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The present study investigates the public health impact of flooding on leptospirosis incidence after Storm Daniel in Thessaly, Greece, in September 2023. A notable increase in cases was observed, with seven cases of female patients and a mean age of 40.2 years, indicating a significant risk among working-age adults. From the end of September to the beginning of November 2023, a total of 35 patients from flood-prone areas presented to the Emergency Department of the Tertiary University Hospital of Larissa. Diagnosis of leptospirosis was established by meeting the criteria suggested by the national public health organisation (EODY)-compatible clinical course, epidemiological exposure, molecular and serologic confirmation by the detection of immunoglobulin M antibodies to leptospira spp. using a commercially available enzyme-linked immunosorbent assay and real-time quantitative PCR for the molecular detection of leptospira. The larger part (84.6%) of leptospirosis cases were associated with contact with floodwater. The majority of these patients (71.4%) were from the prefecture of Larissa, followed by 14.3% from the prefecture of Karditsa, 8.6% from the prefecture of Trikala, and 5.7% from the prefecture of Magnesia. Occupational exposure and urbanisation were key risk factors. The most prevalent clinical feature was rash (69.2%), followed by fever (61.5%) and myalgia (30.7%). The findings emphasise the need for robust public health strategies, improved sanitation, rodent control, and protective measures for sanitation workers. The data highlight the broader implications of climate change on public health and the necessity for ongoing surveillance and community education to mitigate future outbreaks.

The educational environment is important for the development of life skills of nursing students in late- and post-adolescence. Strengthening their mental resilience, enhancing their individual confidence, and controlling stress are necessary conditions in this direction, which will help them cope with the future challenges of their chosen profession. We aimed to study the resilience profiles of nursing students by investigating their mental resilience and its association with their individual characteristics and lifestyle factors. The Connor-Davidson Resilience Scale (CD–RISC–25) scale for resilience, the Perceived Stress Scale (PSS–14) scale for perceived stress, and the Personal Trust and Connection (PerTC) scale for trust and connections were used. The lifestyle determinants were also assessed. An e-survey that targeted 250 nursing students was conducted from November 22 to April 23. Descriptive and advanced statistical analyses were performed. 146 students participated in the study via an on-line questionnaire; the students were predominantly female (82.2%) with mean age of 22 years (SD = 6.8). Two out of ten students smoked (20.5%), 66.4% consumed at least one drink during a usual week, and 48.0% participated in sports during the last year. The mean hours spent on the Internet daily was 4.2 (SD = 1.8) and on social media was 2.7 (SD = 1.6) hours/day. The students scored highly on the 1-to-10 life-satisfaction item (Mean = 6.3, SD = 1.9), where the perceived stress was assessed as moderate/high with a mean of 33 (SD = 4.4) and trust and connections had a mean of 6.2 (SD = 1.1). In the multivariate analysis, the factors found to significantly associate with resilience (CD–RISC–25; Mean = 64.2, SD = 11.8) were age (β = 0.4; 95% CI: 0.1, 0.7), sports participation (β = 5.7; 95% CI: 2.3, 9.1), hours per day spent on social media (β = -1.3; 95% CI: -2.3, -0.3), and the number of friends (β = 0.3; 95% CI: 0.05, 0.5). Finally, resilience was positively associated with life satisfaction and the trust and connections scale (β = 1.8; 95% CI: 0.9, 2.7 and β = 1.8; 95% CI: 0.2, 3.4, respectively).

Background: Influenza vaccination among athletes is a crucial area in sports medicine. This descriptive, cross-sectional study aims to explore the vaccination practices and intentions regarding influenza vaccines among young athletes. Methods: A structured, questionnaire-based study was conducted among students from the National School of Sports in Greece. The survey was conducted over the period of April to May 2023. Overall, 138 participants participated in the study. Results: More than half of the participants had received a flu vaccine in the past, but only 12.3% were vaccinated against influenza for 2022–2023. The main reasons seemed to be the lack of time (40.6%) and the idea that influenza does not lead to any serious health threats for the participants (36.2%). The main factor that affected their decision to get the flu vaccine or not was the need for more information regarding influenza vaccination (79%). Conclusions: The recent study showed low vaccination coverage among people of young age participating in sports activities. The qualitative views of the participants highlighted the significance of the lackof a well-organized information program provided by health professionals and coaches.

