Elpidoforos Soteriades | Harvard University (original) (raw)

Papers by Elpidoforos Soteriades

Background: Medical errors have been highlighted in recent years by different agencies, scientifi... more 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.

Journal of environmental health

International journal of public health, 2015

The present study used attitudinal and behavioural indicators to measure support for smoke-free p... more The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predic...

New England Journal of Medicine

Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin

Following the first imported case in a tourist in Cyprus on 2 June 2009, the influenza A(H1N1)v v... more Following the first imported case in a tourist in Cyprus on 2 June 2009, the influenza A(H1N1)v virus has spread on the island affecting mainly young adults and children. We describe here the first 45 cases in children. Fever, cough, rhinorrhoea and sore throat were the most common symptoms of infection. Half of the children had fever for one day or only for a few hours. Five children were hospitalised, and overall their symptoms were mild. Adherence to oseltamivir treatment was very high, with low frequency of gastrointestinal side effects such as nausea and vomiting. Camping places and summer schools played a significant role in spreading the infection among children of school age.

BMC public health, 2006

Research in the fields of Preventive Medicine, Occupational/Environmental Medicine, Epidemiology ... more Research in the fields of Preventive Medicine, Occupational/Environmental Medicine, Epidemiology and Public Health play an important role in the advancement of knowledge. In order to map the research production around the world we performed a bibliometric analysis in the above fields. All articles published by different world regions in the above mentioned scientific fields and cited in the Journal Citation Reports (JCR) database of the Institute for Scientific Information (ISI) during the period 1995 and 2003, were evaluated. The research production of different world regions was adjusted for: a) the gross domestic product in 1995 US dollars, and b) the population size of each region. A total of 48,861 articles were retrieved and categorized. The USA led the research production in all three subcategories. The percentage of articles published by USA researchers was 43%, 44% and 61% in the Preventive Medicine, Epidemiology, and Public Health subcategories, respectively. Canada and We...

BMC infectious diseases, 2006

A long-term active surveillance of Q fever was conducted in Cyprus organized in two phases. Follo... more A long-term active surveillance of Q fever was conducted in Cyprus organized in two phases. Following serological tests and identification of seropositive humans and animals for C. burnetii in two villages (VIL1 and VIL2), all seronegative individuals were followed up for one year on a monthly basis by trained physicians to detect possible seroconversion for Q fever. In the second phase of the study, active surveillance for one year was conducted in the entire Cyprus. Physicians were following specific case definition criteria for Q fever. Standardized questionnaires, a geographical information system on a regional level, Immunofluorescence Assay (IFA) examinations and shell vial technique were used. Eighty-one seronegative humans and 239 seronegative animals from both villages participated in the first phase surveillance period of Q fever. Despite the small number of confirmed clinical cases (2 humans and 1 goat), a significant percentage of new seropositives for C. burnetii (44.4%...

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2006

We evaluated all articles published by different world regions in the top 50 biomedical journals ... more We evaluated all articles published by different world regions in the top 50 biomedical journals in the database of the Journal Citation Reports-Institute for Scientific Information for the period between 1995 and 2002. The world was divided into 9 regions [United States of America (the U.S.), Western Europe, Japan, Canada, Asia, Oceania, Latin America, and the Caribbean, Eastern Europe, and Africa] based on a combination of geographic, economic and scientific criteria. The number of articles published by each region, the mean impact factor, and the product of the above two parameters were our main indicators. The above numbers were also adjusted for population size, gross national income per capita of each region, and other factors. Articles published from the U.S. made up about two-thirds of all scientific papers published in the top 50 biomedical journals between 1995 and 2002. Western Europe contributed approximately a quarter of the published papers while the remaining one-tent...

