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Aim: This study aimed to analyse the relationship between fear of COVID‐19 and hand hygiene beliefs and practices of surgical nurses. Method: This article is a descriptive correlational study. It was conducted between February and May 2021 with 306 surgical nurses working at public and private hospitals in Northern Cyprus. A personal information form, Fear of COVID‐19 Scale, Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory were used for data collection. Results: Of the participants in the study, 25.41% were 29 years old or younger and 85.15% were female. The mean scores obtained from the Fear of COVID‐19 Scale, Hand Hygiene Belief Scale and the Hand Hygiene Practices Inventory were 23.12 ± 8.03, 81.33 ± 7.67 and 69.15 ± 1.94, respectively. The Fear of COVID‐19 Scale scores were negatively correlated with the Hand Hygiene Belief Scale scores and positively correlated with the Hand Hygiene Practices Inventory scores. Conclusion: Hand hygiene practices were better for nurses with higher level of COVID‐19 fear. Therefore, a high level of seriousness and awareness of nurses about hand hygiene, which was achieved during the COVID‐19 pandemic, should be sustained to maintain proper hand hygiene practices. Summary statement: What is already known about this topic? Hand hygiene is one of the primary ways to control the COVID‐19 pandemic.Adherence to hand hygiene may be influenced by various factors, including personal traits.Hand hygiene adherence among health professionals was low prior to the COVID‐19 pandemic. What this paper adds? The Fear of COVID‐19 Scale scores of surgical nurses were above average.This study found that the fear of COVID‐19 was positively linked to hand hygiene practices of surgical nurses. The implications of this paper: Seriousness and awareness of nurses about hand hygiene during the COVID‐19 pandemic should be sustained in order to maintain good hand hygiene practices.Visual and printed education materials may emphasize disease and mortality rates during the COVID‐19 pandemic.Health institutions have the responsibility to provide appropriate antiseptic products to prevent hand skin problems. [ABSTRACT FROM AUTHOR]

This study explores the influence of individual and relational predictors on bullying perpetration/victimization among semi-professional team sport players in North Cyprus. Three variables reflect on an individual's level characteristics (e.g., gender, age, and nationality), and another one, representing the relational level factor (e.g., negative coaching behavior). The current paper obtained data from athletes through convenient sampling technique and online survey utilization. A total of 190 sports players with an average age of 24.77 (SD = 4.52) participated. All participants were club athletes from 16 diverse nations, competing in four different sports disciplines: football, volleyball, handball, and basketball. Hierarchical regression analysis was implemented to evaluate the above underlying linkages. It was found that age, nationality, and the coach's negative personal rapport significantly predicted bullying victimization dynamics among athletes. Bullying perpetration was only predicted by negative personal rapport with the coach but not by any of the individual level predictors. The moderation analysis showed that negative personal rapport with the coach significantly predicted the level of bullying victimization, the age and the nationality of the athlete moderated the relationship between the negative personal rapport and bullying victimization. In other words, the negative personal rapport had a higher effect on bullying victimization for the younger athletes and for international ones. Such findings have the potential to shape the base for further ongoing works, which could underline the critical demand for more emphasis and analysis of nationality, gender, age, and coach's negative rapport on bullying perpetration or victimization. The significance of the study's findings, its limits, and potential paths for further interpersonal violence research are addressed. [ABSTRACT FROM AUTHOR]

This paper presents a study of exercise behaviours among Maltese gym users where it seeks to understand what factors govern choices among gym users to exercise either alone or in a group. It is argued that being able to predict the propensity to exercise alone or in a group presents an opportunity for fitness providers to organise their efforts more efficiently in the broader context of contributing to improving public health and, therefore, possibly providing a more relevant gym product. Exercise and fitness literature highlights various factors likely to influence participants' proclivities to exercise solo or in a group, including motivation, competitiveness, sporting background, age, and gender. To explore the possible influences of such factors in the Maltese context, a cross-sectional survey was carried out via an online questionnaire, which was analysed statistically using logistic regression. This was conducted by first incorporating the above factors with a propensity to exercise alone or in a group as the dependent binary outcome. Finally, a most parsimonious model was applied following a stepwise iterated process of factor elimination. The results show that gender and age were the most significant predictors of training modality, with being male increasing the likelihood of engaging in solo gym exercise behaviour by over five times. Increased age was also a significant predictor of exercising alone. We present a discussion of the findings in terms of exercise and fitness service provision, as well as broader issues related to the interaction between gym culture and gender norms. [ABSTRACT FROM AUTHOR]

Social work practice and training in the context of political and ethnic conflict has seen renewed interest among scholars. Recent research has tried to shift focus away from simplistic interpretations of social work as an unshakably 'benevolent' profession. A recent emphasis on social work's colonial legacies and the structural causes of political violence provide us with important new directions on how to rethink and reshape social work education and practice in these contexts. Cyprus presents a very interesting, yet under-explored, case study as it remains an island de facto divided, along ethnic lines. The division has resulted in the physical and political separation of the two most populous ethnic communities (Greek Cypriots and Turkish Cypriots). United Nations (UN)-sponsored peace talks have gained momentum in recent years. This paper offers the first systematic exploration of the views of social work students across both sides of the divide. Through a mixed-method approach, students were able to express their thoughts and beliefs on 'the other' and on social work in the post-conflict realities. The study confirms the contradictory nature of social work education in Cyprus challenges the futility of nationalism and argues for the importance of bi-communal social work partnerships. [ABSTRACT FROM AUTHOR]

Background: The traditional Mediterranean diet is defined as the dietary pattern in the countries of the Mediterranean basin between the 1950s and 1960s, and it is now widely accepted that has a beneficial effect on health. A debate exists from empirical and research data if the traditional Mediterranean diet remains the main dietary pattern of the region or if it has changed overtime. Aims: This systematic review addresses whether the people of Cyprus and Greece still follow the traditional Mediterranean diet or whether the diet has become more 'Westernised'. Methods: The MEDLINE database was searched using relevant free terms and independently reviewed by two authors. In addition, all reference lists of identified studies were hand-searched to identify additional, relevant studies. Results: The review resulted in 18 research papers that met the inclusion and exclusion criteria and represented 15 independent studies. The main outcome was consistent between studies and indicated moderate adherence of the Greek, and (probably) of the Cypriot, population to the Mediterranean diet. The majority of studies found no statistically significant differences by gender. There was an observed inter-study lower adherence to the Mediterranean diet by the younger population. Few studies addressed intra-study variations by age. Conclusions: This review shows that adherence to the Mediterranean diet is moderate in Greece (and probably also in Cyprus).This suggests a continuing transition from dietary patterns in the 50s-60s towards a more Westernized diet. [ABSTRACT FROM AUTHOR]

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Background: Hand hygiene (HH) is recognized as an important measure to avoid the transmission of harmful germs, and assists significantly in preventing healthcare-associated infections. HH compliance among health care workers (HCWs) is a result of their knowledge and perceptions. Aim: To investigate the knowledge and perceptions of WHO hand hygiene guidelines among HCWs, and the perceived barriers to compliance with hand hygiene in a major public hospital in Cyprus. Methods: A descriptive correlational study was conducted in September of 2019. The target population was all of the HCWs in Nicosia General Hospital (N = 1,386). The final sample consisted of 820 participants (119 physicians, 613 nurses, 27 physiotherapists, 59 ward assistants, 2 unidentified). This study used the HH knowledge and perception questionnaire that was developed by the WHO. Results: The results revealed that the average percentage score for knowledge among our sample was 61%, and statistically significant differences were observed among HCWs with regard to certain questions. It was found that HCWs, in most of their responses, presented high percentages of correct answers regarding their perceptions on hand hygiene guidelines but several perceived barriers to compliance on HH guidelines were identified as well. Conclusions: Knowledge and perceptions of HH guidelines among HCWs were moderate and good respectively. In addition, several perceived barriers to compliance on HH recommendations were identified. HH education is recognized as an important tool for removing these barriers but the recommended HH strategy should be multi-modal and consider local resources, administrative support and barriers to compliance with HH. [ABSTRACT FROM AUTHOR]