Diphtheria and tetanus could lead to serious morbidity. We aimed to evaluate immunity levels by measuring specific IgG antibodies for diphtheria and tetanus in serum samples from a nationally expanded sample of the Greek population. A geographically stratified sampling approach based on regional units (NUTS level 2) was applied by considering variables such as age group (30–80+) and sex. In total, 1201 persons (47.7% males and 52.3% females) participated in the survey. Bivariate analysis revealed a negative relationship between diphtheria and tetanus median antibody titers and age. The overall seropositivity rate for diphtheria IgG antibodies (≥0.10 IU/mL) was estimated at 31.5%. Regarding tetanus, the total seropositivity rate was estimated at 59.5% (tetanus IgG antibodies ≥0.10 IU/mL). Logistic regression analysis indicated that age groups

This paper proposes a low cost and low-complexity observer that can effectively and accurately estimate in real-time the longitudinal and lateral vehicle velocities, and the road inclination and bank angles. The above are needed in several systems of a vehicle, such as the battery energy management of an electric vehicle, the active suspension and other driver assistance systems. The suggested observer utilizes the neural network technique and is realized by using information provided by sensors that measure the angular velocity of the wheels, the position of the accelerator and decelerator pedals, and the angle of the steering wheel, with which the modern vehicles are usually equipped. The only additional sensors that are required are four inertial measurement units mounted on each wheel-carrier. However, they are relatively low-cost sensors and therefore, the total cost of the vehicle does not considerably increase. The training of the neural network can be easily performed in a test road. The feasibility and effectiveness of the suggested observer are verified on simulation models with the CarMaker and Matlab/Simulink programs. Several simulation results are presented to validate the satisfactory operation of the observer, which are also compared with other techniques from the literature.

Respiratory infections constitute a major reason for infants and children seeking medical advice and visiting health facilities, thus remaining a significant public threat with high morbidity and mortality. The predominant viruses causing viral respiratory infections are influenza A and B viruses (Flu-A, Flu-B), respiratory syncytial virus (RSV), adenovirus and coronaviruses. We aimed to record the proportion of RSV, SARS-CoV-2, influenza A/B and adenovirus cases with rapid antigen tests and validate the results with RT-PCR assays of upper respiratory specimens with a wide range of viral loads and (co)-infection patterns in children. Clinical samples were collected from early symptomatic children (presenting with fever and/or cough and/or headache within 5–7 days). The surveillance program was conducted in five private pediatric dispensaries and one pediatric care unit, from 10 January 2023 to 30 March 2023 in central Greece. The total sample of specimens collected was 784 young children and infants, of which 383 (48.8%) were female and 401 were male (51.2%). The mean age of participants was 7.3 + 5.5 years. The sensitivity of the FLU A & B test was 91.15% (95% CI: 84.33–95.67%), and the specificity was 98.96% (95% CI: 97.86–99.58%). The sensitivity and specificity of the adenovirus and RSV test was {92.45% (95% CI: 81.79–97.91%), 99.32% (95% CI: 98.41–99.78%)} and {92.59% (95% CI: 75.71–99.09%), 99.47% (95% CI: 98.65–99.86%)} respectively. Lastly, the sensitivity of the SARS-CoV-2 test was 100.00% (95% CI: 79.41–100.00%) and the specificity was 99.74% (95% CI: 99.06–99.97%). We recorded a proportion of 14.3% and 3.44% for influenza A and B, respectively, followed by a proportion of 6.9% for adenovirus, a proportion of 3.7% for RSV, and finally, a proportion of 2.3% for SARS-CoV-2. The combination of a new multiple rapid test with multiple antigens will probably be a useful tool with a financial impact for health systems targeting the early detection and appropriate treatment of respiratory infections in emergency departments in primary health care facilities.

