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Background: Diadochokinetic rates tasks are frequently used for the assessment of diadochokinesia (DKK) in young and elderly adults. However, there is scarce research on healthy elderly adults over 65 years old, and little is known about the effect of different types of stimuli (non‐words/real words) in this specific population. Furthermore, the current research supports significant language variations, highlighting the need for language‐specific norms. Aims: To investigate the effect of age, gender and type of stimuli (non‐words versus real words) in DDK rates in healthy elderly adults of over 65 years of age, and to provide normative data for the Greek language. Methods & Procedures: The participants were 791 healthy monolingual Greek‐speaking adults (531 adults, aged 20–39 years; 157 participants aged 65–74 years; and 103 participants aged over 75 years). All participants were monolingual speakers of Greek and had normal hearing acuity, which allowed them to understand and follow instructions. Participants with a medical condition, which would affect DDK rates' performance, were excluded from the study. The time‐by‐count method was used, and all participants had to repeat as accurately and fast as possible: (1) four disyllabic non‐words (/′gaba/, /′taka/, /′kata/, /′baga/); (2) four disyllabic real words (/′kapa/, /′tapa/, /ka′la/, /′paka/); and (3) two trisyllabic non‐words (/′pataka/, /′badaga/). All responses were recorded and the speech samples that did not include at least 5 s of correct repetitions were excluded from the analysis. Outcomes & Results: Age affected DDK rates significantly, with older adults achieving slower DDK rates for all speech stimuli (non‐words/real words). Gender did not have an effect on the performance of DDK rates. The type of speech stimuli affected DDK rates significantly for all age groups. Analytically, trisyllabic non‐word stimuli were articulated more slowly than disyllabic non‐word stimuli, and real words were produced faster than non‐words. A linear regression analysis revealed that only the repetition of non‐words predicted 68.4% of the performance on the repetition of trisyllabic non‐words. Conclusions & Implications: The above results complement prior research, which supports that real word stimuli yield faster performance than non‐word stimuli. Clinicians should keep in mind that age, language and type of stimuli (non‐words/real words) affect significantly the performance of DDK rates, as well as the fact that different types of stimuli tap distinct underlying levels of speech. The current research highlights the need for language‐specific norms for different populations. What this paper adds: What is already known on the subject: DDK rates are significantly affected by the types of stimuli and language used. Moreover, the normal ageing process decreases performance in terms of DDK rates, but scarce evidence exists for healthy elderly adults over 65 years old. What this paper adds to existing knowledge: Most studies have examined DDK rates in healthy elderly people with restricted samples and using non‐word stimuli. The current study administered different types of stimuli (non‐words/words) in a large sample of healthy elderly participants. This is also the first study to attempt to provide DDK normative data for this population in the Greek language. What are the potential or actual clinical implications of this work?: The results of this study strongly suggest that clinicians should bear in mind the significant impact age and language have on performance in terms of DDK rates, especially when normative data are not available for a certain language or age group. Furthermore, non‐word and real‐word stimuli cannot be used interchangeably since they tap into distinct underlying levels of speech, thus providing clinicians with useful information about the level of breakdown and the proper treatment plan. [ABSTRACT FROM AUTHOR]

Although leisure constraints that individuals have to cope with can negatively affect their social inclusion and satisfaction with life, little research has addressed the link between these variables. Therefore, the current paper examined the moderator role of leisure constraints on the relationship between satisfaction with life and leisure constraints among adults living in five different European countries. The respondents were 1,382 women and 877 men adults. The findings of analysis revealed that all factors used in the study accounted for 15% of the variance in satisfaction with life and social inclusion had a significant and positive impact on satisfaction with life. As a result, it can be said that leisure constraints had a moderating effect on the relationship between satisfaction with life and social inclusion. The present research study recommends that social inclusion should be encouraged through decreasing to leisure constraints to increase the life satisfaction. [ABSTRACT FROM AUTHOR]

Background: Limited evidence regarding the post‐COVID‐19 dental status of paediatric patients is available, with most studies assessing only children's oral health habits. Aim: To evaluate the effect of the COVID‐19 lockdown on the oral health of paediatric dental patients in Greece. Design: This was a retrospective cohort study that included a questionnaire on children's oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the International Caries Detection and Assessment System criteria, dmft/DMFT, and Treatment Need Index. The Wilcoxon signed‐rank test was used for a statistical comparison between questionnaire and clinical data before, during, and after the lockdown. Results: A total of 102 children with a median age of 9 years were recruited from the current cohort of patients that had their last dental examination 6 months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency with increased eating frequency and sugar consumption during the lockdown period (p <.001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, and 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significantly increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p =.01) and 0.52 units in the permanent teeth (p =.002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown, were recorded (p <.001). Conclusion: The COVID‐19 lockdown negatively affected children's oral health behavior: caries prevalence increased and more complex dental treatments were required. [ABSTRACT FROM AUTHOR]