Background: Hand hygiene (HH) is recognized as an important measure to avoid the transmission of harmful germs, and assists significantly in preventing healthcare-associated infections. HH compliance among health care workers (HCWs) is a result of their knowledge and perceptions. Aim: To investigate the knowledge and perceptions of WHO hand hygiene guidelines among HCWs, and the perceived barriers to compliance with hand hygiene in a major public hospital in Cyprus. Methods: A descriptive correlational study was conducted in September of 2019. The target population was all of the HCWs in Nicosia General Hospital (N = 1,386). The final sample consisted of 820 participants (119 physicians, 613 nurses, 27 physiotherapists, 59 ward assistants, 2 unidentified). This study used the HH knowledge and perception questionnaire that was developed by the WHO. Results: The results revealed that the average percentage score for knowledge among our sample was 61%, and statistically significant differences were observed among HCWs with regard to certain questions. It was found that HCWs, in most of their responses, presented high percentages of correct answers regarding their perceptions on hand hygiene guidelines but several perceived barriers to compliance on HH guidelines were identified as well. Conclusions: Knowledge and perceptions of HH guidelines among HCWs were moderate and good respectively. In addition, several perceived barriers to compliance on HH recommendations were identified. HH education is recognized as an important tool for removing these barriers but the recommended HH strategy should be multi-modal and consider local resources, administrative support and barriers to compliance with HH. [ABSTRACT FROM AUTHOR]

The present study contributes to the development of effective measures to evaluate classroom climate, especially in elementary education where these remain limited. In addition, it addresses a typical "flaw" of several studies by approaching classroom climate as a group-level construct rather than an individual characteristic. Following a multilevel approach, we attempted to establish validity evidence for an adapted version of the Classroom Behavioral Climate (CBC) questionnaire and examine its equivalence across two contexts. The participants included 2963 students from 176 fourth and fifth grade classes. Multilevel Confirmatory Factor Analyses resulted in a shorter version of the CBC with three correlated factors in both countries. Two-level models performed better than the single-level models. Configural, metric, and partial scalar invariance was also achieved. The study highlights the need for researchers and practitioners to use appropriate methods and instruments to evaluate the classroom environment based on their research aims and intended use. [ABSTRACT FROM AUTHOR]

Background and aim: While the Mediterranean diet (MD) is promoted in non-Mediterranean countries, inhabitants of Mediterranean countries seem to be shifting away from this healthy diet. The aim of this study is to provide an overview of MD adherence in the general adult population of Mediterranean countries. Methods: A systematic review was conducted following the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO databases for studies published from 2010 up to and including 2021. The following inclusion criteria were used: age 18 years and older, sample size > 1000 participants, and using a validated MD adherence score. Studies that only included participants with nutrition-related or other severe chronic disorders, as well as studies that only included specific subpopulations (e.g., pregnant women), were excluded in order to focus on the general adult population. A quality analysis of the included studies was done using the NCCMT scale. Results: A total of 50 studies were included. The number of participants in the included studies ranged between 1013 and 94,113. Most of the included studies pertained to the European Mediterranean countries, with fewer studies from the Middle Eastern and North African Mediterranean countries. The vast majority of the included studies reported low or moderate MD adherence, both based on the mean adherence as well as the low or moderate adherence category often being the most prevalent. There were no clear differences noted between sex and age groups. The quality assessment generally showed weak or moderate scores. Conclusions: Mediterranean populations have been showing moderate adherence to MD in the past 10 years, indicating room for improving adherence to the MD in countries of its origin. [ABSTRACT FROM AUTHOR]

This is the second of two papers reporting the development of a spiritual care competency framework for pre-registration nurses and midwives as part of a PhD study using an embedded sequential mixed methods eclectic research design. The first paper outlines how 116 competency items were generated from an in-depth review of international literature, and offers a theoretical model to underpin development of the Framework. This paper reports how the Framework was developed. Method/Results: Five focus groups were held with stakeholders in Malta (chaplains/spiritual leaders, undergraduate nursing/midwifery educators, qualified nurses/midwives, parents/carers, patients/clients) to ensure that aspects of spirituality/spiritual care important to them, but not identified in the literature review, were included in the Framework. The resulting 55 competencies in seven domains formed the Delphi Questionnaire which was validated using a two round modified Delphi method involving experts from Malta. The final seven domain 54 item Framework demonstrated good to strong internal consistency, stability and a good fit with a six factor model. The Framework's greatest immediate contribution is in its ability to inform undergraduate nursing/midwifery spiritual care curriculum design and delivery. Further development of the Framework could assist in student selection ensuring that the 'art' of nursing/midwifery has parity with the 'science'. • This is the first pre-registration Spiritual Care Competency Framework for nurses/midwives. • It was developed using a rigorous embedded sequential mixed methods eclectic research design. • The Framework is informing design/delivery of spiritula care education programmes across Europe [ABSTRACT FROM AUTHOR]

The study's main goal was to compare the effects of a mobile application versus traditional methods of teaching on nursing students' acquisition of knowledge about pressure injury prevention. In addition, a secondary aim was to discover nursing students' viewpoints related to the advantages and disadvantages of using mobile applications as an educational method. A randomized controlled study design was implemented during November and December of 2023 in a nursing faculty with 60 undergraduate students in their second nursing year. A total of 30 students were assigned to the mobile application group, while the other 30 students were assigned to the traditional lecture group. The study was executed in three stages: pre-test, educational intervention, and post-test. The results of the study during the pre-test showed that there were no statistically significant differences in the mean scores of pressure injury themes between the two groups. However, the post-test scores for all PI themes were higher in the mobile application group compared to the traditional lecture group. Furthermore, five advantages of the mobile application were highlighted by students: "improvement of students' knowledge and skills", "self-confidence", "stress reduction", "enhancement of competence", and "stimulation of learning motivation". This study demonstrated the effectiveness of the mobile application method in enhancing nursing students' knowledge and prophylaxis of pressure injury. Therefore, the mobile application method is recommended as an innovative approach to teaching. [ABSTRACT FROM AUTHOR]

Background Complementary feeding has long-term effects on health but there is heterogeneity in recommendations across Europe. Recommendations include responsive feeding practices and nutritional needs but there is a debate in primary paediatricians as to which one should be the main criterion for complementary feeding. This pilot study investigated (i) the factors affecting the recommendations of paediatricians in Cyprus for starting complementary feeding, (ii) whether their main criterion is the developmental readiness or the nutritional needs of the infant and (iii) how this priority influences recommendations. Methods The 11-item questionnaire was completed by 73 Cypriot paediatricians. Results Approximately 66% of paediatricians recommended starting complementary feeding between 5 and 6 months, 29% between 4 and 5 and 3% between 6 and 7 months. Predefined schemes were recommended by ∼25% of paediatricians, baby-led weaning by 14% and 58% of paediatricians recommended either modality depending on the family circumstances whilst 4% involve the mother in the decision process. Approximately 64% of paediatricians recommended the introduction of parent's diet after the first year of life. Approximately 55% of paediatricians chose developmental readiness and 45% nutritional needs of the infant as their primary criterion for starting complementary feeding. Paediatricians who prioritized developmental readiness were more likely to be younger, less likely to advice on meat quantity and less likely to follow good nutritional practice. Conclusions The younger the paediatrician the more likely they are to prioritize developmental readiness over nutritional needs of the infant for complementary feeding. Paediatricians who prioritized developmental readiness were also less likely to provide nutritional advice. [ABSTRACT FROM AUTHOR]