Background: There are limited data on the attitudes and acceptance of the second booster (fourth dose) of the COVID-19 vaccination among physicians. Methods: A cross-sectional, questionnaire-based, online study was conducted among members of the Athens Medical Association (A.M.A.) who were invited to participate anonymously over the period from January to March 2023. Results: From the 1224 members who participated in the survey, 53.9% did not receive the fourth dose of the COVID-19 vaccine. The main reasons for no vaccination were the lack of obligation to receive the fourth dose, the history of three doses of the COVID-19 vaccine and the lack of sufficient information about the effectiveness of the fourth dose. Over half of the three-dose-vaccinated participants were willing to receive the fourth dose in the near future. Interestingly, the vaccination coverage among participants who had been informed about the fourth dose through scientific sources was low. Conclusions: The low vaccination coverage with the fourth dose reported in this study can lead to broad and serious consequences, such as increase in COVID-19 infections, reduction of available healthcare staff and increased caseloads of COVID-19 in hospitals. Furthermore, hesitant physicians will adversely influence the vaccination uptake among the general population due to their key role in informing and recommending the vaccine. The healthcare system administration should acknowledge and address physician’s concerns through effective communication and better support.

Registry systems play a key role in promoting vaccination campaigns in the general population. In the present narrative review, we provide data from 12 12 countries for vaccination acceptance before the availability of COVID-19 vaccines and vaccination coverage once it is available. We selected a randomized representative sample of 12 countries from WHO regions and 194 total members by the Open Epi Random Program. We observed the results with different levels of vaccine acceptability between the studies that were performed before the availability of a vaccine against COVID-19 and the vaccination coverage after the availability of the COVID-19 vaccine. All the registry systems that were developed for the recent pandemic achieved the initial functional goals. Twelve months after the vaccination campaign has begun, varying results were reported for vaccination coverage against COVID-19 vaccines with rates as high as 98% (subjects with at least one dose of vaccine) in the United Arabic Emirates, and as low as 24% in South Africa. The United Arabic Emirates stood as the leader of the world with the highest number of vaccinations 88% fully vaccinated citizens followed by Canada with 80% fully vaccinated citizens. The available data suggest that vaccine registry systems could help increase vaccination coverage and aim in the control of future outbreaks.

Introduction: Aging, cardiovascular disease (CVD), and heart failure (HF) increase the coexisting morbidity (CM) burden. This study compared the contribution of HF with this increase in elderly patients hospitalized for CVD by comparing patients with and without HF. Methods: Consecutive patients aged >65 years, hospitalized with CVD, were included (104 with and 100 without HF). The prevalence of 10 common CM (hypertension, coronary artery disease, atrial fibrillation, diabetes, dyslipidemia, anemia, chronic kidney disease, chronic obstructive pulmonary disease, sleep apnea, and cancer) was examined. The CM burden was assessed with the CM index (number of CM/patient) and multimorbidity (≥2 CM/patient). Results: The CM index was significantly higher [5 (3-6) vs. 3 (2-4), p

In the context of the evolving current COVID-19 pandemic, influenza vaccination among the public and health care workers is of particular importance. There are sparse data on the influenza vaccination coverage among health care workers amid COVID-19 pandemic. We aimed to study possible factors associated with influenza vaccination coverage among Greek physicians, dentists, and pharmacists during the flu season 2020–2021. We formulated the hypothesis that COVID-19 pandemic exerted a positive impact on the influenza vaccination coverage of health care workers. An online survey was conducted among the members of the Larissa, (Thessaly, Central Greece) Medical, Dentists, and Pharmacists Associations. The influenza vaccination coverage was 74% (251/340). Acceptance of COVID-19 vaccination coverage was the only factor independently associated with the likelihood of influenza vaccination coverage. In conclusion, we report here a considerable improvement of the influenza vaccination coverage among HCWs and especially among physicians. Acceptance of COVID-19 vaccination was the only predictor of influenza vaccination coverage. This finding provides public health workers and policymakers with useful policy-relevant evidence in order to maintain and even further improve the gains of increased vaccination coverage achieved during the flu season 2020–2021.