BMC public health, 2005

The use of geographical information system (GIS) technologies in public health surveillance is gr... more The use of geographical information system (GIS) technologies in public health surveillance is gradually gaining momentum around the world and many applications have already been reported in the literature. In this study, GIS technology was used to help county departments of Public Health to implement environmental health surveillance for the Athens 2004 Olympic and Para Olympic Games. In order to assess the workload in each Olympic county, 19 registry forms and 17 standardized inspection forms were developed to register and inspect environmental health items requiring inspection (Hotels, restaurants, swimming pools, water supply system etc), respectively. Furthermore, related databases were created using Epi Info 2002 and a geographical information system (GIS) were used to implement an integrated Environmental Health inspection program. The project was conducted in Athens by the Olympic Planning Unit (OPU) of the National School of Public Health, in close cooperation with the Mini...

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2005

We studied the type and frequency of differences between data presented in conference abstracts a... more We studied the type and frequency of differences between data presented in conference abstracts and subsequent published papers in the fields of infectious diseases and microbiology. We reviewed all abstracts from the first session of 7 of 15 major research categories presented in the 1999 and 2000 Interscience Conference on Antimicrobial Agents and Chemotherapy. For each selected pair of abstract and related published paper, two independent investigators performed a detailed data comparison. From 190 abstracts reviewed, 68 (36%) were subsequently published as full papers by March 2004. Fifty-two pairs referred to the same study population and period. Differences were found in 30 of 51 pairs, which were further analyzed (point estimate=59%, 95% C.I.: 45-73%). The identified differences were related to both the aims and conclusions of the study (3/30), the study conclusions only (2/30), numbers and/or rates of the studied patients (10/30), numbers or rates of microbiological isolates...

Acta Radiologica Short Reports, 2013

The overall prognosis for patients with b-thalassemia has improved considerably during the past d... more The overall prognosis for patients with b-thalassemia has improved considerably during the past decades mainly due to regular blood transfusions, improvements in chelation therapy, and enhanced surveillance with imaging studies examining iron overload and other clinical complications. However, the prolonged survival of these patients leads to the development of other health problems including degenerative diseases such as arthropathies, which require further attention since they have a significant impact on the quality of life. In the current case report, we present a 45-year-old white man with b-thalassemia complaining of non-traumatic pain and restriction in the range of motion of both knees. Magnetic resonance imaging (MRI) revealed a tear in the medial meniscus of the left knee as well as iron deposits in both knees. Histological findings confirmed the presence of hemosiderin in both joints. To our knowledge, this is the first reported case of macroscopically documented iron deposits in the knee joints of a patient with b-thalassemia using MRI.

American Journal of Hypertension, 2009

Given the physical and psychological rigors of firefighting, law enforcement, and emergency medic... more Given the physical and psychological rigors of firefighting, law enforcement, and emergency medical services (EMS), elevated blood pressure among emergency responders presents a number of clinical and public health concerns. Unquestionably, elevated blood pressures convey increased risk for cardiovascular-related morbidity and mortality. 1-3 Also, strenuous work circumstances can precipitate on-duty cardiovascular disease events among hypertensive emergency responders. Additionally, such acute cardiovascular events can potentially jeopardize co-workers' and public safety by suddenly incapacitating the affected emergency responder. Moreover, state and federal laws unique to emergency responders and providing them with benefits when they develop cardiovascular disease create additional public health and policy rationales for improving blood pressure control among these workers.

Thalassemia Reports, 2014

Many international organizations are struggling today to coordinate limited economic and human re... more Many international organizations are struggling today to coordinate limited economic and human resources in support of governments' efforts to advance public health around the world. The United Nations and the World Health Organization, along with others play a pivotal role in this global effort. Furthermore, during the past few decades an increasingly higher percentage of global efforts on public health are carried out by specific health initiatives, international projects and non-governmental patient-oriented organizations. The Thalassemia International Federation (TIF) is one such organization focusing on the control of thalassemia around the world. The current paper aims at presenting a comprehensive overview of the mission, goals, objectives and activities of this organization. Our ultimate goal is to highlight TIF's public health paradigm and diffuse its success at an international levels for others to follow. TIF is devoted to disseminating information, knowledge, experience and best practices around the world to empower patients with thalassemia and their relatives, support health professionals providing care to such patients and promote national and international policies, which secure equal access to quality care for all patients with thalassemia.