Background: Evidence‐based assessments for people with aphasia (PWA) in Greek are predominantly impairment based. Functional communication (FC) is usually underreported and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The test assesses the everyday FC of PWA in an interactive multimodal communication setting. Aims: To determine the reliability and validity of The Scenario Test‐GR and discuss its clinical value. Methods & Procedures: The Scenario Test‐GR was administered to 54 people with chronic stroke (6+ months post‐stroke): 32 PWA and 22 stroke survivors without aphasia. Participants were recruited from Greece and Cyprus. All measures were administered in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test–retest, and interrater reliability) and validity (construct and known‐groups validity) of The Scenario Test‐GR. Outcomes & Results: The Scenario Test‐GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach's α = 0.95), test–retest reliability (intra‐class coefficients (ICC) = 0.99), and interrater reliability (ICC = 0.99) were found. Interrater agreement in scores on individual items ranged from good to excellent levels of agreement. Correlations with a tool measuring language function in aphasia, a measure of FC, two instruments examining the psychosocial impact of aphasia and a tool measuring non‐verbal cognitive skills revealed good convergent validity (all ps < 0.05). Results showed good known‐groups validity (Mann–Whitney U = 96.5, p < 0.001), with significantly higher scores for participants without aphasia compared with those with aphasia. Conclusions & Implications: The psychometric qualities of The Scenario Test‐GR support the reliability and validity of the tool for the assessment of FC in Greek‐speaking PWA. The test can be used to assess multimodal FC, promote aphasia rehabilitation goal‐setting at the activity and participation levels, and be used as an outcome measure of everyday communication abilities. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to explore factors that influence individuals' attitudes towards mandatory vaccination in Greece. Methods: A nationally representative cross‐sectional telephone survey was conducted via a random multistage selection process in October 2019 in Greece. The survey was designed to obtain information about whether vaccination should be mandated or not among adults 18 years of age or older. A multivariable logistic regression model was used to estimate the association between individuals' sociodemographic, contextual and clinical characteristics, utilization, satisfaction, and trust in the healthcare system and providers and their preference over mandatory vaccination. Results: A total of 901 participants fully completed the survey (response rate 90%‐901/1001). About 85% of the respondents supported mandatory vaccination. Individuals who used preventive services more often compared to those who never or rarely used such, those who reported increased trust in official healthcare authorities' guidelines and recommendations compared to those who reported no trust and those who had underage children living in the household were significantly more likely to support mandatory vaccination. No differences were observed for sociodemographic factors and mandatory vaccination support. Conclusion: This survey revealed that most Greek citizens support mandatory vaccination, which was critically affected by the utilization of preventive services and trust in healthcare authorities. Our results suggest that healthcare policy interventions should promote mandatory vaccination through multi‐level initiatives to improve healthcare providers' and the general public's understanding of the value of vaccination. [ABSTRACT FROM AUTHOR]

This study investigates the impact of a human resource management ( HRM) system, which integrates both content and process of human resource ( HR) practices, on organizational performance, through collective employee reactions. The analysis is based on a sample of 1,250 Greek employees working in 133 public- and private-sector organizations, which operate in the present context of severe financial and economic crises. The findings of the structural equation modeling suggest that content and process are two inseparable faces of an HRM system that help to reveal a comprehensive picture of the HRM-organizational performance relationship. Based on the findings that collective employee reactions mediate the HRM content (i.e., organizational performance relationship) and HRM process moderates the HRM content (i.e., employee reactions relationship), the study has several theoretical and practice implications. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aim: Drinks can contribute to energy as well as micro‐ and macro‐nutrient intake. Drink‐specific, validated, quick and easy to administer questionnaires are needed to monitor secular trends in beverage consumption for different populations. The aim of the present cross‐sectional study was to develop and validate a drink‐specific questionnaire for the Greek population. Methods: A 41‐item semi‐quantitative drinks frequency questionnaire (DFQ) was developed and validated against 7‐day weighed food records, among young Greek adults. Wilcoxon ranks tests, Kendall tau‐b correlations and Bland–Altman plot were used to compare the two methods. Fifty‐nine Greek University students (28 males, 31 females) completed both methods. Results: No difference was observed in total drinks intake between the two methods. The Bland–Altman plot showed that the two methods are likely to agree concerning the total drinks intake. Wilcoxon's rank test showed no significant differences between the two methods, except for the 'whiskey/vodka/gin' intake (P < 0.001). 'Good' agreement (tau‐b > 0.61) was observed for most DFQ items, including low‐fat and chocolate milk, hot chocolate, Greek/espresso coffee, commercial tea, packaged fruit juices, wine, alcohol‐free beer, light cola‐type drinks and water (tap/bottled/sparkling). 'Low' agreement (<0.30) was noted for filtered/instant/iced coffee, freshly squeezed orange juice and some alcoholic drinks (beer/whiskey/vodka/gin). Conclusions: The DFQ appears to be an overall valid means of estimating the habitual intake of drinks in large‐scale epidemiological surveys. The study supports the use of DFQ for assessing drinks consumption patterns and secular trends. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