Introduction: Coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, giving rise to a serious global health threat. Many countries including Greece have seen a two-wave pattern of reported cases, with a first wave in spring and a second in autumn of 2020. Methods: A cross-sectional seroprevalence study was designed to measure the prevalence of IgG antibodies with a quantitative SARS-CoV-2 IgG lab-based serology test, chemiluminescent microparticle immunoassay, against novel coronavirus in rural areas in Greece after the second pandemic wave. The study was conducted on 29 January 2021 in a rural semi-closed area, the municipality of Deskati, prefecture of western Macedonia in Greece after the second pandemic wave. Results: Sixty-nine participants were included in this study. The present study demonstrated a high prevalence of COVID-19 infection (31 of 69 total participants; 45%) and those who were working in the public sector were at higher risk of COVID-19 infection in comparison to their counterparts in private sector (p=0.05364), (relative risk 2.64; 95% confidence interval 1.001-7.086). Conclusion: The study presents data showing a high prevalence of herd immunity for COVID-19 in a semi-closed area in Greece. These findings might help to understand the characteristics of this second wave, the behaviour and danger of SARS-CoV-2 in rural areas in Greece and Europe generally.

The compliance of dentists with good hygiene practices during the COVID-19 pandemic was essential to minimize the transmission of SARS-CoV-2 strains, and the pandemic has significantly interrupted the provision of oral health care to many individuals. We aimed to examine, in a cross-sectional study, factors affecting dental patients’ compliance in primary dental health settings during the pandemic period. The present study was conducted on 300 dental patients visiting four private dental offices in the city of Larissa in Central Greece during the period October–December 2021. The patients in the study sample were of an average age of 45.79 years with a standard deviation of 15.54 years, and 58% of the sample were females. A significant proportion of the participants, 22%, reported that they would be influenced if they knew that the dentist had been ill with COVID-19 despite being fully recovered. A total of 88% of the participants reported that they would feel safe if they knew their dentist was vaccinated against COVID-19. Regarding the information received by dentists, 88% of the participants agreed that the dentist’s role is important in dealing with the COVID-19 pandemic, and 89% of them agreed that the information they received from the dentist about the COVID-19 pandemic was sufficient. One-third of the total sample reported that COVID-19 negatively impacted keeping dental appointments, and 43% of the sample kept scheduled appointments. A total of 98% reported that the dentist followed all health protocols against COVID-19 and that their office was equipped to follow health protocols. In the present study, we observe that dentists had adequate knowledge of, attitudes towards, and practices of infection control protocols against COVID-19 during the second wave, according to patients’ perceptions.

This paper proposes an improved non-schedulable load forecasting (NLF) technique that can be utilized to enhance the performance of the energy management system (EMS) in a nearly zero energy building (nZEB). The suggested NLF is based on a long short-term memory (LSTM) framework in conjunction with a semi-supervised clustering (SSC) technique, considering the most important features which may affect the energy consumption of the non-schedulable appliances (NAs), i.e. number and identity of residents, energy consumption, weather, temperature, humidity, outdoor irradiance, correlation with other loads, day of the week and holidays. The SSC algorithm is utilized to fill the uncompleted information for the residents’ presence in the house and its output constitutes one of the inputs of the LSTM based technique which provides as output a set of forecasting sequences of the NAs’ energy consumption. Unlike the published techniques, the proposed NLF method is not only based on the modeling of the residents’ preferences and habits, but it considers them as variables which affect the nZEB’s microgrid and EMS performance. Therefore, it predicts the residents’ behavior considering its interdependence with the nZEB’s microgrid, which can considerably contribute to the enhancement of the EMS effectiveness and performance. For the implementation of the proposed NLF, no additional hardware is required, but only amendments in the EMS to consider the NLF’s outcomes. To validate the effectiveness of the proposed NLF, selective Hardware-in-the-Loop results from a real nZEB are presented.

