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Physician shortage is a major concern in many health care systems globally, while healthcare leadership constitutes one of the most vital factors within human resource management. Our study examined the relationship between managers’ leadership styles and physicians’ intent to leave their current position. In this cross-sectional national survey, questionnaires were distributed to all physicians working in the public health sector of Cyprus. Most demographic characteristics evaluated by chi-square or Mann-Whitney test, were statistically significantly different between those who intended to leave their job and those who did not. The results of our study demonstrated that transformational leadership has a positive influence on retention of physicians in public hospitals, while non leadership infers a negative influence. Developing leadership skills in physician supervisors is of a great importance for organizations to make a large impact on health professionals’ retention and overall performance. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to summarize patterns of correlations between variables and reduce a large number of variables to a smaller number of factors. Methods: During 2005 we conducted a national, cross-sectional, multistage study among 1140 children (mean age = 10.70 ± 0.98). Principal component analysis was employed to extract the main factors out of 21 variables assessing children's duration of physical and sedentary activities. Results: Eight factors emerged as important, explaining 63% of the total variance in children's PA patterns. The combined explained variance of 3 factors for exercise was 24.1% (PA and sports after school [11.6%]; home and outside home chores, aerobics, gymnastics, sports [6.8%]; Sports for All, after-school activities [except sports] [5.7%]) and of 5 factors for sedentary activities was 38.9% (video, electronic games, and computers [10.2%]; watching TV, video, and DVD [9.5%]; homework and private lessons [7.3%]; theater cinema, use of mobile phone [6.2%]; afternoon sleep, less private lessons [5.8%]). Further analyses of the emerged factors by gender showed that boys, on a daily basis, are engaged in higher duration in physical activity and sports after school (factor 1) and in electronic games and computers (factor 2), whereas they are engaged in lower durations in factor 4 type behavior (homework and private lessons) and factor 6 type behavior (theater cinema, use of mobile phone). Conclusion: Use of the above factors will inform further research and enable researchers to identify potential differences in physical and sedentary activities patterns by various environmental and sociodemographic variables. Furthermore, associations of factors by gender may inform public health programs. [ABSTRACT FROM AUTHOR]

Background: Non-sexually active young females very rarely develop genital ulcers. Such ulcers pose a diagnostic challenge as well as physical and emotional distress for patients and family; therefore, the search for their etiology requires exhaustive investigation. Several viruses such as Epstein-Barr virus have been associated with this entity; however, Mycoplasma pneumoniae has rarely been linked to such ulcers in the literature. We present a case of vulvar ulcers in a non-sexually active young girl during the course of pneumonia caused by Mycoplasma pneumoniae.Case Presentation: A 10-year-old non-sexually active girl of cypriot origin presented at a hospital with fever, dry cough, and acute vulvar ulcers. Laboratory investigations as well as imaging studies revealed Mycoplasma pneumoniae as the cause of her pneumonia and acute vulvar ulcers.Conclusions: Although a rare cause of vulvar ulcers, Mycoplasma pneumoniae should be considered in the differential diagnosis of acute vulvar ulcers coexisting with respiratory symptoms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. OBJECTIVE: This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. METHODS: A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department. RESULTS: Employees' participation in the program was 3%. A total of 12 employees participated (6 each year). The participants were all women and the mean participation period was 21.6 days (range 10 - 65 days). The two most frequent reasons for a modified duty assignment were pregnancy and back pain. Employees were assigned either on limited duties or on a combination of limited duties and reduced work hours. Employees reported being very satisfied with their participation based on a follow-up narrative oral assessment. CONCLUSION: The small participation rate does not allow for advanced statistical analyses. Further studies from larger organizations are urgently needed to evaluate the effectiveness of modified duty programs. The development of a legal framework for such modified duty programs in Cyprus as well as internationally may promote their implementation in order to facilitate the effective management of temporary partial job disability for the benefit of both employees and businesses. [ABSTRACT FROM AUTHOR]

Purpose – Radon is responsible for approximately 50 per cent of public exposure to environmental radiation. The purpose of this paper is to quantitatively assess indoor radon levels in Cyprus. Design/methodology/approach – In total, 500 passive radon detectors were used to estimate radon levels in the areas of Nicosia (capital), Paphos, Nisou and Famagusta. A total of 240 different public and private buildings were randomly selected in the above districts and two passive radon detectors were placed inside each building. The detectors were collected on average, three months following placement. Findings – The average radon level from all passive detectors was 53.7 and 49.2 Bq/m3 after excluding the seven highest values. The two highest measurements were observed in Paphos, Tsada-Kili elementary school (429 Bq/m3) and Emba, Paphos district (410 Bq/m3), respectively. Differences were also seen in public buildings compared to private buildings (p=0.058). In addition, rural buildings had higher radon levels compared to urban buildings (p=0.001). Predictive multilevel regression models for logarithmic radon levels were employed and differences were seen on point estimates regarding building- and district-level radon measurements. Most of the random variability observed was due to building-level variation. Practical implications – Residents from different geographic areas in Cyprus are reassured about the safety of indoor radon levels in public and private buildings. Originality/value – The estimation of indoor radon levels was done by the optical microscopy technique using a specific mathematical formula. Observed radon levels do not raise concern regarding residents’ radon exposure in Cyprus. Paphos district and Nisou area may require further investigation. [ABSTRACT FROM AUTHOR]