Purpose – This study aims to investigate the effects of the use of symbols in the development of young children's ability to form questions in mainstream early-childhood education. Hypotheses examined whether the use of graphic symbols help 3. 5-5 year-old students to increase the number of questions and the number of words in the questions asked for a particular subject. Design/methodology/approach – Following an experimental design approach, an experimental (EG) and a control group (CG) of children, matched to age (4:2) and to their ability to make questions (pre-test), attended an instructional programme. The EG used Widgit Symbols and the CG the traditional methods used by educators to teach questioning. Data collection involved pre and post oral assessment tests, which measured the number of questions and the length of questions in role play activities. Findings – Findings of the study showed that symbols have positively affected children's ability to make questions. The EG scored higher than the CG on variables examined, and the within groups improvement (pre to post test) was again higher for the EG. Research limitations/implications – The paper discusses some possibilities of a lengthier implementation of the use of symbols and their effect on language acquisition. Practical implications – The study raises some considerations about the development of new teaching methodologies with the use of symbols and Information Communication Technology to enhance language development and maximize learning for all learners. Originality/value – Usually emphasis is placed on the use of symbols as a means of assistive technology (AT) for the accommodation of the needs of children with disabilities. This paper is an effort to cover a gap in literature and emphasize on the benefits of AT in general learning environments for all children. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to discuss factors affecting temporary migrants' ability to access and make effective use of public and private healthcare services in the Republic of Cyprus (hereafter referred to as Cyprus). These factors are raised in the context of a larger study focusing on the healthcare needs of temporary migrants from non-EU countries living and working in Cyprus. Design/methodology/approach -- Semi-structured interviews with 13 domestic workers and 17 students from Sri Lanka, Pakistan, Bangladesh, India and the Philippines explored migrants' experiences with accessing and utilizing healthcare services in Cyprus. The theoretical framework utilized is grounded in the health capability approach which focuses on individuals' confidence and ability to be effective in achieving optimal health. Findings -- The study highlights issues concerning the accessibility and acceptability of healthcare services which emerge as the result of both the organisation and delivery of healthcare services and social, political and economic structures. Research limitations/implications -- The implications of this study are relevant in the current debate taking place at the EU level about the opportunities and challenges of temporary migration. Specifically, it is argued that governments and societies should promote individual freedoms and opportunities that empower people to lead the lives they want to live. Originality/value -- Temporary migrants form a group whose experiences and needs have not been as extensively investigated as those of other migrant groups, particularly in Cyprus. The capability approach allows for assessing both policy and health systems taking into consideration equity and the impact of multi-sectoral influences on health. [ABSTRACT FROM AUTHOR]

This paper focuses on the evaluation of the therapeutic use of photocards by prisoners and facilitators in a counselling psychology led European project, based on responses to open-ended questionnaires. It is part of a wider project, involving seven partner organisations in six European countries (England, Finland, Greece, Italy, Malta and Romania), which developed and trialled four different approaches to using photography in the context of counselling in prisons. Of the 51 inmates that participated in the project, 48 (94%) completed the questionnaires; of those, 39 (77%) were available for individual analysis due to prison restrictions in one partner organisation only allowing group data. Of those 39, who returned their completed questionnaires, over 92% found the therapeutic use of photographs either very helpful (56.4%) or helpful (35.9%), and the remaining 7.7% described it as average. From the thematic analysis, main themes emerging regarding inmates’ experiences of working with photocards were that it: facilitates emotional expression and sharing; unlocks memories and reconnects with life outside; fosters insight, reflection and self-growth; breaks the monotony of prison life and, overall aids emotional learning. A thematic analysis of 11 psychological therapists/facilitators’ perspectives showed that the use of photocards: gives clients a voice; provides a safe and collaborative frame and a therapeutic relationship; and, provides a useful icebreaker, helpfully overcoming anxieties of both client and psychotherapist/facilitator. Overall, photocards were considered useful as their projective nature can help facilitate prisoners’ strong need for expression in a context where there are limited opportunities and trust is fragile. [ABSTRACT FROM PUBLISHER]

Aims: This study aimed to investigate the level of physical activity of children and reveal a physical activity map in Northern Cyprus. Relevant factors, facilitators, and inhibitors for physical activity were also investigated. Methods: Sample size and pilot schools were determined for the cross-sectional population-based study. Region, school, class, age, and gender were recorded. The Physical Activity Questionnaire for Children (PAQ-C) was used as a self-report questionnaire. Time spent on screen-based activities and presence of a park were examined. Results: The data for 2283 (1131 = girls) children were used in the study. The mean PAQ-C score of all children was determined as 3.48 ± 0.71. Gender, age ,and region significantly changed the PAQ-C scores of the children (p < 0.05). The children who stated that their homes had neighbourhood park areas had higher PAQ-C levels than those who stated otherwise (p < 0.05). There was no significant difference between the levels of PA of the children who spent normal time and excess time for technological devices with screen (p > 0.05). Conclusion: Physical activity and related sociodemographic comparisons were indicated for the children living in Northern Cyprus. While park availability was found essential to support the physical activity levels as an opportunity, screen-based activities were not found to be have an effect on physical activity as a barrier. [ABSTRACT FROM AUTHOR]

Stroke is a global leading cause of death and disability. Knowledge of related guidelines is crucial for emergency department (ED) staff, influencing early diagnosis and timely treatment. We investigated Greek Cypriot ED healthcare professionals' (nurses and physicians) knowledge in recognizing and managing stroke. A descriptive cross-sectional study spanned November 2019 to April 2020, encompassing four private and seven public EDs in the Republic of Cyprus. The data were collected through a self-reported questionnaire developed by the research team, consisting of 37 questions. Eight questions focused on sociodemographic and employment characteristics, twenty-eight assessed knowledge in stroke recognition and management (each item was equally weighted without deliberate prioritization), and one question addressed self-assessment of knowledge in stroke care. A total of 255 nurses (response rate (RR): 74.1%) and 26 physicians (RR: 47.3%) completed the questionnaire. The average correct response rate was 12.9 out of 28 statements (SD: 4.2), with nurses and physicians scoring 12.6 (SD: 4.1) and 15.7 (SD: 4), respectively. Work experience significantly influenced stroke knowledge, with all groups demonstrating superiority over those with less than one year of experience. Participants with previous training scored an average of 1.45 additional correct answers while educational attainment did not significantly influence stroke knowledge. Investigating stroke knowledge among emergency department nurses and physicians in the Republic of Cyprus revealed significant deficits. This study stresses targeted interventions, including education, yearly examinations, workshops with hands-on training, and repeated training, to address these gaps and enhance the overall stroke care capabilities of the healthcare professionals. [ABSTRACT FROM AUTHOR]

The progressive population ageing observed in Western countries determines a growing need for long-term care for older people. At the same time, migrants and refugees often have integration difficulties in regards to the hosting country society and labour market, with one reason being the lack of EU recognition of the educational degrees obtained in their native country. Creating educational opportunities in elderly care for migrants may facilitate their social inclusion, increase their employability, and constitute a response to the growing labor demand. The HERO project moved in this direction by planning, designing, and carrying out an original training curriculum targeted to migrants and refugees from African and Middle Eastern countries, piloted in four Mediterranean countries (Cyprus, Greece, Italy, and Portugal). The impact of the training on migrants and refugees' quality of life was assessed through the WHOQOL-BREF questionnaire, while social inclusion was assessed through semistructured interviews and participant observation carried out during the internship in elderly care facilities. Eighty-two migrants (70.7 percent women) were involved in the study. The results showed that despite the fact that the training did not have an impact on the trainees' quality of life, it was associated with social inclusion. Four ideal types of migrant learners were drawn: "ex-professional trainees," "fall-back trainees," "care-oriented trainees," and "nonprofessional care workers," based on which as many possible educational pathways were drawn to optimise the trainees' learning process. The study results shaped the formulation of suggestions on migrants' education in elderly care. [ABSTRACT FROM AUTHOR]