Background & Aims This study ran within the framework of the Thales Aphasia Project that investigated the efficacy of elaborated semantic feature analysis (ESFA). We evaluated the treatment integrity (TI) of ESFA, i.e., the degree to which therapists implemented treatment as intended by the treatment protocol, in two different formats: individual and group therapy. Methods & Procedures Based on the ESFA manual, observation of therapy videos and TI literature, we developed two ESFA integrity checklists, for individual and group therapy, and used them to rate 15 videos of therapy sessions, delivered by three speech-language therapists (SLTs). Thirteen people with aphasia (PwA) were involved in this study. Reliability of the checklists was checked using Kappa statistics. Each session's TI was calculated. Differences in TI scores between the two therapy approaches were calculated using independent sample t-tests. Treating SLTs' views on what facilitates TI were also explored through a survey. Outcomes & Results Inter- and intra-rater reliability were excellent (.75 ≤ κ ≤ 1.00) for all but one video (κ = .63). Overall, a high TI level (91.4%) was achieved. Although both approaches' TI was high, TI for individual therapy sessions was significantly higher than for group sessions (94.6% and 86.7% respectively), t(13) = 2.68, p = .019. SLTs found training, use of the treatment manual, supervision and peer support useful in implementing ESFA therapy accurately. Conclusions & Implications ESFA therapy as delivered in Thales is well described and therapists can implement it as intended. The high TI scores found enhance the internal validity of the main research project and facilitate its replication. The need for more emphasis on the methodological quality of TI studies is discussed. [ABSTRACT FROM AUTHOR]

Background No studies assessing the association between gagging and dental fear are available in pediatric samples. Aim To assess the psychometric properties of the Greek version of the Gagging Assessment Scale ( GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. Design A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale ( CFSS- DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale ( MDAS). The short form of dentist part of the Gagging Problem Assessment ( GPA-de-c/ SF) was used to objectively assess gagging. Results A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/ SF. Children rated as gaggers on the GPA-de-c/ SF had significantly higher GAS scores. There were no relationships between GPA-de-c/ SF and the CFSS- DS or MDAS. The GAS ratings were significantly correlated with the CFSS- DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). Conclusions The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Nurses in intensive care units confront various challenges and problems during their everyday work that adversely affect performance and patient safety. Despite their importance, performance obstacles have been studied extensively only in the USA, with no validated instrument being available in the Greek setting for their measurement. Aims and objectives To develop a questionnaire that quantifies the obstacles nurses of intensive care units (ICUs) of Greek hospitals might be facing and examine its properties; to assess if such obstacles existed in selected Greek National Health System hospitals. Methods A questionnaire was developed and administered to nurses who were working in intensive care units in Thessaloniki. Exploratory factor analysis was applied, and the reliability, validity and ceiling and floor effects of the constructed scales were evaluated. The potential influence of socio-demographic characteristics on scale scores was assessed by independent sample t-tests and analysis of variance ( ANOVA). Summated mean and median scores were computed. Results Two hundred and five nurses participated with a response rate of 65·3%. Resulting scales were 'Space Adequacy', 'Staff Collaboration', 'Materials' Suitability', 'Time Inefficiencies' and 'Psychological Aggravation'. Cronbach's alpha values ranged between 0·67 and 0·86. Multi-trait analysis confirmed construct validity. Ceiling effects were reasonable, whereas floor effects took acceptable values with the exception of the 'Materials' Suitability' scale. The medians of the scales ranged from 1·50 to 3·33. In terms of the measurement of performance obstacles per se, we found that considerable problems exist in the ICUs in all dimensions. Specifically, the suitability of hospital materials, the lack of appropriate spaces and facilities design and psychological distress were recorded as the most serious. Conclusions The questionnaire is a promising tool that can be exploited in the health care system to assess the obstacles faced by intensive care nursing staff. In fact, there is considerable room for performance improvement in hospitals in Northern Greece. Recommendations Nursing administrators and health care policy makers should administer the questionnaire in all Greek hospitals in order to quantify performance obstacles and identify potential managerial remedies. [ABSTRACT FROM AUTHOR]