Background Erythema infectiosum is the most common clinical manifestation of Parvovirus B19 infection although it has also been associated with rheumatologic diseases and various types of systemic vasculitides. Acute hepatitis and benign myositis however are rarely reported in association with Parvovirus B19 infection. Case presentation Here we report a 14-year old male, who developed acute hepatitis and benign myositis associated with erythema infectiosum following Parvovirus B19 infection. Conclusion Parvovirus B19 infection has rarely been associated with acute hepatitis and exceptionally rarely with benign myositis. Parvovirus B19 should be considered in the differential diagnosis of acute non-A to E hepatitis and in the case of acute benign myositis presenting with a rash especially in children. [ABSTRACT FROM AUTHOR]

Background: Population studies on end-of-life decisions have not been conducted in Cyprus. Our study aim was to evaluate the beliefs and attitudes of Greek Cypriots towards end-of-life issues regarding euthanasia and cremation. Methods: A population-based telephone survey was conducted in Cyprus. One thousand randomly selected individuals from the population of Cyprus age 20 years or older were invited to participate. Beliefs and attitudes on end-of-life decisions were collected using an anonymous and validated questionnaire. Statistical analyses included cross-tabulations, Pearson’s chi-square tests and multivariable-adjusted logistic regression models. Results: A total of 308 males and 689 females participated in the survey. About 70% of the respondents did not support euthanasia for people with incurable illness and/or elders with dementia when requested by them and 77% did not support euthanasia for people with incurable illness and/or elders with dementia when requested by relatives. Regarding cremation, 78% were against and only 14% reported being in favor. Further statistical analyses showed that male gender, being single and having reached higher educational level were factors positively associated with support for euthanasia in a statistically significant fashion. On the contrary, the more religiosity expressed by study participants, the less support they reported for euthanasia or cremation. Conclusions: The vast majority of Greek Cypriots does not support euthanasia for people with incurable illness and/or elders with dementia and also do not support cremation. Certain demographic characteristics such as age and education have a positive influence towards attitudes for euthanasia and cremation, while religiosity exerts a strong negative influence on the above. Family bonding as well as social and cultural traditions may also play a role although not comprehensively evaluated in the current study. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines the current National Food Safety System (NFSS) of Cyprus in contrast to NFSS of European Union (EU) countries and the EU central level. The main organizational structure of Cyprus, its legal framework, the competent authorities and division of their responsibilities are discussed. Particularly, we examine the roles and responsibilities of different agencies in order to identify possible similarities and differences with NFSS operating in Europe and determine which features are considered most successful. Cyprus is one of the EU countries that have not yet implemented institutional or organizational changes to establish a single National Food Safety Authority (NFSA) or a similar organization on the national level. The existing food safety system of Cyprus is characterized by an “off-hand” addition of structures and division of responsibilities among different government agencies, that are accountable to different Ministries. Therefore, the efforts to effectively manage the existing and emerging food safety risks are impeded due to duplication and overlapping of responsibilities among different agencies. The overall goal of our study was to develop a comprehensive proposal for the establishment of a single and independent NFSA in Cyprus based on EU experiences and good practices in an effort to improve the efficiency and effectiveness of the current system. [Copyright &y& Elsevier]

Background: Medical errors have been highlighted in recent years by different agencies, scientific bodies and research teams alike. We sought to explore the issue of medical errors in Cyprus using data from the Eurobarometer survey. Methods: Data from the special Eurobarometer survey conducted in 2005 across all European Union countries (EU-25) and the acceding countries were obtained from the corresponding EU office. Statistical analyses including logistic regression models were performed using SPSS. Results: A total of 502 individuals participated in the Cyprus survey. About 90% reported that they had often or sometimes heard about medical errors, while 22% reported that a family member or they had suffered a serious medical error in a local hospital. In addition, 9.4% reported a serious problem from a prescribed medicine. We also found statistically significant differences across different ages and gender and in rural versus urban residents. Finally, using multivariable-adjusted logistic regression models, we found that residents in rural areas were more likely to have suffered a serious medical error in a local hospital or from a prescribed medicine. Conclusion: Our study shows that the vast majority of residents in Cyprus in parallel with the other Europeans worry about medical errors and a significant percentage report having suffered a serious medical error at a local hospital or from a prescribed medicine. The results of our study could help the medical community in Cyprus and the society at large to enhance its vigilance with respect to medical errors in order to improve medical care. [ABSTRACT FROM AUTHOR]