Specialist nurses play a significant role in healthcare. This study investigated and evaluated the primary and extended roles and the development of specialist nurses in Malta. Methods: A qualitative case study design and purposive sampling techniques were used to gain a deep understanding of the complex issues surrounding specialist nurses from multiple data sets. A survey of the total specialist nurse population in 2013 (n=27), in-depth interviews with a group of specialist nurses (n=9) and four focus groups with key professionals and policy stakeholders (total n=28) were carried out. Data were collected between 2013 and 2015 and analysed using thematic analysis. Findings: Three themes emerged: the roles and attributes of specialist nurses in Malta; the development of specialist nurses; and the influences on the advancement of specialist nursing practice in Malta. Although these data are nearly a decade old, no further research has been carried out. Conclusions: A legally accepted set of definitions as well as preparation and evaluation of the specialist nurse role from a national policy perspective is needed. Attitudes and systems that limit specialist nurses need to be challenged. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to determine whether multi-type child maltreatment is associated with health-risk behaviours and mental ill-health in adolescence. Design/methodology/approach – In total, 406 15-16-year-old students from Maltese schools answered the “Child maltreatment physical and mental health” questionnaire (Nguyen et al., 2010). This assessed demographics, health risk behaviour, mental health and child maltreatment. Findings – Of the four categories of maltreatment measured (physical, sexual, emotional and neglect), 27.4 per cent of the young people experienced one type, 16.6 per cent two types, 11.1 per cent three and 6.5 per cent four. For health-risk behaviours, there were positive relationships between multi-type maltreatment and school fights (r=0.27, p<0.01), breaking school rules (r=0.19, p<0.01), illicit drug use (r=0.14, p<0.05) and alcohol use (r=0.10, p<0.05). As regards mental health, multi-type maltreatment was positively associated with depression (r=0.38, p<0.01) and anxiety (r=0.23, p<0.01), and negatively associated with self-esteem (r=-0.26, p<0.01). Practical implications – Early recognition of multi-type maltreatment and its consequences enables providers of children’s services to offer the required diverse range of services. Additionally, policy makers should ensure the adoption of multi-sectoral and collaborative inter-agency approaches so as to effectively and holistically manage child maltreatment, not only during the acute childhood phase but also during adolescence and adulthood, when consequences are expected to emerge. Originality/value – This study raises awareness about the prevalence of multi-type child maltreatment in Malta. It also highlights the negative association between cumulative exposure to multi-type child maltreatment and mental health outcomes and risky behaviours. [ABSTRACT FROM AUTHOR]

Individuals with adult or juvenile Huntington disease can be cared for within psychiatric hospitals. In this paper, nurses' perceptions about the appropriateness of a psychiatric setting for these patients were explored. Semistructured interviews were conducted with 10 Maltese nurses involved in the care of these individuals. Their responses were analyzed using thematic analysis. Three main themes were identified from this study: (i) Huntington disease is not a mental illness; (ii) the lack of specialized staff and equipment within a psychiatric setting; and (iii) a need for alternative care options. The findings provide an insight into the perceptions of nurses, as they play a key role in the care and management of individuals with Huntington disease in a psychiatric setting. The findings demonstrated the need to provide alternative residential options in the community, and to improve the care and support provided both within psychiatric hospitals and the community through staff education and the provision of necessary facilities and equipment. [ABSTRACT FROM AUTHOR]

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026-1037. Abstract Aim. This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients ( n = 1659) and their nurses ( n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients ( P < 0·05) with important differences in the 'assurance of human presence' ( P < 0·001) and the 'respectful deference to others' ( P < 0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' ( F = 24·199, P < 0·001) and patients' views on caring ( F = 26·945, P < 0·001). Conclusions. Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses. [ABSTRACT FROM AUTHOR]

Aim: To understand the meaning of surviving out of hospital cardiac arrest and its aftereffects among Greek‐speaking survivors. Design: Hermeneutical phenomenological method based on Martin Heidegger's philosophy. Methods: Eight Greek‐speaking out of hospital cardiac arrest survivors were recruited using purposive sampling method. Data collection and analysis using the seven stages of hermeneutic analysis described by Diekelman. Data were collected through semi‐structured personal interviews with open‐ended questions. Results: Analysis revealed five themes: 'The unexpected attack', 'Experiencing a different world: Transformation of Body, Time, Emotion and Sensation', 'Restoration of the re‐embodied self', 'Life transformation' and 'Personal transformation'. The themes are commensurate with transcultural components of Near‐Death Experiences. Surviving out of hospital cardiac arrest was perceived as a 'divine gift' and a chance to continue 'living in a more conscious and meaningful way'. Despite participants' physical and psychosocial challenges, the narratives highlighted a newly acquired deep appreciation for the joy of life, living and others. Construction of meaning and a heightened spirituality seem central in reconstructing life after out of hospital cardiac arrest survivors. Patient or Public Contribution: Out of hospital cardiac arrest survivors reflected and described in‐depth on their lived experiences of out of hospital cardiac arrest through a 60‐ to 90‐min interview. In addition, the participants provided their feedback on the interpretation of the findings, confirmed the study findings, and ensured that the analysis reflected aspects of their individual experiences and were true to them. [ABSTRACT FROM AUTHOR]

Simple Summary: A Gastro-Intestinal Stromal Tumour (GIST) is a rare type of cancer discovered in the last decades of the 20th century and whose characteristics are still being defined. Knowledge of the distribution of any disease and its severity among a population is paramount for the best distribution of efforts and resources intended for its diagnosis and treatment. The present study was started by the European Union Joint Action on Rare Cancers and is aimed at shedding light on the current status of GISTs in a region in the southeast of Spain, the matter being quite unknown in the whole of Europe because of there being few previous studies and partial invalidation of those studies due to prior consideration of some subgroup of GIST as non-cancerous. Aside from producing useful information for health authorities, our study will contribute to expanding the knowledge of this relatively new and, from a population level point of view, poorly known cancer. Gastro-Intestinal Stromal Tumours (GISTs) are a kind of neoplasm whose diagnosis in common clinical practice just started in the current century, implying difficulties for proper registration. Staff from the Cancer Registry of Murcia, in southeastern Spain, were commissioned by the EU Joint Action on Rare Cancers into a pilot study addressing GIST registration that also yielded a population-based depiction of GISTs in the region, including survival figures. We examined reports from 2001 to 2015 from hospitals as well as cases already present in the registry. The variables collected were sex, date of diagnosis, age, vital status, primary location, presence of metastases, and risk level according to Joensuu's Classification. In total, 171 cases were found, 54.4% occurred in males, and the mean age value was 65.0 years. The most affected organ was the stomach, with 52.6% of cases. Risk level was determined as "High" for 45.0%, with an increment of lower levels in recent years. Incidence for the year 2015 doubled that of 2001. Overall, the 5-year net survival estimation was 77.0%. The rising incidence magnitude is consistent with trends in other European countries. Survival evolution lacked statistical significance. A more interventional approach in clinical management could explain the increase in the proportion of "Low Risk GISTs" and the first occurrence of "Very Low Risk" in recent years. [ABSTRACT FROM AUTHOR]