This paper investigates the problem of the vehicle’s braking performance and a control method is proposed that can reduce the stopping time and distance, through the proper control of the active suspension system. Specifically, a Linear Quadratic Controller is utilized, that regulates the vehicle’s frame pitch angle during the braking process for establishing a correct balance between the front and rear axles. Moreover, a fuzzy-logic system is introduced, which penalizes the effort of the actuators aiming to the reduction of the consumed power. The proposed control method of the active suspension system is energized only in an emergency condition, which is identified through the travel of the braking pedal pushed by the driver. Under normal conditions, the active suspension returns to the regular operation, that is the improvement of the passengers’ comfort by means of rejecting the vehicle’s disturbances induced by road’s irregularities. The effectiveness of the proposed emergency control technique of the active suspension system is verified through a simulation model, by using the MATLAB/Simulink software, in comparison to a passive, semi-active and an active suspension, as in the literature. Selective simulation results for various road conditions are presented to demonstrate the operating improvements.

Since the emergence of the SARS-CoV-2 Omicron variant, many issues have arisen. We report SARS-CoV-2 vaccinations, SARS-CoV-2 cases and COVID-19 outcomes in Greece during weeks 2–26 of 2021 (Alpha variant period), weeks 27–51 of 2021 (Delta variant period) and week 51 of 2021 to week 27 of 2022 (Omicron variant period). The average weekly cases were higher during the Omicron period vs. the Delta (25,354.17 cases/week) and Alpha periods (11,238.48 cases/week). The average weekly vaccinations were lower in the Omicron period (26,283.69/week) than in the Alpha and Delta period. Joinpoint regression analysis identified that the trend of SARS-CoV-2 cases increased by 88.5% during the rise of the Omicron wave in Greece. The trend of the intensive care unit (ICU) admissions related to COVID-19 decreased by 5.0% immediately after the rise of Omicron while the trend of COVID-19-related deaths decreased by 8.1% from the 5th week of the Omicron wave until the end of the study. For vaccinations, an increasing trend of 8.3% was observed in the first half of 2021 (weeks 18–25/2021), followed by a decreasing trend in weeks 26–43/2021. For the weeks before and during the early rise of Omicron (44/2021–1/2022), we identified an increasing trend of 10.7% and for weeks 2–27/2022 we observed a decreasing trend of 18.1%. Unfortunately, we do not have available data about the vaccination status of the SARS-CoV-2 cases, ICU admissions or deaths. Our findings suggest that the Omicron variant is associated with increased transmissibility and reduced morbidity and mortality despite the previous increase in the trend of SARS-CoV-2 vaccinations.

Background: There are limited data on the vaccination practices of footballers in low professional categories in Greece and Europe. The aim of this study was to investigate the vaccination practices followed by the medical staff of the low professional football categories in Central Greece. Methods: A questionnaire was developed and included questions on the vaccination practices of football players. The participants were chief medical officers of the fifteen low-category football teams in Central Greece. Overall, 10 out of 15 chief medical officers participated (response rate: 67%). Results: All participants recommended only the tetanus monovalent vaccine in cases with deep trauma of athletes. Influenza, pneumococcal vaccine, and Hepatitis A and B vaccines were not recommended by the medical officers. This was also the case for measles, mumps, rubella (MMR) vaccine and meningococcal vaccine with strains A, C, Y, W. Participants reported the lack of specific guidelines for vaccination in professional footballers. Conclusions: The recent study showed poor vaccination practices in low categories of professional football teams in Central Greece. The qualitative view of the respondents revealed the importance of the absence of guidelines on vaccination of football players.