European journal of epidemiology, 1999

A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross... more A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross sectional population survey conducted in eight villages of Fokida, a rural area of central Greece. The maps of Greece (boundary) and the topographical maps of the eight villages were created using the CMP. A volunteer sample of 1121 out of 2607 inhabitants of the study area participated in the population survey. The participants were tested for brucellosis using serological tests (ELISA and Rose Bengal) and the intradermal reaction test. A questionnaire was used to obtain information concerning the risk factors for brucellosis. The risk factors found through statistical analysis were occupation (RR: 5.81, p < 0.00001), consumption of raw milk (RR: 1.98, p < 0.001) and unpasteurised fresh cheese (RR: 2.13, p < 0.01). The same factors were indicated by the CMP. The CMP also indicated manure-contaminated playgrounds in residential yards as a potential risk factor for children. The...

European journal of epidemiology, 1999

Long term active surveillance of brucellosis was implemented in a rural area (Fokida) of Greece f... more Long term active surveillance of brucellosis was implemented in a rural area (Fokida) of Greece from 1989 to 1993 while the rural area of Grevena was selected as a control area. The computerised mapping programme was used to identify and protect the suspected animal brucellosis free zones. Health education of the inhabitants was further used to teach them how to avoid the risk factors. Three suspected brucellosis free zones were identified and two of them were successfully protected. The incidence for the 10 year period (1979-1988) was estimated at 1.4/1000/year for the study area and 1.6/1000/year for the control area. During the surveillance period the incidence in the study area dropped to 0.2/1000/year while in the control area it decreased to 1.0/1000/year. The methodology of identification and protection of suspected brucellosis free zones combined with health education proved to be efficient in reducing the incidence of the disease. The same methodology could be used in the c...

Environmental health : a global access science source, Jan 6, 2003

Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefig... more Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4-556); training (OR = 7.6, 95% CI 1.8-31.3) and alarm response (OR = 5.6, 95% CI 1.1-28.8) carried significantly higher relative risks of CHD death. Compared to the active fir...

Tobacco Control, 2014

Smoke-free policies aiming to improve quality of indoor air and significantly reduce exposure to ... more Smoke-free policies aiming to improve quality of indoor air and significantly reduce exposure to secondhand smoke in the hospitality industry are faced with strong opposition from the tobacco industry and hospitality venue owners claiming that they lead to reductions of revenues. The objective of our study was to examine the impact of a recently introduced smoke-free legislation on the revenues of the hospitality industry in Cyprus. Anonymous information on revenues was obtained from the Cyprus government value added tax office for the entire hospitality industry in Cyprus including hotels, bars, restaurants and cafeterias between 2005 and 2011. Panel data methodology was used to examine the effect of a smoke-free legislation, on tourism, businesses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; revenues adjusting for gross domestic product, inflation, unemployment rate, tourists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; arrivals, seasonal variation and the economic crisis. Our study showed that the implementation of the smoke-free policy did not have negative effects on the hospitality industry profitability. We conclude that even in regions with relatively high smoking rates, pro-smoking societal attitudes and weak social norms against tobacco control, and even during periods of economic crisis, smoke-free legislation does not impact negatively on hospitality industry revenues and if anything may lead to a small positive increase.

The Scientific World Journal, 2013

Migration from different parts of the world to several European countries leads to the introducti... more Migration from different parts of the world to several European countries leads to the introduction of haemoglobinopathy genes into the population, which creates several demanding needs for prevention and treatment services for Hb disorders. In this paper we examined the degree to which European health services have responded to such challenges and in particular to health services necessary to address the needs of patients with thalassaemia and sickle cell disease (SCD). Information on available services was obtained from international organizations, collaborated European project, and the Thalassaemia International Federation (TIF) Databases, which include information from published surveys, registries, field trips, and delegation visits to countries and regions by expert advisors, local associations, and other collaborators' reports. Results show that countries with traditional strong prevention and treatment programs are well prepared to face the above challenges, while others are urgently needed to address these problems in a systematic way. The Thalassaemia International Federation (TIF) is committed to monitor the progress, raise awareness, and support the promotion of more immigrant-oriented health policies to ensure their integration in society and their access to appropriate, adequate, and timely health services.