A growing body of evidence links obstructive sleep apnea (OSA) with hypertension. The authors performed a retrospective cohort study using the University Hospital of Larissa Sleep Apnea Database (1501 patients) to determine predictors of in-laboratory diagnosed OSA for development of hypertension. Differences in continuous variables were assessed via independent samples t test, whereas discrete variables were compared by Pearson's chi-square test. Multivariate analysis was performed via discriminant function analysis. There were several significant differences between hypertensive and normotensive patients. Age, body mass index, comorbidity, daytime oxygen saturation, and indices of hypoxia during sleep were deemed the most accurate predictors of hypertension, whereas apnea-hypopnea index and desaturation index were not. The single derived discriminant function was statistically significant (Wilk's lambda=0.771, χ(2) =289.070, P<.0001). Daytime and nocturnal hypoxia as consequences of chronic intermittent hypoxia play a central role in OSA-related hypertension and should be further evaluated as possible severity markers in OSA. [ABSTRACT FROM AUTHOR]

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. [ABSTRACT FROM AUTHOR]

In times of economic downturn, perceived realistic intergroup threats (e.g., labour competition) often dominate political and media discourse. Although local outgroups (e.g., local immigrants) can be experienced as sources of realistic threats, we propose that such threats can also be perceived to be caused by distant outgroups (e.g., European Union members perceiving Greece to threaten their economies) and that such distant threats can carry over into local intolerance (e.g., increasing intolerance towards local immigrant groups). We predicted and found in two studies that perceived distant realistic threats carried over into local intolerance via two different pathways. First, direct reactions towards the distant outgroup can generalize to culturally similar local outgroups (the group-based association pathway). Secondly, Study 2 indicated that when the distant threat was attributed to stereotypical outgroup traits (e.g., being lazy), distant realistic threats activated local realistic threats, which subsequently influenced local intolerance (the threat-based association pathway). Taken together, our studies indicate that perceived realistic threats foreign can turn domestic, but in two different ways. [ABSTRACT FROM AUTHOR]

Background A number of studies have suggested that language in individuals with Down syndrome (DS) may not be simply delayed compared with language in typically developing (TD) children, but deviant. The deviance has been detected in the comprehension of pronouns, and it has triggered proposals for the existence of a specific syntactic deficit in individuals with DS. However, the developmental path of pronoun comprehension in individuals with DS is unknown as there are no studies examining individuals of different ages. Aims To perform a pilot study examining pronoun comprehension in adolescents and adults with DS in comparison with TD children. Research questions include: Are some pronoun types more difficult than others for each of the two groups (DS and TD)? Is there a difference in performance between the two groups? Does performance correlate with chronological age in the DS group? Methods & Procedures Using a manual picture selection task, we examined the comprehension of different types of pronouns in 14 Greek-speaking individuals with DS, ranging from 10 to 34 years of age. We also tested a control group of TD children as well as a typical adult group. The TD and DS groups were recruited and tested in pre-schools and schools/centres for individuals with learning disabilities, respectively. Within- and between-group comparisons were performed for all conditions. For the DS group, correlations between chronological age and performance in each condition were also explored. Outcomes & Results Results reveal a significant positive correlation of age with performance in the DS group, but only in structures that also presented difficulties to TD children. Structures that presented difficulties only to individuals with DS do not appear to be less problematic for older participants. Conclusions & Implications These findings provide support to the deviance hypothesis by suggesting that the syntactic deficit in the comprehension of pronouns in individuals with DS is present in individuals of a wide age range. At the same time, the results, if corroborated by large-scale studies, suggest that some aspects of grammatical development in individuals with DS may continue even after adolescence and well into adulthood. We argue that these findings can contribute towards more targeted intervention practices by increasing our knowledge of the behavioural phenotype of DS. [ABSTRACT FROM AUTHOR]