The reported cases of pertussis vary considerably globally. In the present nationwide study, we aimed to record the Bordetella pertussis prevalence in Greece by measuring serum IgG specific antibody levels to pertussis toxin (anti-PT IgG). General practitioners and laboratories participated in this study from 12 regions of Greece. A geographically stratified sampling plan based on regional units (NUTS level 2) was applied in order to produce a representative sample, taking into consideration age group (30–39, 40–49, 50–59, 60–69, 70–79 and 80+) and sex. In total, 1169 subjects participated in the study. The percentage of participants with anti-PT IgG antibodies higher than 50 IU/mL was 3.7%. The levels of anti-PT IgG antibodies of total sample ranged between 1.46 IU/mL to 126.60 IU/mL, with mean 17.74 IU/mL and standard deviation 14.03 U/mL (p-value < 0.001). The total seroprevalence of Greek regions for pertussis disease varied significantly among prefectures. The region with the highest seroprevalence was Peloponnese 21.3%, followed by the region of Central Greece 15.3%. The proportion of adults who have pertussis specific antibodies 90%, suggesting that a large number of adults may be vulnerable to infection of pertussis despite well-established vaccination programs in Greece. Despite the fact that vaccination reduced the number of reported pertussis cases in the last decades in Greece, our seroprevalence study may indicate that the herd immunity level among Greek adults is suboptimal.

The aim of this study is to investigate the relation between multimorbidity, traumatic events and frailty among older adults in the community. The studied population consisted of 257 older people who were recipients of the services and active members of Open Care Centers for the Elderly (OCCE) of the Municipality of Grevena and meet a set of selection criteria. The collection of the data was carried out using a fully structured questionnaire, which consisted of two sections: a form of individual features and the Tilburg Frailty Indicator (TFI). The sample consisted of 114 men (44.4%) and 143 women (55.6%) aged between 61 and 96 years with an average of 75.12 years. The results showed that the mean scores were 2.70 for the Physical Frailty (standard deviation = 2.16), 1.43 for the Psychological Frailty (standard deviation = 1.21), 1.32 for the Social Frailty (standard deviation = 0.64) and 5.44 for the total Frailty (standard deviation = 3.02). We took into account the cut-off point five of 54.1% (n = 139) in terms of the participants’ frailty. Physical, Psychological, and Total Frailty are related to (a) the presence of two or more chronic diseases or disorders, (b) the experience of a serious illness in the previous year, and (c) the experience of a serious illness of a loved one during the previous year. The outcomes helped to identify frailty syndrome in older people and the factors associated with it.

Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020–2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01–1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07–3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51–60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation.

Little is known about the risk of COVID-19 infection among footballers. We aimed to investigate the incidence and characteristics of COVID-19 infection among footballers. In total, 480 football players of Super League Greece and 420 staff members participated in a prospective cohort study, which took place from May 2020 to May 2021. Nasopharyngeal swabs were collected from footballers and staff members weekly. All samples (n = 43,975) collected were tested using the reverse transcriptase polymerase chain reaction (RT-PCR) test for the detection of “SARS-CoV-2”. In total, 190 positive cases (130 among professional football players and 60 among staff) were recorded. Out of the 190 cases that turned positive, 64 (34%) cases were considered as symptomatic, and 126 (66%) cases were asymptomatic. The incidence rate of a positive test result for footballers was 0.57% (confidence interval (CI) 0.48–0.68%) and for staff members it was 0.27% (CI 0.20%, 0.34%), respectively. Footballers recorded a twofold increased risk of COVID-19 infection in comparison to staff members (relative risk = 2.16; 95% CI = 1.59–2.93; p-value < 0.001). No significant transmission events were observed during the follow-up period. We found a low incidence of COVID-19 infection among professional footballers over a long follow-up period. Furthermore, the implementation of a weekly diagnostic testing (RT-PCR) was critical to break the transmission chain of COVID-19, especially among asymptomatic football players and staff members.

Vaccines are important for older adults, and the morbidity and mortality of vaccine-preventable diseases among older adults are high. There are limited data on vaccination coverage among elderly people in Greece. The aim of this observational study was to record the vaccination coverage for vaccines recommended by the National Vaccination Program in Greece for the elderly people ≥60 years old. Two hundred general practitioners (GPs) around the country from the primary healthcare system were invited to “participate,” and one hundred fifty from them participated in the present study. The GPs were selected using geographically stratified random sampling methodology. Two thousand and seventy-two participants participated in the present study: of which, 1043 were males and 1029 were females. The mean age of the participants was 73.3 years, and 83% vaccination coverage for flu vaccine, 49.5% for conjugate pneumococcal vaccine, and 23.5% for polysaccharide pneumococcal vaccine were recorded. In addition, the vaccination coverage for herpes zoster vaccine was 20%, while very low percentages were recorded for diphtheria, tetanus, pertussis, and polio vaccine for adults. We found significant gaps in vaccination coverage, especially with regard to pneumococcal, herpes zoster, and tetanus. On the contrary, influenza vaccination coverage was satisfactory.

