects. Material- Methodology: The methodology that was followed in this paper was the review of the international bibliography on the Pubmed, Scopus και Google Scholar on the subject of mental health during pandemics and the presentation of the wide range of psychosocial needs that emerged during the SARS, MERS and COVID-19 pandemics. Results: The conclusions derived from the first literature research on the mental health of different target groups during the COVID-19 pandemic are comparable to those that emerged during the previous two major pandemics. Therefore, the pandemic has demonstrated the necessity of timely mental health care by the immediate adoption of appropriate measures and the implementation of interventions that will be based on the different needs of the population. Conclusions: Although the Greek government took timely measures against the spread of the virus, published research efforts regarding the mental health outcomes within the Greek population, are still in their infancy. At this critical time, mental health assessment and evaluation should be a priority for health authorities in their way to managing psychological crises due to a pandemic. [ABSTRACT FROM AUTHOR]

In recent years, bibliometric studies have a particular weight, due to the important conclusions drawn concerning the trend of research projects. The current paper focuses on the analysis of scientific literature in the field of Food and Nutrition Sustainability. The aim of the paper is to imprint the dominant research tendencies. Material/Method: The scientific data base Scopus is used. The number of papers per year in the field of Sustainable Food and Nutrition, their geographic area, author, research institution, language and article type are initially investigated. Then, the main trends of scientific research are analyzed through the analysis of the keywords used in the articles. Results: According to our research, the first contributions on Sustainability and Food and Nutrition were published in 1982 and 1987. By 2000, article production was small. Then, an exponential increase occurred, leading to 1,202 and 186 articles respectively for the two cases in 2016. The dominant scientific field is that of Agricultural and Biological Sciences. The overwhelming majority concerns articles, followed by reviews, presentations in conferences and book chapters. There is no concentration of publications in some specific journals. The first country of publications is the USA, and the top 2 foundations worldwide for both searches are: Cornell University and Wageningen University. Conclusions: There is a large increase of published work in both fields, concentrated mainly in the US. [ABSTRACT FROM AUTHOR]

The rapid technological developments of the 21st century and the adoption of Internet 4.0 technologies in all facets of everyday life, has led to the digitization of services even in areas that have traditionally operated without the help of technology. One of the areas that is being modernized due to the abovementioned developments is that of health care. Medical process automation, robotics and medical devices are creating a wealth of digital health data. Each patient's health data is organized and structured in electronic health records (EHR), which are usually stored in the central databases of healthcare providers. Although EHRs offer many possibilities, the centralized data storage makes them vulnerable to malicious attack, and they do not provide interoperability between the systems of different healthcare providers. Blockchain is a technology that provides appropriate solutions and which can eliminate the abovementioned challenges in the healthcare sector. Decentralized data storage and data management by the patients themselves can provide greater security, interoperability and, generally, more efficient health services. The scope of this paper work is to present the challenges in the field of eHealth, to introduce blockchain as a solution for most of these challenges, and to present appropriate methodology that can be used to store medical data in a healthcare application based on blockchain. The methodology presented is already being developed and applied in the context of the Impilo research project, which aims to develop a blockchain-based social networking application in the healthcare domain. [ABSTRACT FROM AUTHOR]

