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Background/Objectives: Depressive and anxiety syndromes are associated with elevated disability and are more prevalent in women. Data on the prevalence of depressive and anxiety disorders in the rural context are limited and contradictory. It is relevant to study common mental disorders in rural areas in the most vulnerable population of women, particularly in the post-COVID-19 pandemic era. Methods: This is a cross-sectional study that was conducted in two primary healthcare sites in the rural region of Farsala, Central Greece after the obviation of all restrictive measures that had been posed due to the COVID-19 pandemic. All consecutive female patients that attended the study sites for any non-emergent reason were asked to participate in the study. For the recording of symptoms of depression and anxiety, the self-reported Depression, Anxiety, Stress Scale-21 (DASS-21) was used. Results: The study sample consisted of 129 women. The majority of participants were >50 years, with 27.9% being older adults. A small percentage (13.2%) suffered a chronic physical disease. A large proportion of the sample, slightly exceeding 40%, reported clinically relevant symptoms of anxiety, whereas a lower percentage of women with depressive symptoms was detected (17.1%). Symptoms of anxiety and depression were found to be interrelated, while a number of sociodemographic variables were associated with both, such as older age, education (primary), living status (alone, OR 123.5; 95% CI: 7.3–2098.8 for anxiety; OR 3.5; 95% CI: 1.3–9.8 for depression), employment (not working, (OR 0.157; 95% CI: 0.06–0.41 for anxiety; OR 0.08; 95% CI: 0.01–0.62 for depression) and the history of a chronic disease (OR 33.8; 95% CI: 4.3–264.7 for anxiety; OR 37.2; 95% CI: 10–138.1 for depression). Self-rated financial status was not related to symptoms of anxiety or depression. Conclusions: The study highlights the importance of inquiring for symptoms of depression and anxiety in women attending the rural primary care setting. The use of valid and reliable self-reported instruments that are easy to administrate may be helpful in this regard. [ABSTRACT FROM AUTHOR]

Background/Objectives: The COVID-19 pandemic has posed significant challenges, particularly for individuals residing in psychiatric facilities. This study aims to investigate the impact of COVID-19 on psychiatric patients, focusing on factors such as their vaccination status, comorbidities, medication regimens, and biomarkers like C-reactive protein (CRP) and ferritin. Methods: This retrospective study analyzed 100 patients with confirmed SARS-CoV-2 infections admitted to the private psychiatric clinic "Asclepius of Upper Volos" from March 2020 to March 2023. The data collected included sociodemographic characteristics, vaccination status, symptom severity, medication regimens, and levels of CRP and ferritin. Statistical analyses using IBM SPSS Statistics version 29 included Pearson's chi-square tests, Student's t-tests, and a survival time analysis via the log-rank test to assess associations between clinical characteristics and outcomes. Results: Among the participants, 64% were female and 74% received two doses of the COVID-19 vaccine. The majority experienced mild symptoms, with a survival rate of 74%. Statistically significant findings include a higher survival rate among vaccinated individuals (98.6%) versus unvaccinated individuals (1.4%, p < 0.001). Comorbidities like chronic obstructive pulmonary disease (COPD), coronary artery disease, and renal failure were associated with severe symptoms and higher mortality rates. Higher ferritin levels were significantly associated with poorer outcomes, with survivors having a mean ferritin level of 246.2 (SD = 150.3) compared to the 416.9 (SD = 215.9) seen in non-survivors (p < 0.001). Similarly, mean CRP levels were lower in survivors (1.58, SD = 1.96) than in non-survivors (3.46, SD = 2.92), with a p-value of 0.002. Conclusions: The findings underscore the importance of tailored health protocols and continued support for this vulnerable population. Enhanced strategies for managing comorbidities and utilizing biomarkers can aid in better predicting and improving psychiatric patient outcomes. [ABSTRACT FROM AUTHOR]

The Tuning-Medicine Project produced a set of "level one" and "level two" learning outcomes/competences to be met by European medical graduates. In the learner-centered era self-assessment becomes more and more important. Our aim was to develop a self-completion questionnaire ("iCAN!") evaluating graduates' learning outcomes. The Tuning "level two" learning outcomes were transformed to a 104 closed items questionnaire, tested with a convenient sample of 512 graduates from the seven Greek medical schools during the 2009-2011 graduation cohorts, 21 practitioners, and seven different undergraduate student groups. Cronbach alpha, factor analysis, and mean score comparisons were used to check internal consistency, construct validity, and sensitivity respectively. Question mean scores were used to differentiate weak and strength areas of competence. Among graduates, all overall alphas were >0.95 and all subscale alphas higher than expected, indicating an at least acceptable internal consistency. Factor analysis produced one factor per "level one outcome", except for "practical procedures" which was split in two meaningful factors. Overall mean score was 44.4%, 52.2%, 61.2%, 73.4%, 81.4% among 2nd-year, 4th-year, 6th-year students, graduates, and practitioners respectively (p<0.001); improvement through progressively matured groups suggest good sensitivity, indicating also good responsiveness. Among graduates, question mean scores ranged from very weak (blood transfusion, 39%) to very strength (measuring blood pressure, 95%), indicating good differentiation of strengths and weaknesses. A consistent, well-structured, and sensitive version of a questionnaire is hereby released for graduates' abilities and professionalism self-assessment and differentiation of strengths and weaknesses that could be used for informed SWOT policy.