Objectives Gender may be associated with postoperative pain. This study aimed to assess pain intensity and postoperative analgesic requirements in female and male patients scheduled for major abdominal surgery. Methods Sixty-five patients, 31 men and 34 women, scheduled for major abdominal surgery were recruited. Anesthesia and intraoperative analgesics were standardized in all patients. Postoperatively, all patients had access to a 60 mL PCA pump containing 1 mg/ mL morphine and 50 μg/ mL droperidol. Morphine consumption and VAS scores at rest and after cough were recorded 2, 4, 8, 24, and 48 hours postoperatively. Results Of the 65 patients recruited for the study, 30 women and 30 men aged 65 ± 8.9 and 66 ± 9.0 years, respectively, were included in the analysis. Morphine consumption was examined 2, 4, 8, 24, and 48 hours after surgery and did not differ in women vs. men (mean ± standard deviation, 4.4 ± 3.2 vs. 5 ± 4.8, 7.2 ± 4.8 vs. 8.7 ± 6.9, 10.4 ± 7.1, vs. 12.5 ± 8.5, 22.9 ± 11.6 vs. 25.6 ± 14.5, and 36.2 ± 15.7 vs. 39.7 ± 21.7 mg, P = 0.384). Cumulative morphine consumption was not significantly different in women vs. men when normalized for body mass index (mean ± standard deviation, 0.17 ± 0.13, 0.28 ± 0.20, 0.40 ± 0.30, 0.88 ± 0.46, and 1.38 ± 0.59 mg/kg/m2 in women and 0.18 ± 0.18, 0.31 ± 0.25, 0.46 ± 0.32, 0.95 ± 0.54, and 1.47 ± 0.81 mg/kg/m2 in men at 2, 4, 8, 24, and 48 hours postoperatively ( P = 0.567). Both genders exhibited similar VAS pain scores (mm) at rest and after cough ( P = 0.476, P = 0.378, respectively). Conclusions Postoperative morphine requirements did not differ between female and male patients undergoing major abdominal surgery. Pain intensity reported at rest and after cough did not differ between the 2 groups. [ABSTRACT FROM AUTHOR]

Background and Objective Periodontitis and acute myocardial infarction ( AMI) are two diseases that share common risk factors. The role of periodontitis as an independent risk factor for cardiovascular disease has been under debate. The aim of this study was to investigate whether an association exists between periodontitis and AMI in a nondiabetic population, using multiple periodontal case definitions. Material and Methods Periodontal examination was performed in 204 patients with AMI. The control group comprised 102 healthy subjects, without significant coronary disease, confirmed angiographically. Periodontitis was assessed using measurements of clinical attachment loss ( CAL), probing depth and number of missing teeth. From these measurements, five different case definitions of periodontitis were generated. Results Using the continuous forms of periodontal measurements, the odds ratio (95% confidence interval) of the association with incident AMI was 1.74 (1.26-2.50), 1.83 (1.10-3.17) and 1.08 (1.06-1.13) for mean CAL, probing depth and number of missing teeth, respectively. A consistent positive association was observed regardless of the case definition of periodontitis. Conclusion In this nondiabetic population, the association between periodontitis and AMI was consistent across different measurements and/or definitions of periodontitis. The strength of the association increased concomitantly with the robustness of the criteria used to define periodontitis. [ABSTRACT FROM AUTHOR]

Aim To compare the clinical and microbiological outcome of the 1-h ultrasonic debridement of chronic periodontitis patients ( CPP) with and without frequent sessions of oral hygiene reinforcement. Methods Clinical measurements and subgingival plaque were collected from 44 CPP at baseline, 3- and 6-months. The control group received a single session of 1-h full-mouth ultrasonic debridement, while oral hygiene instructions ( OHI) were reiterated over four visits. In the test group, OHI were limited in the 1-h treatment session. At 3-months, both groups received additional debridement and OHI. The 'Checkerboard' DNA- DNA hybridization technique quantified Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola in plaque. Results At three months, smaller reductions in plaque and bleeding indices, and in P. gingivalis numbers were noted in the test group, while these differences disappeared at six months. After the 3-month re-treatment visit, the test group presented with a greater probing pocket depth ( PPD) reduction. Plaque negatively affected PPD in a similar manner after both treatment approaches. Conclusions Lack of oral hygiene reinforcement in the 1-h full-mouth debridement resulted in higher plaque and bleeding scores and numbers of P. gingivalis at three months; professional removal of dental biofilm every three months is beneficial in subjects with compromised plaque control. [ABSTRACT FROM AUTHOR]