Background. The achievement of quality of care constitutes a priority for modern health care systems. The objective of our study was to evaluate a quality improvement intervention in primary care of Cyprus. [ABSTRACT FROM PUBLISHER]

Background: Even though there is a severe obesity problem in Cyprus, information about the contribution of predisposing lifestyle factors is limited. Our aim was to investigate the relationship between physical activity (PA), sedentary behaviour and various obesity indices [i.e. body mass index (BMI), waist circumference (WC), percentage of body fat (BF%) and ‘total & abdominal obesity’ (TAO)]. Methods: A national cross-sectional study of 1140 children (mean age = 10.7 ± 0.98 years) selected by multistage sampling in Cyprus was conducted during 2004–05. Children completed a 32-item, semi-quantitative PA questionnaire, which assessed organized and free-time PA and sedentary behaviours. Weight, height and WC were collected from a random sub-sample of 622 children and obesity was defined by IOTF criteria. Body fat percentage was calculated, and TAO status was computed based on obesity status and WC [i.e. (i) both BMI/WC, (ii) either BMI/WC abnormal and (iii) both BMI/WC abnormal]. Linear and logistic regression analyses with obesity indices as dependent variables were applied after adjusting for several potential confounders. Results: Only variables describing sedentary behaviours were retained in the final regression models in both boys and girls. Girls who spent ≥4 h/day on TV and DVD watching were almost three times more likely to be overweight or obese [OR = 2.84 (95% CI 1.08–7.47)], three times more likely to have WC ≥75th percentile [OR = 3.25 (95% CI 1.06–9.98)] and 3.5 times more likely to have ≥30% body fat [OR = 3.63 (95% CI 1.01–12.98)], while in boys, even though the same variable was retained in almost all final models, it did not reach statistical significance. Conclusion: Sedentary behaviours such as TV watching may be more important predictors of children's various obesity indices than PA behaviours. Interventions targeting sedentary behaviours, such as TV watching, may help in the prevention and treatment of obesity among Cypriot children. [ABSTRACT FROM PUBLISHER]

Background The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previouslly computernaïve public primary care centres in Cyprus. Methods One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters. Results Two public primary care centres participated, and a total often health professionals served as EMR system evaluators. Physicians and nurses rated EMR relatively highly, while patients were the most enthusiastic supporters for the new information system. Major implementation impediments were the physicians' perceptions that EMR usage negatively affected their workflow, physicians' legal concerns, lack of incentives, system breakdowns, software design problems, transition difficulties and lack off amiliarity with electronic equipment. Conclusion The importance of combining qualitative and quantitative evaluation tools is highlighted. More efforts are needed for the universal adoption and routine use of EMR in the primary care system of Cyprus as several barriers to adoption exist; however, none is insurmountable. Computerised systems could improve efficiency and quality of care in Cyprus, benefiting the entire population. [ABSTRACT FROM AUTHOR]

Introduction: Leishmaniasis is endemic in more than 95 countries and is the only tropical/subtropical vector-borne disease that has been endemic in Southern Europe for decades. To the best of our knowledge, this is the first case of cutaneous leishmaniasis by Leishmania donovani in a child and the first cluster with adult cases reported in Europe. Case presentation: We describe a familial cluster of four cutaneous leishmaniasis cases among Greek Cypriots caused by L. donovani in a Paphos village, in Cyprus. A 6-year-old boy (Case number 1) had a persistent lesion in the left angle of his upper lip, a 60-year-old woman (Case number 2) presented with a 2cm-diameter glabella lesion on her forehead, a 60-year-old man (Case number 3) developed a lesion on his moustache area and a 40-year-old woman (Case number 4) had a lesion on her neck. In Case number 3 the lesion was self-cured; the other cases recovered after surgical resection followed by liposomal amphotericin B (Case numbers 1 and 4) or thermotherapy and liposomal amphotericin B (Case number 2). Conclusions: This familial cluster of cutaneous leishmaniasis, due to the anthroponotic L. donovani, shows that the sand fly species responsible for transmitting this parasite species is found in the area around the three neighbouring houses involved. The factors favourable for the survival, spread and contact of the vector with people could be assessed in this area for the establishment of preventative measures to safeguard public health.

Highlights: [•] We examine beliefs and attitudes of food safety actors in Cyprus. [•] Our study reveals important limitations on the operation of the current system. [•] The majority of actors are not satisfied from the Cyprus food safety system. [•] Consumers confidence appears low concerning the delivery of food safety services. [•] Actors support the system reform including the creation of a food safety authority. [ABSTRACT FROM AUTHOR]