BMC public health, 2007

Data on the prevalence of tobacco use among teenagers in Greece are limited. We examined the prev... more Data on the prevalence of tobacco use among teenagers in Greece are limited. We examined the prevalence of smoking among middle-school students in Greece using the Global Youth Tobacco Survey (GYTS). The Global Youth Tobacco Survey was implemented in Greece during the academic year 2004-2005 by the University of Thessaly and the National School of Public Health. Data were collected using the GYTS self-administered anonymous questionnaire, which was distributed by specifically trained field workers to a nationally representative sample of middle-school students aged 13-15 years (through randomly selected schools and classes), randomly selected through a two-stage cluster sample design. Data processing and statistical analyses were performed at the Centers for Disease Control and Prevention (CDC). About one third of the students 32.1% (29.4-35.0) reported that they had tried tobacco in the past, while 16.2% (14.3-18.4) reported being current users of tobacco products. In addition, 1 i...

Cardiology in review

Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-... more Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. CVD in the fire service also has adverse public safety implications as well as significant cost impacts on government agencies. Over the last decade, our understanding of CVD among firefighters has significantly improved and provides insight into potential preventive strategies. The physiology of cardiovascular arousal and other changes that occur in association with acute firefighting activities have been well-characterized. However, despite the strenuous nature of emergency duty, firefighters' prevalence of low fitness, obesity, and other CVD risk factors are high. Unique statistical approaches have documented that on-duty CVD events do not occur at random in the fire service. They are more frequent at certain times of day, certain periods of the year, and are overwhelmingly more frequent during strenuous duties compared with nonemer...

Background: Medical errors have been highlighted in recent years by different agencies, scientifi... more 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.

Journal of environmental health

International journal of public health, 2015

The present study used attitudinal and behavioural indicators to measure support for smoke-free p... more The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predic...

New England Journal of Medicine

Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin

Following the first imported case in a tourist in Cyprus on 2 June 2009, the influenza A(H1N1)v v... more Following the first imported case in a tourist in Cyprus on 2 June 2009, the influenza A(H1N1)v virus has spread on the island affecting mainly young adults and children. We describe here the first 45 cases in children. Fever, cough, rhinorrhoea and sore throat were the most common symptoms of infection. Half of the children had fever for one day or only for a few hours. Five children were hospitalised, and overall their symptoms were mild. Adherence to oseltamivir treatment was very high, with low frequency of gastrointestinal side effects such as nausea and vomiting. Camping places and summer schools played a significant role in spreading the infection among children of school age.

BMC public health, 2006

Research in the fields of Preventive Medicine, Occupational/Environmental Medicine, Epidemiology ... more Research in the fields of Preventive Medicine, Occupational/Environmental Medicine, Epidemiology and Public Health play an important role in the advancement of knowledge. In order to map the research production around the world we performed a bibliometric analysis in the above fields. All articles published by different world regions in the above mentioned scientific fields and cited in the Journal Citation Reports (JCR) database of the Institute for Scientific Information (ISI) during the period 1995 and 2003, were evaluated. The research production of different world regions was adjusted for: a) the gross domestic product in 1995 US dollars, and b) the population size of each region. A total of 48,861 articles were retrieved and categorized. The USA led the research production in all three subcategories. The percentage of articles published by USA researchers was 43%, 44% and 61% in the Preventive Medicine, Epidemiology, and Public Health subcategories, respectively. Canada and We...