The available coronavirus disease 2019 (COVID-19) vaccines have shown their effectiveness in clinical trials. We aimed to assess the real-world effects of SARS-CoV-2 vaccinations in Greece. We combined national data on vaccinations, SARS-CoV-2 cases, COVID-19-related ICU admissions and COVID-19-related deaths. We observed 3,367,673 vaccinations (30.68% of the Greek population), 278,821 SARS-CoV-2 infections and 7401 COVID-19-related deaths. The vaccination rate significantly increased from week 2 to week 6 by 85.70%, and from week 7 to 25 by 15.65%. The weekly mean of SARS-CoV-2 cases, COVID-19 ICU patients and COVID-19 deaths markedly declined as vaccination coverage accumulated. The rate of SARS-CoV-2 cases increased significantly from week 2 to week 13 by 16.15%, while from weeks 14–25 the rate decreased significantly by 13.50%. The rate of COVID-19-related ICU admissions decreased significantly by 7.41% from week 2 to week 4, increased significantly by 17.22% from weeks 5–11, then decreased significantly from weeks 17–20, by 11.99%, and from weeks 21–25, by 16.77%. The rate of COVID-19-related deaths increased significantly from week 2 to week 15 by 12.08% and decreased significantly by 16.58% from weeks 16–25. The data from this nationwide observational study underline the beneficial impact of the national vaccination campaign in Greece, which may offer control of the SARS-CoV-2 pandemic.

There are limited data on the prevalence and determinants of COVID-19 vaccination coverage among physicians. A cross-sectional, questionnaire-based, online study was conducted among the members of the Athens Medical Association (I.S.A.) over the period 25 February to 13 March 2021. All members of I.S.A. were invited to participate in the anonymous online survey. A structured, anonymous questionnaire was used. Overall, 1993 physicians participated in the survey. The reported vaccination coverage was 85.3%. The main reasons of no vaccination were pending vaccination appointment followed by safety concerns. Participants being informed about the COVID-19 vaccines by social media resulted in lower COVID-19 vaccination coverage than health workers being informed by other sources. Logistic regression analysis demonstrated that no fear over COVID-19 vaccination-related side effects, history of influenza vaccination for flu season 2020–2021, and the perception that the information on COVID-19 vaccination from the national public health authorities is reliable, were independent factors of reported COVID-19 vaccination coverage. Our results demonstrate a considerable improvement of the COVID-19 vaccination uptake among Greek physicians. The finding that participants reported high reliability of the information related to COVID-19 vaccination provided by the Greek public health authorities is an opportunity which should be broadly exploited by policymakers in order to combat vaccination hesitancy, and further improve COVID-19 vaccination uptake and coverage among physicians/HCWs, and the general population.

Introduction: Psychological health is the expression of harmonic expression of human’s personality and is often disrupted by multiple factors. Especially during academic years human has to confront various stressful situations that endanger his Psychological health. Aim: This study aims to assess psychological distress in university students and to examine possible factors that are associated with it. Material and Methods: A cross sectional study was conducted in which 206 university students were participated. Data were collected by the Hospital Anxiety and Depression Scale, HADS and a sheet contain information regarding demographic, social and academic background special design for the purpose of the study. Spss v. 21 was used for analyzing data and the signicant level was set in p≤0,05. Results: From the total of 206 students 76,2% were women (n=157) and 23,8% were men with a mean age 30.1 ±7.15. Anxiety symptoms were negative associated with cohabitation and marital status (p=.019 and p=.001 respectively). While place of residence was also negative associated (p=.000).While monthly income and duration of were associated with the experience of anxiety symptoms. One the other hand depression was associated with sex (p=.004) place of residence and origins of students (p=.038 and p=.058 respectively). Finally the number of uncompleted courses and sexual preferences were associated with depression to (p=.009). Conclusions: Within the context of student life that is characterized by anxiety, crises of interpersonal relationships and uncertainty maintaining student’s mental health and wellbeing must be a top propriety among university services.