Background As part of the measures to contain the initial cases of Coronavirus Disease (COVID-19) in 2020, all educational facilities were closed in March 2020 and remained so for the remainder of that scholastic year. When they reopened in October 2020, most educational facilities on the Maltese islands did so with various mitigation measures in place. Methods A Schools Contact Tracing Team (SCTT) dedicated to the management of COVID-19 cases within schools was set up and networks established between the Ministries responsible for Health and Education to facilitate timely communication and, consequently, effective contact tracing. All cases pertaining to educational facilities, be they students, teaching or non-teaching staff were assessed and managed by this Team. Results Between October 2020 and June 2021, the SCTT assessed 2603 COVID-19 cases within educational facilities in Malta. The highest rate of cases overall was observed in teaching staff (56.53/1000). In 72.45% of cases, no contacts were identified as high risk and thus nobody was placed in quarantine. In 3.07% of school cases >21 high-risk contacts were placed in mandatory quarantine together with their household members. Only 11% of the cases were epi-linked to another positive case within school. Conclusions The strong collaboration between the health and education authorities combined with strict measures observed in schools ensured that schools remained open throughout most of this pandemic. This study describes the processes by which contact tracing for COVID-19 cases in Maltese schools was carried out and analyses the data collected throughout the scholastic year 2020–21. [ABSTRACT FROM AUTHOR]

Violence against women (VaW) is a widespread crime and violation of the rights of women. It is present in every country without exception and crosses boundaries of culture, class, education, income, and race. Despite the magnitude of the literature and the abundance of publications on this problem, the field lacks a comprehensive and homogeneous way to measure and compare the extent of VaW across countries. Proper quantification of this problem is needed to develop preventive policies and strategies to reduce it. This article develops an index of VaW (VAWI) with global scope and multidimensional approach for 102 countries. It is an original index that calculates the total level of VaW by capturing information from the main VaW types (physical, sexual, psychological, and economic violence) in a single value between 0 and 1, where 0 denotes complete absence of violence and 1 the highest level of violence in a country. The proposed index is easy to compute and is comparable across countries. Our main results show that the nations with the highest levels of global VaW are Yemen, Senegal, Oman, Cameroon, and Uganda. The countries with the lowest levels are the Northern European Countries, Canada, and Malta. This VAWI makes a novel and important contribution to the study of gender issues. It can be used not only to monitor the statistics on VaW data within countries over time but also to make comparisons among countries. Further, it could be useful in designing new policy initiatives to reduce VaW. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the effect of auditory perceptual phonetic training on the identification and production of English vowels by Cypriot Greek children and adults. Another two groups of Cypriot Greek child and adult speakers served as controls. The trained groups participated in the pretest, training, and posttest phase, while the controls completed only the pretest and posttest phase. The results showed that perceptual training improved identification accuracy, with children showing greater gains than adults. Although the performance of adults was poorer than the performance of children, their phonological system did undergo substantial alteration through perceptual phonetic training as they significantly improved their identifications in the posttest. Also, the results support a common mental space for the speech perception and production domains since the perceptually-oriented training affected the learners' productions. However, transfer of improvements in production was observed only to some extent in children and not in adults, suggesting that training has an impact mostly on the trained modality and that some production improvement after perceptual training might be more evident in younger learners. [ABSTRACT FROM AUTHOR]

Home care nursing for cancer patients often involves palliative care, as it offers the potential to significantly improve the patients' quality of life. For the vast majority of patients, their home is the most preferable space for palliative care, since care in their own private space ensures they experience a feeling of meaningful existence and preserves the feeling of control over their life. The current study aims to evaluate the quality of palliative home care for cancer patients in Cyprus. This qualitative research follows the STROBE cross-sectional checklist. The study took place in the Republic of Cyprus and the study tool involved a questionnaire that was distributed by hand via convenient sampling. In the current research, a total of 80 cancer patients who participated in in-home care nursing in Cyprus were investigated. The psychological support and the communication provided by the home care nursing toward the patient appear to have a pivotal role when it comes to improving the quality of the individual's life as well as the perceived levels of respect and recognition of one's own needs. However, further research within a larger sample size of patients who receive palliative home care nursing is required in order to yield conclusions that are further representative of the wider population and which can be generalizable to a greater extent. [ABSTRACT FROM AUTHOR]

Background: Device‐associated health care‐associated infections (DA‐HAIs) are a major threat to patient safety, particularly in the Intensive Care Unit (ICU). This study aimed to evaluate the effectiveness of a bundle of infection control measures to reduce DA‐HAIs in the ICU of a General Hospital in the Republic of Cyprus, over a 3‐year period. Methods: We studied 599 ICU patients with a length of stay (LOS) for at least 48 hours. Our prospective cohort study was divided into three surveillance phases. Ventilator‐associated pneumonia (VAP), central line‐associated blood‐stream infections (CLABSI), and catheter‐associated blood‐stream infections (CAUTI) incidence rates, LOS, and mortality were calculated before, during, and after the infection prevention and control programme. Results: There was a statistically significant reduction in the number of DA‐HAI events during the surveillance periods, associated with DA‐HAIs prevention efforts. In 2015 (prior to programme implementation), the baseline DA‐HAIs instances were 43: 16 VAP (10.1/1000 Device Days), 21 (15.9/1000DD) CLABSIs, and 6 (2.66/1000DD) CAUTIs, (n = 198). During the second phase (2016), CLABSIs prevention measures were implemented and the number of infections were 24: 14 VAP (12.21/1000DD), 4 (4.2/1000DD) CLABSIs, and 6 (3.22/1000DD) CAUTIs, (n = 184). During the third phase (2017), VAP and CAUTI prevention measures were again implemented and the rates were 6: (3 VAP: 12.21/1000DD), 2 (1.95/1000DD) CLABSIs, and 1 (0.41/1000DD) CAUTIs, (n = 217). There was an overall reduction of 87% in the total number of DA‐HAIs instances for the period 1 January 2015 to 31 December 2017. Conclusions: The significant overall reduction in DA‐HAI rates indicates that a comprehensive infection control programme can affect DA‐HAI rates. [ABSTRACT FROM AUTHOR]

DECOLA P., BENTON D., PETERSON C., & MATEBENI D. (2012) Nurses' potential to lead in non-communicable disease global crisis. International Nursing Review 59, 321-330 Background: The incidence and projected rise of non-communicable diseases (NCDs) are a significant global public health threat. Nurses as health educators are well positioned to support health promotion and prevention efforts. The intent was to understand nurses' interest, challenges and enabling factors in carrying out this important role in addressing the NCD crisis. Method: A stratified representative survey of 1600 nurses in eight countries was conducted to better understand how nurses perceive their role in addressing risk factors associated with NCDs, as well as the types of supports required in order to facilitate this work. The study also explores nurses' changing views of the profession and their practice environment. The structured survey was administered via telephone and face-to-face interviews composed primarily of multiple choice closed-ended questions. Results: Key findings included that 95% of nurses wanted to use their knowledge, skills and time to educate individuals on the threat and prevention of NCDs. They expressed their belief that they should be spending significantly more time, on average almost twice the amount as they currently are able to devote, on preventing the development or escalation of NCDs. However, nurses' potential to do this is diluted by heavy workloads; over one third reported that their workload had worsened over the last 5 years, and 95% of nurses are experiencing time pressures. Nurses believe these constraints, almost unanimously (98%), keep them from being able to spend more time with patients in an educational capacity. Conclusions: Nurses are interested in spending more time addressing NCD prevention, but workload, time constraints and their perception towards the job of nursing hinder them from achieving their potential. Unhealthy lifestyle choices are a risk factor for NCDs; through awareness and education, positive behaviour change is possible. Research has demonstrated that nurses are effective at supporting individuals to make behaviour change, administering disease management programmes and enabling self-care as well as self-management. Practice environment issues that prevent nurses from fully reaching their potential in addressing the NCD crisis need to be addressed. [ABSTRACT FROM AUTHOR]