Background Some small cohort studies have noted that obesity co-exists with lower serum iron levels. The present study aimed to examine the association between being overweight and iron deficiency ( ID) in a large cohort of Greek children and adolescents. Methods A representative sample of 2492 primary schoolchildren aged 9-13 years old was examined. Anthropometric, biochemical, clinical, dietary intake and physical activity data were collected. Results The prevalence of ID and iron deficiency anaemia ( IDA) was higher in obese boys and girls compared to their normal-weight peers ( P < 0.05). Serum ferritin was higher in obese compared to normal-weight boys ( P = 0.024) and higher in obese compared to normal-weight and overweight girls ( P = 0.001). By contrast, a negative association was found between transferrin saturation and adiposity in both boys and girls ( P = 0.001 and P = 0.005). Furthermore, obese girls had significantly higher fibre intake than normal-weight girls ( P = 0.048) and also overweight and obese boys and girls recorded significantly fewer pedometer steps than their normal-weight peers ( P < 0.001). Finally, obesity more than doubled the likelihood of ID in both boys (odds ratio = 2.83; 95% confidence inteval = 1.65-4.85) and girls (odds ratio = 2.03; 95% confidence interval = 1.08-3.81) after controlling for certain lifestyle and clinical indices as potential confounders. Conclusions The present study shows that obese children and adolescents were at greater risk for ID and IDA than their normal-weight peers. Low grade inflammation induced by excessive adiposity may be a reason for the observed low iron levels. This is also strengthened by the elevated serum ferritin levels, comprising an acute phase protein that is plausibly increased in inflammation. [ABSTRACT FROM AUTHOR]

Background Heart failure is a serious chronic syndrome that is accompanied by significant physical and psychological burdens, resulting in poor quality of life. Aim To assess the quality of life of patients with severe heart failure and its correlation with patient demographic, socio-economic and clinical characteristics. Method We studied 199 patients with heart failure who were hospitalized in the Cardiology Department of three general hospitals of Greece during a 1-year period. Demographic and socio-economic data were obtained using a short questionnaire, while clinical data were obtained from medical record review. The assessment of the patients' quality of life was performed using Minnesota Life with Heart Failure Questionnaire ( MLWHFQ). Findings The mean MLWHFQ score was 62.7 (±20.3). Significantly lower quality of life was found in patients with diabetes mellitus (Coefficient beta (β) = 11.4; 95% Confidence Interval ( CI), 5.2-17.5), hypertension (β = 10.3; CI, 1.4-19.1), chronic renal failure (β = 13.9; CI, 5.9-21.9), chronic respiratory failure (β = 11.2; CI, 4.7-17.7), cancer (β = 12.3; CI, 2.3-22.4), psychiatric disease (β = 10.5; CI, 0.6-20.4) and those patients who were classified in New York Heart Association class IV (β = 10.6, CI = 4.1-17.0). Conclusions The average score of the MLWHFQ was high, and this reflects the poor quality of life of patients. Higher scores in specific patient groups show the negative influence of these factors in quality of life. The holistic care of patients with heart failure by a multidisciplinary team of healthcare professionals could improve their quality of life. [ABSTRACT FROM AUTHOR]

Aims: To describe crucial information needs of ICU charge nurses, and to compare these needs in two countries in Europe. Background: ICU charge nurses are on the front line for ensuring that the activities of their units are running smoothly. They are accountable for making sure that the right tasks are performed under the right circumstances, with the right people, at the right time. Design and participants: An online survey based on a previous observation study regarding the ad hoc decision-making of ICU shift leaders. A total of 257 Finnish and 50 Greek ICU charge nurses participated in this study, from 17 Finnish and 16 Greece ICUs for adults. Methods: Our survey incorporated 122 statements divided into six dimensions (patient admission, organization and management of work, allocation of staff, allocation of material, special treatments and patient discharge) with a rating scale from 0 to 10. Analysis involved descriptive statistics. Mann-Whitney U and Kruskal-Wallis tests were used to compare the answers of the two countries. Validity was verified with confirmatory factor analysis and the reliability was tested with Cronbach's α values. Results: The most crucial information needs of ICU charge nurses concerned the overall organization and management of work. Both staff-related and individual patient-related information was needed. Information needs of Finnish and Greek charge nurses concerned similar kinds of situations in ICUs. However, there were some differences that might depend on the cultural differences between the countries. Conclusions: Accurate and real-time information is a prerequisite for ICU charge nurses' ad hoc decision-making during daily care management. Identification of the most crucial information is needed when tools for information management are developed. Relevance to clinical practice: The results of this study indicated that a major portion of immediate information needs of ICU charge nurses are internationally common in similar settings. [ABSTRACT FROM AUTHOR]