OBJECTIVE The assessment of migrants' access and use of health services in Greece. METHOD A cross-sectional study was conducted and the study population included 1152 migrants that gave their informed consent. Migrants originated from Albania, Pakistan, Bangladesh, Philippines, Afghanistan, Ukraine, Georgia, Nigeria, Ethiopia, Egypt and Moldavia. "Snowball" sampling method was applied and response rate was 60% (=1152/1920). Study questionnaire included demographic characteristics of the migrants, information about health status and information about migrants' access and use of health services. Data analysis was conducted with IBM SPSS 21.0 (Statistical Package for Social Sciences). RESULTS Mean age of the migrants was 37.6 years and mean duration of stay in Greece was 10.9 years. Albanian and Africans had more often insurance and legal papers. Thirty-six point five percent of the migrants self-estimated their access in public health services worse than Greeks and this percentage was higher for Asians and Africans. Albanian performed more often preventive blood, pressure and cholesterol exams and then migrants from East Europe, Africa and Asia. Twenty-one percent of the migrants had unmet needs. Laboratory exams and visit at private phyisican/dentist were the most frequent unmet needs. The most frequent reasons for the unmet needs were the cost, the lack of insurance, the appointment procedures and the long waiting time. Moreover, 21% of the migrants had unmet pharmaceutical needs with cost to be the most important reason. The most frequent difficulties that migrants faced off at emergency departments and outpatients clinics of the hospitals were complicated [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has caused great changes worldwide leading to stressful emotions of insecurity about the future and abrupt differentiations in the daily routine of millions of people during a short time period. In the same vein, it proved that, despite the great progress in medicine, continuous vigilance is necessary. The history of mankind has witnessed quite a few epidemics but the transmission of infectious disease may nowadays be easier than ever before due to the current lifestyle. Mass disaster phenomena pose a challenge for the psychological resilience of persons and societies since everybody must adapt to a new situation that demands rapid and forced changes in pervasive parts of daily life. Additionally, they may lead to manifestation of intense stress and other psychiatric symptoms in cases when health status, or even life itself, seem to be in danger. People react to such situations in various ways, but societies, as organized groups, usually react by increasing their cohesion and their social solidarity, and by supplying help to people or groups who need it. In the first period, during which attempts are made and measures are implemented in order to manage the sanitarian consequences of the pandemic, many people may manifest intense anxiety and other psychopathological symptoms. These people, including those belonging to more vulnerable groups (e.g., patients suffering from chronic mental disorders), may need psychological support interventions. When these consequences subside, the need for an organized approach to the treatment of the psychological consequences of the pandemic may become apparent. These consequences may result from facts such as the acute changes enforced in the daily life, the financial and vocational problems, the sense of insecurity about the future and the loss of beloved ones. The current Covid-19 pandemic, with such a totally new extent and intensity of effects for the humanity, provides an occasion to delve with the psychology of people under these circumstances. The paper gives a brief report of the psychological responses in both individual and group basis. Furthermore, it refers to the psychological effects of quarantine and to vulnerability factors that could lead to the manifestation of psychopathological symptoms during pandemics. [ABSTRACT FROM AUTHOR]

Persons with disabilities constitute a vulnerable population group in Europe, systematically exposed to high levels of poverty and social exclusion, with adverse effects on their health and well-being. This paper analyzes the legal scope of equal treatment and non-discrimination of persons with disabilities in healthcare settings from the human rights perspective. Disability constitutes a multidimensional concept and, as such, it must be approached not only from the public health perspective, but also from the human rights perspective. In this analysis, the case of Greece is examined, to identify the extent to which there is a sense of state responsibility towards ensuring and, ultimately, implementing the equal treatment of persons with disabilities in healthcare settings. Finally, the full participation of persons with disabilities, and disability mainstreaming in the design and implementation of interventions, are proposed as practical ways for eliminating the inequalities in health care currently experienced by persons with disabilities. [ABSTRACT FROM AUTHOR]

Introduction: Central line-associated bloodstream infections (CLABSIs) are one of the most common nosocomial infections and are associated with increased mortality, prolonged hospitalization and increased healthcare costs. Aim: The aim of the present review was to investigate the impact of central line insertion and maintenance care checklists on CLABSIs in Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs) and Hematology/Oncology Units. Material and Methods: Search was performed on PubMed with the key-words: "children", "hematology/oncology", "NICU", "PICU", "pediatric intensive care unit", "neonatal intensive care unit", "central line-associated bloodstream infections", "CLABSI","checklists", without time limit for the publication of scientific papers. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor. Of the 11 studies that were included, 7 referred to NICUs, 2 to PICUs and the remaining 2 to hematology/oncology units. Results: CLABSI rate was reduced in all 11 studies. In NICUs, the highest reduction of CLABSI rate was 92%, in PICUs more than 50% and in hematology/oncology units the reduction was 28% and 64% respectively. Conclusions: Central line insertion and maintenance care checklists reduce CLABSIs, either as an independent intervention or as element of CLABSI bundle. [ABSTRACT FROM AUTHOR]