The questionnaire "Nurses Attitudes Towards Computerization" which reflects the views of nurses on the use of information technology in hospitals, was translated into Greek. The purpose of this paper is to show the weight of the above questionnaire into Greek in terms of reliability and validity. Overall, 621 nurses in public and private hospitals of Cyprus completed the questionnaire. The construct validity of the questionnaire was examined by exploratory factor analysis and the internal consistency of the factors that emerged with the coefficient of reliability Cronbach alpha. The export factor was principal components analysis with Varimax rotation. The criterion for acceptance of the factors is the eigenvalue to be equal to one. The analysis shows that the scale has good psychometric properties. The results showed high reliability and validity, strong correlation to the content of the scale, therefore the assessment tool Nurses Attitudes Towards Computerization (NATC) can be a reliable tool for capturing relevant views of nurses as regards the introduction and use of information technology in hospitals. [ABSTRACT FROM AUTHOR]

Idiopathic pulmonary fibrosis is a progressive fibrotic lung disease that is on the rise globally. The disease is associated with significant morbidity and hence poses significant challenges for their informal carers, particularly daughters in mid‐adulthood, who struggle with their own personal demands and that of their ill parents. Yet there is a dearth of literature on the experiences of these specific carers. Hence, the purpose of this study is to explore the lived experiences of daughters caring for a parent with pulmonary fibrosis within a community setting. This was explored using a phenomenological qualitative framework that was conducted between January and April 2017. Semi‐structured audio‐recorded interviews were conducted with six adult daughters who provided care to a parent having pulmonary fibrosis. Purposive sampling was used to recruit study participants. Transcribed data were analysed using Interpretative Phenomenological Analysis. Three main themes were extracted which communicate the essence of the daughters' lived experiences: "Walking on tiptoes", "Flooded by emotions" and "Shifts in family dynamics." Participants described experiencing the toll of being constantly vigilant for symptoms. They also expressed a range of emotions that included guilt, helplessness and worry related to their care experience. However, these emotional struggles were suppressed in order to present an external facade of strength and control. A shift in roles was also described where the daughters became the informal carers/support for both their ill and well parent, albeit in different ways. Caring for a person with pulmonary fibrosis is an emotional and life changing experience and hence, there is the need for individualised interventions that target the unique perceptions of these informal carers. [ABSTRACT FROM AUTHOR]

Objective. This web-based survey, as a tool of teledentistry, is aimed at assessing the level of knowledge, attitudes, and awareness regarding MRONJ among dental professionals in Northern Cyprus. Methods. An online self-administered questionnaire about MRONJ was sent to all dentists in Northern Cyprus through Google Forms. The first part of the questionnaire consists of demographic and professional information, and the second part included questions about knowledge and awareness questions about MRONJ. The SPSS software was used for statistical data analysis. A Chi-square test was performed to compare between the groups. The significance level was set at p < 0.05. Results. A total of 112 dentists participated in this survey. The participants showed an insufficient level of knowledge regarding MRONJ, as only 56.6% of the participants stated that they had general knowledge about MRONJ. Regarding the practical questions of the survey, the participants showed poor knowledge about implant and tooth extraction procedures while a patient is using antiresorptive or antiangiogenic drugs, particularly the usage of oral antiresorptive or antiangiogenic drugs for less than 3 years. Participants showed adequate knowledge in terms of usage area of medications and administration of them. Conclusion. Teledentistry can be used as a supportive tool for dentists in diagnosing MRONJ. Similar to previous studies, the knowledge and awareness of MRONJ of dentists in Northern Cyprus were found to be inadequate. There is a significant need to provide more professional information as part of undergraduate programs so that the next generation of dentists can practice more confidently. [ABSTRACT FROM AUTHOR]

The aim of this study was two-fold: to investigate the relationship between emotion regulation, dispositional mindfulness and bullying/victimization experiences at school, and to examine the mediating effects of internalizing and externalizing problems on this relationship. Self-reports measuring the above variables were completed by 444 adolescents (mean age 15.3) who attended high school in Cyprus. Data were collected at three points in time. Specifically, data were collected during the second week of October, 2018 (T1), the third week of January, 2019 (T2) and the first week of June, 2019 (T3). It was found that mindfulness at T1 had a significant negative effect on both internalizing and externalizing symptoms and through these variables, it had an indirect negative effect on both bullying and victimization at T3. Similarly, adaptive emotion regulation at T1 had an indirect effect on victimization, fully mediated by internalizing problems. In contrast, maladaptive emotion regulation had a positive, direct effect on both bullying and victimization. [ABSTRACT FROM AUTHOR]

Loneliness has been examined by an increasing number of scholars, being implicated in numerous detrimental outcomes for mental and physical health. However, most loneliness prevalence studies have focused on particular age groups, thus overlooking how loneliness differs across the lifespan. This study assessed loneliness prevalence in a nationally representative sample (n = 1,009) of the Maltese population aged 11 years and above using the 11-item De Jong Gierveld Loneliness Scale, while also identifying associations between loneliness and sociodemographic factors. Results demonstrate that 43.5% of the Maltese population experiences some form of loneliness. The association between loneliness and age demonstrates a nonlinear relationship, with elevated loneliness rates among adolescents, which decrease slightly in early adulthood, before slowly increasing from age 35 onward. Loneliness is also significantly associated with education level, employment status, household composition, mortgage payment status, perception of income, presence of a disability, active citizenship, as well as self-rated physical health, coping ability, and subjective wellbeing. These findings indicate that loneliness is experienced in significant rates across the lifespan, and intervention efforts should be targeted toward individuals of all ages. [ABSTRACT FROM AUTHOR]

Background: Spiritual well-being is increasingly investigated in relation to patients' perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer. Methods: One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored. Results: Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD = 23.7) and it was associated with the mean scores in the scales "Emotional functioning" and "Cognitive functioning" of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p < 0.01). The mean score for the "Relationship with God" scale (74.9, SD = 29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island's population. Conclusions: All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool's suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being. [ABSTRACT FROM AUTHOR]

Background: The selection of quality indicators demonstrating the efficiency and relevance of nursing practice in patient outcomes in the intensive care unit remains a challenge. Aim: The aim of this study was to develop a set of potential quality indicators to quantify nursing care provided to critically ill patients through a consensus method. Design: This was a three‐phase study including a European survey of intensive care unit (ICU) nurses (phase one) followed by a two‐phase face‐to‐face consensus meeting of experts from Cyprus. Method: Two distinct panels of experts were asked to rate each quality indicator using a 4‐point Likert scale in phases one and two. The level of consensus was set at 60%. In phase three, scores of the content validity index for items and scales were considered for the final selection of quality indicators. Results: The phase one survey included 139 ICU nurses from 13 European countries, and phases two and three included seven ICU experts from Cyprus. "Consensus in" was achieved for 12 items at the end of phase two. Three of the quality indicators were significantly different by country: (a) falls (P =.006), (b) accidental removal of nasogastric tube (P <.001), and (c) accidental removal of intravascular catheters (P <.001). Only falls was significantly correlated with higher academic qualifications of the participants (P =.002). Conclusions: Fifteen items have been identified as potential indicators for adult ICU nursing quality. These need to be prospectively studied to determine the extent to which they can accurately capture nursing care quality in this setting. Relevance to clinical practice: The study provides a set of relevant quality indicators. A nursing set for the ICU may serve as the basis for nursing management and facilitate the strategy dedicated to the vision of health care quality assurance. [ABSTRACT FROM AUTHOR]