Background Williams syndrome (WS) is a genetic disorder causing intellectual disability. Children with WS often exhibit various kinds of maladaptive behaviours that affect their social functioning. In order to determine whether these behaviours are syndrome-specific, it would be necessary to compare children with WS with children with other syndromes as well as to provide data on the socio-emotional profile in WS from a variety of cultures. The present study investigated the behavioural profile and its relation to maternal stress in Greek young children with WS in comparison with young children with Down syndrome and typically developing (TD) children. Methods Participants were 60 mothers, 20 in each syndrome group and 20 in the control group. The three groups were matched for mental age. The behavioural profile of the participants was investigated through the Child Behaviour Checklist (1.5-5 years) and maternal stress through the Parental Stress Index. Results In accordance with studies in other cultures, it was found that young children with WS received significantly higher rates in emotional problems and anxiety/depression, compared with both children with Down syndrome and TD children. Moreover, mothers of children with WS reported significantly higher scores in the Total Stress index compared with mothers of TD children. However, in contrast with previous studies, only 25% of children with WS fell into the clinical range in the total Child Behavior Checklist score. Conclusion The consistency of the socio-emotional characteristics of children with WS across cultures and developmental stages implies a strong influence of the genetic phenotype. However, Greek mothers avoided to characterize these behaviours as pathological. Implications of these findings for clinical practice are also discussed. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the association between nurses' characteristics (educational level, country, work title, gender, type of work, age, and length of working experience) and their assessments of individualized care. Design: A cross-sectional comparative survey using questionnaires was employed to sample nurses from seven countries. Methods: Data were collected from orthopedic and trauma nurses from Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the United States ( N= 1,163, response rate 70%) using the Individualized Care Scale-Nurse (ICS-Nurse) and a sociodemographic questionnaire in 2008. Data were analyzed using descriptive statistics and general linear models. Results: When compared with practical nurses, registered nurses, length of working experience, and the country of the nurses were associated with assessments of the support of patient individuality in specific nursing activities (ICS-A-Nurse) and country assessments of individuality in the care provided (ICS-B-Nurse). The background and experience within nursing teams together with the country affect the delivery of individualized care. Conclusions: Overall, our findings suggest that nurses' personal attributes have important effects on their assessments of individualized nursing care that will be useful when making context-dependent recruitment decisions. Clinical Relevance: The characteristics of nurses contribute to the care delivered in healthcare organizations. Recognition of these nurse-related factors may help nurse leaders in the development and management of clinical practice. Journal of Nursing Scholarship, 2012; 44:3 ©2012 Sigma Theta Tau International. [ABSTRACT FROM AUTHOR]

Background The role of information on patients' decision to non-adhere is important, yet not well explored. Objective To identify differences between perceived information needs for hypertension and medication to treat it, to explore the information channels used by patients and to test what type of information is more important to adhere to medication. Design, setting and participants A questionnaire study was designed and conducted by telephone in the Centre for the Treatment of Hypertension in Athens, Greece, among 743 individuals. Main variables studied The main variables included perceived information needs, information channels, non-adherence to medication and socio-demographic characteristics. Main outcome measures Non-adherence to medication was measured using the Morisky scale. Results Patients reported feeling better informed about hypertension (90%) than medication to treat it (80%). The doctor remains the dominant information source, while the Media and magazines on health issues were reported more frequently than the family and the pharmacist. Feeling well informed about medication for hypertension was a predictor of better adherence. Other determinants of adherence were the use of the Internet and the Media. Discussion The results confirm the importance of patients leaving the consultation feeling well informed about their medication as this improves adherence. They also show that the use of the Internet and the Media can be beneficial for adherence. Conclusions Given the restricted time the doctor can usually spend with the patient, it is important to know that more emphasis on the information regarding medication is important. [ABSTRACT FROM AUTHOR]