Health Care Workers are at the front line of the fight against Covid-19. The aim of this study was to evaluate the acceptability of vaccination against COVID-19 among health professionals (physicians, dentists, pharmacists) two weeks prior to the start of the Greek vaccination campaign against COVID-19. A cross-sectional online survey was conducted over the period 15–22 December 2020 in 340 health professionals in Central Greece. We found a high level of acceptance for COVID-19 vaccine (78.5%) and a high vaccination coverage for the influenza vaccine (74%). Age > 45 years (OR = 2.01; 95% C.I. = 2.01−4.3), absence of fear over vaccine safety (OR = 4.09; 95% C.I. = 1.36–12.3), and information received from the Greek public health authorities (OR = 11.14; 95% C.I. = 5.48–22.6), were factors independently associated with the likelihood of COVID-19 vaccination acceptance. Our study indicates a high level of the COVID-19 vaccination acceptance among physicians, dentists and pharmacists. Nevertheless, several interventions can be implemented to increase acceptance of vaccine among health-care workers (HCWs) and could be especially directed at younger and vaccine-hesitant health care workers due to fear of vaccine side-effects. Last, our results provide some evidence that receiving vaccine-related information from the Greek Center for Diseases Control (E.O.D.Y.) could reduce the drivers of hesitancy and enhance the acceptability of COVID-19 vaccination.

Background. Suicide mortality increased in Greece after the 2008 financial crisis. This study aimed to explore the regional variation of suicide mortality before and after the economic crisis, and its correlation with socio-economic and mental health-related variables factors. Methods. This is a quasi-experimental ecological study. Data from the national mortality statistics were analyzed, and standardized death rates and age-specific mortality rates were calculated. The effect of economic crisis was explored by comparing mortality rates before and after crisis onset. Pearson’s and Spearman’s correlation coefficients and multiple linear regression were used to assess the impact of socioeconomic and mental health-related factors on suicide mortality. Results. Trends of suicide mortality showed a rise during 2011–2014, followed by a decline during 2015–2016. Significant differences were observed between regions, ranging from 27.6% lower to 54% higher than the national average. Unemployment, income, and change of gross domestic product were significantly correlated with regional variation. No association was found with mental disorder mortality rates and psychotropic drug consumption. Conclusions. Socio-economic factors explained only a part of the suicide mortality variation. Mental health-related factors were not significantly correlated with suicide mortality. More research is needed to investigate other possible determinants of suicides.

Background: We aimed to assess general practitioners' (GPs) knowledge, attitudes, and practices (KAPs) toward screening recommendation guidelines of the United States Preventive Services Task Force (USPSTF). Methods: The survey was conducted during a 6-month period in a stratified random sample of GPs, drawn from a national database of GPs in Greece. Participants were queried about their knowledge, attitudes, and self-reported practice patterns regarding screening in a primary care setting. Sociodemographic characteristics associated with vague screening practicing were identified using multivariable logistic regression models. Results: A total of 299 participants agreed and underwent telephonic survey (response rate: 78.2%). GPs agreed on the key role of population-based screening in improving patient care, and nine out of ten reported that their performance would be improved with the adoption of computer-based support systems in clinical practice. GPs, older than 50 years of age, those who those practicing for more than 15 years and GPs working in private sector, were less likely to comply with screening recommendations. Latent class analysis revealed that male physicians and those working in public sector were more likely to comply with USPSTF recommendations. Conclusions: Our findings highlight the need of educational intervention programs for GPs in order to promote the implementation of national evidence-based screening recommendation statements in clinical practice.