BMC infectious diseases, 2006

A long-term active surveillance of Q fever was conducted in Cyprus organized in two phases. Follo... more A long-term active surveillance of Q fever was conducted in Cyprus organized in two phases. Following serological tests and identification of seropositive humans and animals for C. burnetii in two villages (VIL1 and VIL2), all seronegative individuals were followed up for one year on a monthly basis by trained physicians to detect possible seroconversion for Q fever. In the second phase of the study, active surveillance for one year was conducted in the entire Cyprus. Physicians were following specific case definition criteria for Q fever. Standardized questionnaires, a geographical information system on a regional level, Immunofluorescence Assay (IFA) examinations and shell vial technique were used. Eighty-one seronegative humans and 239 seronegative animals from both villages participated in the first phase surveillance period of Q fever. Despite the small number of confirmed clinical cases (2 humans and 1 goat), a significant percentage of new seropositives for C. burnetii (44.4%...

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2006

We evaluated all articles published by different world regions in the top 50 biomedical journals ... more We evaluated all articles published by different world regions in the top 50 biomedical journals in the database of the Journal Citation Reports-Institute for Scientific Information for the period between 1995 and 2002. The world was divided into 9 regions [United States of America (the U.S.), Western Europe, Japan, Canada, Asia, Oceania, Latin America, and the Caribbean, Eastern Europe, and Africa] based on a combination of geographic, economic and scientific criteria. The number of articles published by each region, the mean impact factor, and the product of the above two parameters were our main indicators. The above numbers were also adjusted for population size, gross national income per capita of each region, and other factors. Articles published from the U.S. made up about two-thirds of all scientific papers published in the top 50 biomedical journals between 1995 and 2002. Western Europe contributed approximately a quarter of the published papers while the remaining one-tent...

BMC public health, 2005

The use of geographical information system (GIS) technologies in public health surveillance is gr... more The use of geographical information system (GIS) technologies in public health surveillance is gradually gaining momentum around the world and many applications have already been reported in the literature. In this study, GIS technology was used to help county departments of Public Health to implement environmental health surveillance for the Athens 2004 Olympic and Para Olympic Games. In order to assess the workload in each Olympic county, 19 registry forms and 17 standardized inspection forms were developed to register and inspect environmental health items requiring inspection (Hotels, restaurants, swimming pools, water supply system etc), respectively. Furthermore, related databases were created using Epi Info 2002 and a geographical information system (GIS) were used to implement an integrated Environmental Health inspection program. The project was conducted in Athens by the Olympic Planning Unit (OPU) of the National School of Public Health, in close cooperation with the Mini...

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2005

We studied the type and frequency of differences between data presented in conference abstracts a... more We studied the type and frequency of differences between data presented in conference abstracts and subsequent published papers in the fields of infectious diseases and microbiology. We reviewed all abstracts from the first session of 7 of 15 major research categories presented in the 1999 and 2000 Interscience Conference on Antimicrobial Agents and Chemotherapy. For each selected pair of abstract and related published paper, two independent investigators performed a detailed data comparison. From 190 abstracts reviewed, 68 (36%) were subsequently published as full papers by March 2004. Fifty-two pairs referred to the same study population and period. Differences were found in 30 of 51 pairs, which were further analyzed (point estimate=59%, 95% C.I.: 45-73%). The identified differences were related to both the aims and conclusions of the study (3/30), the study conclusions only (2/30), numbers and/or rates of the studied patients (10/30), numbers or rates of microbiological isolates...

Acta Radiologica Short Reports, 2013

The overall prognosis for patients with b-thalassemia has improved considerably during the past d... more The overall prognosis for patients with b-thalassemia has improved considerably during the past decades mainly due to regular blood transfusions, improvements in chelation therapy, and enhanced surveillance with imaging studies examining iron overload and other clinical complications. However, the prolonged survival of these patients leads to the development of other health problems including degenerative diseases such as arthropathies, which require further attention since they have a significant impact on the quality of life. In the current case report, we present a 45-year-old white man with b-thalassemia complaining of non-traumatic pain and restriction in the range of motion of both knees. Magnetic resonance imaging (MRI) revealed a tear in the medial meniscus of the left knee as well as iron deposits in both knees. Histological findings confirmed the presence of hemosiderin in both joints. To our knowledge, this is the first reported case of macroscopically documented iron deposits in the knee joints of a patient with b-thalassemia using MRI.