ABSTRACT This research aims to investigate the impact of minority members' decision about whether or not to adopt the majority's religion on how the majority perceives these minority members and on beliefs about religious and cultural diversity. It is hypothesized that the adoption of the majority's religion would be more positively evaluated, the minority person adopting the religion would be perceived to identify more with the national polity and less with the minority ingroup, the minority group as a whole would be more positively viewed, more tolerant religious beliefs would prevail and the majority would accept cultural maintenance by the minority. However it is also hypothesized that the positive effect of this strategy would be moderated by the origins of the minority person. Greek-Orthodox students ( n = 223) participated in a 2 (type of decision) x 5 (group membership) between-subjects design conducted in Greece, a mono-religious society which has become culturally diverse due to immigration. The target groups represent religious minorities with Greek citizenship (Jews and Muslims of Thrace), immigrant groups of different ethnic orientation and similar religious background (Albanian Muslims and Pakistanis) or groups sharing ethnicity but differing in religious beliefs (Albanian Muslims and Albanian atheists). The moderation hypothesis was confirmed for perceived identification with the minority ingroup, presenting Albanians in a worse position. However, group membership influenced mainly group perceptions and beliefs about diversity. The theoretical and political implications of the findings and their importance for the specific context are discussed. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Markou E, Boura E, Tsalikis L, Deligianidis A, Konstantinidis A. The influence of sex hormones on proinflammatory cytokines in gingiva of periodontally healthy premenopausal women. J Periodont Res 2011; 46: 528-532. © 2011 John Wiley & Sons A/S Background and Objective: The aim of this work was to investigate any correlation between the fluctuation of levels of specific proinflammatory cytokines in gingival crevicular fluid and the fluctuation of sex hormones in peripheral blood at ovulation and progesterone peak. Material and Methods: Eighteen premenopausal women with normal and consistent menstrual cycles and healthy periodontium were included in this study. The exclusion criteria were as follows: (i) pregnancy; (ii) use of oral contraceptives; (iii) metabolic or systemic disease that might affect the periodontium; (iv) use of antimicrobial or nonsteroidal anti-inflammatory drugs during the past 6 mo; and (v) smoking. The measurements were performed at two specific time points for each participant [(i) on the day of ovulation; and (ii) on the day of the progesterone peak) and included the following: (i) plaque index; (ii) bleeding on probing; and (iii) the gingival crevicular fluid levels of interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor-α (TNF-α). Results: During the menstrual cycle, plaque index values remained unchanged (0.71 ± 0.07 at ovulation; 0.73 ± 0.08 at progesterone peak; p > 0.05), as did bleeding on probing (0.35 ± 0.07 at ovulation; 0.41 ± 0.07 at progesterone peak; p > 0.05). At ovulation, mean gingival crevicular fluid levels were as follows: IL-1β, 13.3 pg/sample; IL-6, 5.9 pg/sample; IL-8, 18.7 pg/sample; and TNF-α, 25.9 pg/sample. The corresponding values at progesterone peak were as follows: 14.1, 10.1, 19.5 and 26.3 pg/sample. Only IL-6 gingival crevicular fluid levels were significantly different between ovulation and progesterone peak ( p < 0.05). This could reflect sensitivity to subclinical amounts of plaque and biofilm constituents. Conclusion: The subclinical increase of IL-6 at progesterone peak is not accompanied by clinical changes in the periodontium. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the factors that might affect the length of stay in the intensive care unit (ICU-LOS) among cardiac surgery patients. Background: ICU-LOS forms an important factor for assessing the effectiveness of the provided nursing care. A number of factors can be accused for increasing patient hospitalization. The nursing workload (NWL), among others, was found to play a significant role as it is closely associated with the quality of care. Design: An observational cohort study among 313 consecutive patients who were admitted to the cardiac surgery intensive care unit of a general, tertiary hospital of Athens, Greece from November 2008 to November 2009. Methods: Data collection was performed by using a short questionnaire (for basic demographic information) and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE, for assessing the NWL and the perioperative risk for each patient respectively. Results: ICU-LOS of more than 2 days increased with age and was more common among females ( p < 0·001 and p = 0·02, respectively). Multivariate logistic regression analysis revealed a positive association between increased perioperative risk and the increased ICU-LOS [odd ratio (OR) 1·9, 95% confidence interval (CI) 1·0-3·5, p = 0·04], while patients with a first day NAS of more than 61·6% had an almost 5·2 times greater probability to stay in the cardiac surgery unit for more than 2 days (OR 5·2, 95% CI 3·0-8·8, p < 0·001). Conclusions: Increased level of NWL and patient perioperative risk are closely associated with increased ICU-LOS. Relevance to clinical practice: The correlation between patient perioperative risk and ICU-LOS encourages the early identification of high-risk patients for prolonged hospitalization. Furthermore, the relationship between NWL and ICU-LOS allows the early identification of these patients with the use of an independent nursing tool. [ABSTRACT FROM AUTHOR]

The article offers information on topics related to statistics. It states that the Census at School program which encourage children to study statistical skills would also be introduced in South Africa, and Australia. It says that the 58th World Statistics Congress of the International Statistical Institute (ISI) would be held in Dublin, Ireland from August 21-26, 2011, while the 5th International Conference on Mathematics & Statistics would take place in Athens, Greece from June 13-16, 2011.