Background: Approximately, 20% of intensive care unit (ICU) survivors develop post‐traumatic stress disorder (PTSD) symptoms. Although Davidson Trauma Scale (DTS) provides a comprehensive approach to PSTD symptoms, there is no evidence on DTS‐I‐M use in ICU survivors. Aims and objectives: To validate the modified intensity Davidson Trauma Scale (DTS‐I‐M) (wherein the frequency and severity subscales are combined to express symptoms intensity) in a convenience sample of ICU survivors in Cyprus, and to explore the prevalence of PTSD symptoms and related predictors. Design: An instrument validation design, along with a cross‐sectional, correlational study design was employed. Methods: Translation and cultural adaptation of the instrument were achieved through a group of experts and pilot testing. The DTS‐I‐M was administered via telephone. Participants' clinical data (length of ICU stay [LOS], mechanical ventilation duration [MVD], admission diagnosis, medication history) and demographics (age, gender) were collected. Non‐parametric comparisons, and regression analyses to identify predictors of DTS‐I‐M scores and PTSD symptoms were employed. Results: The Cypriot DTS‐I‐M version demonstrated high test‐retest (Pearson's r = 0.928, P <.001) and internal consistency (Cronbach's [α] alpha =.97) reliability in a sample of 69 ICU survivors (62.7% response). About 36.2% of participants reported PTSD symptoms. Factor analysis confirmed the construct validity of the DTS‐I‐M, and a 3‐factor structure (encompassing intrusive, avoidance, hyperarousal, mood, and cognitive symptoms). In a multiple regression, MVD (B = −3.11, OR [95% CI] = 22.58 [3.07‐166.09, P =.002]) and LOS (r2 = 0.302, P =.002) were statistically significant predictors of DTS‐I‐M score. Conclusion: We confirm the applicability of the DTS‐I‐M for the assessment of PTSD symptoms in ICU survivors; and offer preliminary evidence on the prevalence and predictors of post‐ICU PTSD symptoms in Cyprus. Relevance to clinical practice: DTS‐I‐M is an appropriate screening tool for PTSD symptoms after ICU hospitalization. Patients with longer MVD and LOS are at higher risk for post‐ICU PTSD symptoms and seem to experience more intense relevant symptoms. [ABSTRACT FROM AUTHOR]

Pain is a common symptom for cancer patients. It is a problem for themselves and their relatives. Nurses are confronted with the treatment of cancer pain in their everyday clinical practice. Efficient management requires accurate and appropriate knowledge, positive attitudes, and competent evaluation skills. The aim is to explore the knowledge and attitudes of Cypriot home care nurses in pain management of cancer patients. Regarding methodology, a quantitative descriptive design was used and the data were collected with the Greek version of the McCaffery and Ferrell Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire along with a demographic questionnaire. The sample of the study consisted of home care nurses working in non-profit organizations in Cyprus (n = 31). For the analysis of data, the SPSSv.21. was used and the statistical significance was set to the p =.05. Results revealed of the total of 35 questions only 13 were answered correctly by the 80% of the participants. Limited knowledge was reported mainly on the duration of action, the effect and dosage of Pethidine, the risk of addiction and the use of non-medication interventions. Significant differences were found to the level of knowledge as regards the age and the experience of nurses. In the case study exercise, it was found that false assessment of pain was related to wrong decisions. Nurses' attitudes seemed to be positive. In conclusion, the study revealed the knowledge deficits and need for continuous education of home care nurses on the assessment and management of pain for patients with cancer. Empowering nurses with better skills to deal with pain, a most distressing symptom of cancer, will result in a better quality of life for patients. However, the integration of pain management within the national cancer strategies is also very important. [ABSTRACT FROM AUTHOR]

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The islands of Sardinia, Crete, and Cyprus are hosting the last native insular griffon populations in the Mediterranean basin. Their states have been evaluated from "vulnerable" to "critically endangered". The sequence analysis of molecular markers, particularly the mtDNA D-loop region, provides useful information in studying the evolution of closely related taxa and the conservation of endangered species. Therefore, a study of D-loop region sequence was carried out to estimate the genetic diversity and phylogenetic relationship within and among these three populations. Among 84 griffon specimens (44 Sardinian, 33 Cretan, and 7 Cypriot), we detected four haplotypes including a novel haplotype (HPT-D) that was exclusively found in the Cretan population with a frequency of 6.1%. When considered as a unique population, haplotype diversity (Hd) and nucleotide diversity (π) were high at 0.474 and 0.00176, respectively. A similar level of Hd and π was found in Sardinian and Cretan populations, both showing three haplotypes. The different haplotype frequencies and exclusivity detected were in accordance with the limited matrilineal gene flow (FST = 0.07097), probably related to the species reluctance to fly over sea masses. The genetic variability we observe today would therefore be the result of an evolutionary process strongly influenced by isolation leading to the appearance of island variants which deserve to be protected. Furthermore, since nesting sites and food availability are essential elements for colony settlement, we may infer that the island's colonization began when the first domestic animals were transferred by humans during the Neolithic. In conclusion, our research presents a first contribution to the genetic characterization of the griffon vulture populations in the Mediterranean islands of Sardinia, Crete and Cyprus and lays the foundation for conservation and restocking programs. [ABSTRACT FROM AUTHOR]

Oral health is not only limited to healthy teeth and gums, but it is really interconnected to the general health. Oral cavity frequently reveals the existence of eating disorders, blood diseases, endocrine and metabolic disorders, which may be the result of microbial infections, immune disorders and medications. This study aimed to evaluate the knowledge and habits of patients and physicians concerning oral care and moreover to compare their knowledge about the relationship between oral and general health. A questionnaire was developed by the authors and distributed to all 94 primary care general practitioners who worked at public health units in Cyprus and 550 dental patients. A two sided p-value equal to 0.05 was considered statistically significant. The SPSS program, version 19.0 was used for statistical analysis. The mean score of dental patients' knowledge regarding oral health was found poor, just 3.7/10, while physicians score was higher 6.4/10 (p < 0.001). More than half of patients (55.5%) and 29.5% of physicians reported that the reason for their last visit to a dentist was an emergency situation. Dental patients with higher educational level and patients who have been informed about the significance of oral health by their doctors visited 4.4 and 1.9 times more often dentist within 6 or 12 months compared to those with low educational level (p < 0.001/p = 0.005 respectively). Patients' and physicians' level of knowledge, behavior and perceptions about oral health are not satisfactory and these results underline the necessity for improving relevant health promotion programs. [ABSTRACT FROM AUTHOR]

Introduction: The ignorance of the population regarding organ donation and their inadequate information affect negatively the growth of donors in Cyprus. Aim: To assess the knowledge and attitudes of the general population of Limassol, regarding organ donation and the factors that influence their decision. Methods: A cross-sectional study was conducted with a sample of 1200 people in Cyprus, in the Limassol province. The sampling method used was the sampling of convenience and the questionnaire completion was made anonymous in public venues from June to September 2014. Data analysis was performed with IBM SPSS 21.0. Results: Women with 56,7%, felt that organ donation saves lives (p <0.05) and would like to become organ donors. In addition, they knew that there was a waiting list for prospective recipients (p <0.05) and agreed that to remove an organ from the donor he must be brain-dead compared to the 43,3% to the men. In contrast, men with 40,1% were more likely to know if brain death was reversible (p <0.05), unlike women with 34,7%. The participants stated that they had no information about the issue of donation and whether they were informed by the media. Still, the attitude of the Orthodox Church remains unknown to them. Conclusion: There is no proper information on organ donation and therefore there is a shortage of donors. [ABSTRACT FROM AUTHOR]