American Journal of Hypertension, 2009

Given the physical and psychological rigors of firefighting, law enforcement, and emergency medic... more Given the physical and psychological rigors of firefighting, law enforcement, and emergency medical services (EMS), elevated blood pressure among emergency responders presents a number of clinical and public health concerns. Unquestionably, elevated blood pressures convey increased risk for cardiovascular-related morbidity and mortality. 1-3 Also, strenuous work circumstances can precipitate on-duty cardiovascular disease events among hypertensive emergency responders. Additionally, such acute cardiovascular events can potentially jeopardize co-workers' and public safety by suddenly incapacitating the affected emergency responder. Moreover, state and federal laws unique to emergency responders and providing them with benefits when they develop cardiovascular disease create additional public health and policy rationales for improving blood pressure control among these workers.

Thalassemia Reports, 2014

Many international organizations are struggling today to coordinate limited economic and human re... more Many international organizations are struggling today to coordinate limited economic and human resources in support of governments' efforts to advance public health around the world. The United Nations and the World Health Organization, along with others play a pivotal role in this global effort. Furthermore, during the past few decades an increasingly higher percentage of global efforts on public health are carried out by specific health initiatives, international projects and non-governmental patient-oriented organizations. The Thalassemia International Federation (TIF) is one such organization focusing on the control of thalassemia around the world. The current paper aims at presenting a comprehensive overview of the mission, goals, objectives and activities of this organization. Our ultimate goal is to highlight TIF's public health paradigm and diffuse its success at an international levels for others to follow. TIF is devoted to disseminating information, knowledge, experience and best practices around the world to empower patients with thalassemia and their relatives, support health professionals providing care to such patients and promote national and international policies, which secure equal access to quality care for all patients with thalassemia.

European journal of epidemiology, 1999

A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross... more A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross sectional population survey conducted in eight villages of Fokida, a rural area of central Greece. The maps of Greece (boundary) and the topographical maps of the eight villages were created using the CMP. A volunteer sample of 1121 out of 2607 inhabitants of the study area participated in the population survey. The participants were tested for brucellosis using serological tests (ELISA and Rose Bengal) and the intradermal reaction test. A questionnaire was used to obtain information concerning the risk factors for brucellosis. The risk factors found through statistical analysis were occupation (RR: 5.81, p < 0.00001), consumption of raw milk (RR: 1.98, p < 0.001) and unpasteurised fresh cheese (RR: 2.13, p < 0.01). The same factors were indicated by the CMP. The CMP also indicated manure-contaminated playgrounds in residential yards as a potential risk factor for children. The...

European journal of epidemiology, 1999

Long term active surveillance of brucellosis was implemented in a rural area (Fokida) of Greece f... more Long term active surveillance of brucellosis was implemented in a rural area (Fokida) of Greece from 1989 to 1993 while the rural area of Grevena was selected as a control area. The computerised mapping programme was used to identify and protect the suspected animal brucellosis free zones. Health education of the inhabitants was further used to teach them how to avoid the risk factors. Three suspected brucellosis free zones were identified and two of them were successfully protected. The incidence for the 10 year period (1979-1988) was estimated at 1.4/1000/year for the study area and 1.6/1000/year for the control area. During the surveillance period the incidence in the study area dropped to 0.2/1000/year while in the control area it decreased to 1.0/1000/year. The methodology of identification and protection of suspected brucellosis free zones combined with health education proved to be efficient in reducing the incidence of the disease. The same methodology could be used in the c...