The surgical theatre educational environment measures STEEM, OREEM and mini-STEEM for students (student-STEEM) comprise an up to now disregarded systematic overestimation (OE) due to inaccurate percentage calculation. The aim of the present study was to investigate the magnitude of and suggest a correction for this systematic bias. After an initial theoretical exploration of the problem, published scores were retrieved from the literature and corrected using statistical theorems. Overestimations and differences between pseudo-percentages and real percentages were plotted against real percentages. Reported STEEM overall mean score of 74.4% (pseudopercentage) was corrected to 67.9% (real percentage), eliminating thus the 6.4% OE. Corresponding figures for OREEM and student-STEEM are 73.6%, 67.0%, 6.6% and 69.1%, 61.4%, 7.7% respectively. A total of 45 overestimated scores were retrieved and corrected. OE (range 2.8 to 13.6%, mean 7.3%) showed a complete (r = -1, p < 0.001) negative linear regression of real percentages (RP), namely, OE = 20-0.2*RP. No uncorrected score can achieve less than 20%. The non-0-based 1-to-5 coding overestimates STEEM, OREEM and student-STEEM educational environment scores if expressed as percentages due to the "1-to-5 bias", or rather 1-to-L bias, whereupon L correlates to the number of points in the Likert scale, the number of options. The worse the educational environment the greater the overestimation, reducing instruments' usefulness exactly then when alarm bells should be ringing. Hence, question coding should always be zero (0) based, as proposed by Likert. The 1-to-L bias applies to any questionnaire at any field of research.

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Background: Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices. Aim: We aimed to investigate the social patterns of involuntary psychiatric admissions from 2008 to 2017 at University General Hospital in Ioannina, Greece. Method: We retrospectively assessed inpatient records from 2008 to 2017 of patients admitted to the Department of Psychiatry of the Ioannina University General Hospital, Northwestern Greece. Alternative patients of alternative years were selected for inclusion; this yielded 332 patients involuntarily admitted, corresponding to 28.5% of total involuntary psychiatric admissions. Results: Over the 10-year period, the overall numbers of annual involuntary psychiatric admissions remained relatively stable, as did the length of hospital stay (mean = 23.8 days). The most common disorder upon admission was schizophrenia spectrum disorders, accounting for approximately two-thirds of all admissions, followed by mood disorders (about 20%). There was evidence that people who lacked social support or experienced financial hardship were more greatly represented among those admitted: 70.2% of admitted patients were single and 64.8% were unemployed. Most patients had been admitted to the psychiatric ward in the past (64.2%). Conclusion: Our study indicates potentially worrisome evidence that patients who are in vulnerable positions are at elevated likelihood of being involuntarily admitted to psychiatric wards. Future research is needed to evaluate the socio-demographic patterning of involuntary admissions in other European countries. [ABSTRACT FROM AUTHOR]

Background Multiple studies report reductions in air pollution associated with COVID-19 lockdowns. Methods We performed a systematic review of the changes observed in hazardous air pollutants known or suspected to be harmful to health, including nitrogen dioxide (NO2), nitrogen oxides (NOx), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3) and particulate matter (PM). We searched PubMed and Web of Science for studies reporting the associations of lockdowns with air pollutant changes during the COVID-19 pandemic in Europe and North America. Results One hundred nine studies were identified and analyzed. Several pollutants exhibited marked and sustained reductions. The strongest was NO2 (93% of 89 estimated changes were reductions) followed by CO (88% of 33 estimated pollutant changes). All NOx and benzene studies reported significant reductions although these were based on fewer than 10 estimates. About three-quarters of PM2.5 and PM10 estimates showed reductions and few studies reported increases when domestic fuel use rose during COVID-19 lockdowns. In contrast, O3 levels rose as NOx levels fell. SO2 and ammonia (NH3) had mixed results. In general, greater reductions appeared when lockdowns were more severe, as well as where baseline pollutant levels were higher, such as at low-elevation and in densely populated areas. Substantial and robust reductions in NO2, NO, CO, CO2, PM2.5, PM10, benzene and air quality index pollution occurred in association with COVID-19 lockdowns. O3 levels tended to increase, while SO2 and NH3 had mixed patterns. Conclusions Our study shows the profound impact of human activity levels on air pollution and its potential avoidability. [ABSTRACT FROM AUTHOR]