Health professionals fulfil an essential role within the multiagency response to safeguarding concerns. This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection (CP) work. A mixed‐methods approach was adopted, using the explanatory sequential design. The quantitative strand involved a population survey of paediatricians (N = 56). Data were analysed and used to inform a subsequent qualitative strand. Both strands indicated that CP work was perceived as complex, emotive and stressful. Paediatricians perceived themselves to be working within an unstructured system. Despite most reporting to have assessed CP cases, 77.4 per cent (n = 41) had never received training. The majority reported that response pathways and reporting procedures were unclear and that they were not involved in tasks beyond identification. These factors contributed to a lack of confidence and ambivalence towards CP, particularly child sexual abuse. Participants felt reassured by having a designated consultant, however, this role also enabled them to offload responsibility. Overall, CP work was not being fully owned. This study suggests that the lack of mandatory and statutory guidance results in significantly suboptimal practice. Investment in structured training and support systems is recommended to engage professionals. Designated professionals should complement, rather than minimise, the role and responsibility of other professionals. 'This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection work' Key Practitioner Messages: Child protection is the responsibility of every professional working with children.Developing child protection systems requires a strong national commitment reflected in legislation and statutory guidance in order to ensure that they are standardised, robust and sustainable.Engaging professionals in child protection work is essential and calls for structured training programmes, support systems and provisions in law that protect against legal liability.Designated professionals in child protection are essential, however, their role should complement, rather than minimise, the role and responsibility of other professionals.Child sexual abuse requires specialist input. [ABSTRACT FROM AUTHOR]

Aim: To record the types of conflict management that health professionals in Cyprus hospitals encounter in their daily work and to explore the conflicts, their parameters and causes, and the role ambiguity faced by the hospital employees. Material and Methods: This is a descriptive study in which data were collected with an anonymous self‐referral questionnaire. The study population consisted of 300 health professionals from six different hospitals in Cyprus. Data are presented with averages and standard deviations. Results: The health professionals identified the following causes of conflicts in the workplace in descending order: heavy workload, low pay, and varying instructions from different leaders. To deal with the conflict, 73.2% of the participants reported using avoidance, 54.2% engaged in negotiation for mutual benefit, and 40.5% cited compromise as a method. Conclusions: Identifying the way in which conflicts are managed contributes to the smooth functioning of organisations, and it improves the effectiveness of the services provided. Implications for Nursing Management: It is generally known that the high levels of conflict in hospitals are associated with increased mistakes and low employee satisfaction and performance levels. Managers deal with conflict‐management issues within organisations on a daily basis. It is therefore essential to comprehend the reasons behind conflicts and provide suitable training for the development of communication skills and conflict‐management strategies. [ABSTRACT FROM AUTHOR]

Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder. The aim of this study was to characterise the SLE patients living in Malta in order to estimate the prevalence and incidence of SLE and characterise the clinical presentation as well as identify any unmet needs. 107 SLE patients who fulfilled SLICC classification criteria were identified. These were invited to participate in the study by means of an interview, blood and urine tests, and filling of the following questionnaires: Fatigue Severity Scale (FSS), visual analogue scale (VAS) for fatigue, Hospital Anxiety and Depression Scale (HADS), VAS for pain, Pittsburgh Sleep Quality Index (PSQI), and modified Health Assessment Questionnaire (mHAQ). The estimated prevalence of SLE in Malta is 29.3 patients per 100,000 and the estimated incidence is 1.48 per 100,000 per year. 93.5% of SLE patients were female, and the mean age at diagnosis was 33.1 years. 60.8% were overweight or obese and body mass index (BMI) had a significant positive correlation with daily dose of prednisolone (R=0.177, p=0.046). 20.7% and 3.3% had a moderate and high disease activity, respectively, as measured by SLEDAI-2K. Disease activity had a significant positive correlation with functional disability measured by mHAQ (R=0.417, p<0.001). 56.5% had an abnormal level of fatigue (FSS >3.7) and 57.6% had a high level of anxiety (HADS ≥8). This study has identified a number of unmet needs of SLE patients, including obesity, uncontrolled disease activity, fatigue, and anxiety. [ABSTRACT FROM AUTHOR]

Background: The knowledge of Maltese women not attending the Maltese Breast Screening Programme (MBSP) for mammography screening is scarce. Previous research has identified two distinct groups of non-attendees: those who do not attend because a mammogram was taken elsewhere and those who never attended for mammography anywhere. It is however unknown which determinants are predictive of lifetime attendance 'anywhere' and 'real' non-attendance. The present study examines the relationship between ever-using (Lifetime attendees) or never using mammography (Lifetime non-attendees) and psychosocial - as well as sociodemographic factors, with the aim to identify predictors that can inform practice.Methods: Women's characteristics, knowledge, health beliefs and illness perceptions were compared, based on prior data of 404 women, aged 50-60 years at the time of their first MBSP invitation. The main variable of interest described women's attendance to mammography (LIFETIME ATTENDEES) and no mammography (LIFETIME NON-ATTENDEES). Data were analyzed using descriptive statistics, chi-square tests, Mann Whitney test, Independent Samples t-test, Shapiro Wilk test and logistic regression.Results: During their lifetime, 86.1% of Maltese women (n = 348) were attendees, while 13.9% (n = 56) were non-attendees. Non-attendees were more likely to be women with a lower family income (χ2 = 13.1, p = 0.011), widowers (χ2 = 9.0, p = 0.030), non-drivers (χ2 = 7.7, p = 0.006), without a breast condition (χ2 = 14.2, p <  0.001), who had no relatives or close friends with cancer (χ2 = 8.3, p = 0.016), and who were less encouraged by a physician (χ2 = 4.9, p = 0.027), unsure of the screening frequency (χ2 = 28.5, p <  0.001), more anxious (p = 0.040) and fearful (p = 0.039). Perceived benefits, barriers, cues to action, self-efficacy and emotional representations were the most significant variables to describe the differences between lifetime attendees and non-attendees. Perceived barriers and cues to action were the strongest predictors for lifetime non-attendance (p <  0.05 respectively).Conclusions: The health beliefs of women who have never attended for mammography during their lifetime should be targeted, particularly perceived barriers and cues to action. Further research should focus on understanding knowledge gaps, attitudinal barriers and emotional factors among 'real' non-attendees who require a more targeted approach. [ABSTRACT FROM AUTHOR]

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This article presents results from the Cypriot experience of participation in a pan European health promotion project called 'Shape Up'. Implemented between September 2007 and June 2008, the aims of the overall programme reflect the primary concern of health promotion to facilitate healthy choices by creating the necessary conditions for their enactment. We describe the processes used in Shape Up before reporting findings from the evaluation undertaken by the University of Hull, UK. Findings from the Cypriot case studies demonstrate schools' potential to work in health promoting ways by enabling school communities to create environments conducive to health, where individuals are better able to take care of their health rather than simply implementing healthy activities at school. Participants in Shape Up Cyprus increased their access to healthier foods and opportunities to be active during and after school. Apart from visible environmental changes, participants were equipped with skills and critical knowledge to be healthier and more active citizens. They investigated the wider determinants of health and options for health improvement in specific contexts. They identified what needed changing within and around the school, developing visions of how changes could be enacted. They transferred visions into actions by writing letters, undertaking research, developing networks and accessing advice and financial support. We conclude that increasing awareness of the impact of structural factors upon health and the acquisition of skills in community action were central to Shape Up's success in Cyprus, and are therefore relevant for school-based health promotion. [ABSTRACT FROM AUTHOR]