Environmental health : a global access science source, Jan 6, 2003

Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefig... more Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4-556); training (OR = 7.6, 95% CI 1.8-31.3) and alarm response (OR = 5.6, 95% CI 1.1-28.8) carried significantly higher relative risks of CHD death. Compared to the active fir...

Tobacco Control, 2014

Smoke-free policies aiming to improve quality of indoor air and significantly reduce exposure to ... more Smoke-free policies aiming to improve quality of indoor air and significantly reduce exposure to secondhand smoke in the hospitality industry are faced with strong opposition from the tobacco industry and hospitality venue owners claiming that they lead to reductions of revenues. The objective of our study was to examine the impact of a recently introduced smoke-free legislation on the revenues of the hospitality industry in Cyprus. Anonymous information on revenues was obtained from the Cyprus government value added tax office for the entire hospitality industry in Cyprus including hotels, bars, restaurants and cafeterias between 2005 and 2011. Panel data methodology was used to examine the effect of a smoke-free legislation, on tourism, businesses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; revenues adjusting for gross domestic product, inflation, unemployment rate, tourists&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; arrivals, seasonal variation and the economic crisis. Our study showed that the implementation of the smoke-free policy did not have negative effects on the hospitality industry profitability. We conclude that even in regions with relatively high smoking rates, pro-smoking societal attitudes and weak social norms against tobacco control, and even during periods of economic crisis, smoke-free legislation does not impact negatively on hospitality industry revenues and if anything may lead to a small positive increase.

The Scientific World Journal, 2013

Migration from different parts of the world to several European countries leads to the introducti... more Migration from different parts of the world to several European countries leads to the introduction of haemoglobinopathy genes into the population, which creates several demanding needs for prevention and treatment services for Hb disorders. In this paper we examined the degree to which European health services have responded to such challenges and in particular to health services necessary to address the needs of patients with thalassaemia and sickle cell disease (SCD). Information on available services was obtained from international organizations, collaborated European project, and the Thalassaemia International Federation (TIF) Databases, which include information from published surveys, registries, field trips, and delegation visits to countries and regions by expert advisors, local associations, and other collaborators' reports. Results show that countries with traditional strong prevention and treatment programs are well prepared to face the above challenges, while others are urgently needed to address these problems in a systematic way. The Thalassaemia International Federation (TIF) is committed to monitor the progress, raise awareness, and support the promotion of more immigrant-oriented health policies to ensure their integration in society and their access to appropriate, adequate, and timely health services.

BMC public health, 2007

Data on the prevalence of tobacco use among teenagers in Greece are limited. We examined the prev... more Data on the prevalence of tobacco use among teenagers in Greece are limited. We examined the prevalence of smoking among middle-school students in Greece using the Global Youth Tobacco Survey (GYTS). The Global Youth Tobacco Survey was implemented in Greece during the academic year 2004-2005 by the University of Thessaly and the National School of Public Health. Data were collected using the GYTS self-administered anonymous questionnaire, which was distributed by specifically trained field workers to a nationally representative sample of middle-school students aged 13-15 years (through randomly selected schools and classes), randomly selected through a two-stage cluster sample design. Data processing and statistical analyses were performed at the Centers for Disease Control and Prevention (CDC). About one third of the students 32.1% (29.4-35.0) reported that they had tried tobacco in the past, while 16.2% (14.3-18.4) reported being current users of tobacco products. In addition, 1 i...

Cardiology in review

Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-... more Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. CVD in the fire service also has adverse public safety implications as well as significant cost impacts on government agencies. Over the last decade, our understanding of CVD among firefighters has significantly improved and provides insight into potential preventive strategies. The physiology of cardiovascular arousal and other changes that occur in association with acute firefighting activities have been well-characterized. However, despite the strenuous nature of emergency duty, firefighters' prevalence of low fitness, obesity, and other CVD risk factors are high. Unique statistical approaches have documented that on-duty CVD events do not occur at random in the fire service. They are more frequent at certain times of day, certain periods of the year, and are overwhelmingly more frequent during strenuous duties compared with nonemer...