Adherence is defined according to WHO as "the extent to which a person's behavior - taking medication, following a diet, and / or executing lifestyle changes - corresponds with agreed recommendations from a health care provider." It can be evaluated by subjective or objective methods. The purpose of this paper is to investigate the role of patient adherence in chronic disease therapies, ways of assessing it, the factors that affect it, the consequences of nonadherence and interventions that can lead to its improvement. PubMed and Google Scholar bibliographic databases were searched for publications. Review articles on the subject in English and Greek and recently published were selected and studied. The factors that may affect adherence are defined as socio-economic, patient-related, disease-related, treatment-related, healthcare system-related. Non- adherence is deliberate/intentional and unintentional. The consequences of poor adherence are poor health and increased health care costs. Improvement of adherence is not achieved through individual interventions but with multidimensional targets that influence the key components of the therapeutic relationship: the patient, the health provider and external factors. Effective interventions are needed to improve adherence, coordinated action and collaboration between patients, carers and health providers. [ABSTRACT FROM AUTHOR]

The concept of quality in medicine is quite complex and complicated due to the different factors that affect it. Those defining factors are diverse and are corresponding with the evaluation levels that refer to the structures and procedures that characterize the function of a health unit as well as the results of the given care, the evaluation of which refers to the outcome of the disease, patient satisfaction as well as doctors and health professionals. The concept of patient satisfaction constitutes the most reliable indicator in order for health care given results to be evaluated. The evaluation provides the ability ïf systemic assessment of the set goals in a given timeframe. The measurement of patient satisfaction targets the programs and health systems evaluation so emerging points can be improved. The benefits-health, social, financial-that come out of the improvement of health services are mainly applicable to patients as well as health professionals, nursing units and the state mechanism. In this paper, through the definitions and the historical recursion of health services, and after studying-understanding the quality and safety factors of patients, based on bibliography, we try to review the securing of the quality of health services, the need for evaluation as well as the effectiveness of quality systems in medicine. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the health status of a cohort of elderly people living in a rural district of Crete. This paper reports the preliminary results of the present study. METHOD An observational study was conducted on subjects aged 65 years and over living in 4 rural villages, of whom 600 were eligible and 411 (179 men and 232 women) participated. Data on the medical and family history were recorded and a standardized physical examination was conducted on each participant. Cognitive and mood disorders were assessed by the Geriatric Depression Scale (GDS) and the Mini Mental State Examination (MMSE). Urinary incontinence in women was assessed using a specific questionnaire. The quality of life (QoL) of the elderly participants and their orientation to life was evaluated by using self-completed questionnaires that have been validated in the Greek language, the Quality of Well Being (QWB-SA) scale and the Sense of Coherence (SOC) scale. The dependency of their daily life activities was assessed using the Barthel index. RESULTS Of the 411 participants, 175 (42.7%) were aged ≥75 years, and had a good cognitive status (mean MMSE score 25.2±4.3; p<0.001) and a high level of independence according to the Barthel index (mean 96.9±8). Hypertension was found in 182 subjects (55.8%), musculoskeletal disorders in 28.2%, diabetes mellitus (DM) in 21.2%, and chronic obstructive pulmonary disease (COPD) in 14.4%. Mood disorders were more frequent among the women (GDS=4.6 versus 3.2; p<0.001), and the men presented higher SOC scores than the women (128.2 versus 117.9; p=0.032). The most important behavioral risk factors were found to be physical inactivity (73%), obesity, and low consumption of fruit and vegetables (22.8%). A higher prevalence of smoking was recorded in the men (36.0% versus 4.4%; p<0.001). CONCLUSIONS This observational study made a contribution to standardization of the organization and implementation of a health needs assessment program in the rural primary care setting. Constructing a database of the diseases and the needs of the elderly will aid health policy makers to plan prevention programs and to promote primary health care in isolated areas. [ABSTRACT FROM AUTHOR]