A. Benos - Academia.edu (original) (raw)

Papers by A. Benos

Education for Primary Care, 2016

In the spirit of this special WONCA edition we would like to encourage readers to consider sharin... more In the spirit of this special WONCA edition we would like to encourage readers to consider sharing best educational practice across geographical, socioeconomic and cultural boundaries through internet-based collaborative working technologies.

Journal of Health Organization and Management, 2005

PurposeThe emotionally taxing nature of health‐care work has been increasingly recognized. In par... more PurposeThe emotionally taxing nature of health‐care work has been increasingly recognized. In parallel, the field of work and family has been searching for more specific antecedents of both work interference with family (WFI) and family interference with work (FWI). The current study aims to examine the relationship between surface acting and hiding negative emotions with WFI and FWI among Greek health‐care professionals.Design/methodology/approachThe research is a cross‐sectional study of 180 Greek doctors and 84 nurses using self‐report measures.FindingsResults indicated that, for doctors, surface acting at work was positively related to WFI and, for nurses, surface acting at home was positively related to FWI.Research limitations/implicationsThe respondents were sampled on a convenience basis and the non‐random procedure may have introduced unmeasured selection effects. The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally.Pract...

BioMed Research International, 2015

The aim of this study was to estimate the short term consequences of job insecurity associated wi... more The aim of this study was to estimate the short term consequences of job insecurity associated with a newly introduced mobility framework in Greece. In specific, the study examined the impact of job insecurity on anxiety, depression, and psychosomatic and musculoskeletal symptoms, two months after the announcement of the mobility framework. In addition the study also examined the “spill over” effects of job insecurity on employees not directly affected by the mobility framework. Personal interviews using a structured questionnaire were conducted for 36 university administrative employees awaiting repositioning, 36 coworkers not at risk, and 28 administrative employees of a local hospital not at risk. Compared to both control groups the employees in the anticipation phase of labor mobility had significantly worse scores for perceived stress, anxiety, depression, positive affect, negative affect, social support, marital discord, common somatic symptoms, and frequency of musculoskeleta...

Archives of Hellenic Medicine, 1999

ABSTRACT

Public Health, 2021

OBJECTIVES Ensuring access to care for all patients-especially those with life-threatening and ch... more OBJECTIVES Ensuring access to care for all patients-especially those with life-threatening and chronic conditions-during a pandemic is a challenge for all healthcare systems. During the COVID-19 pandemic, many countries faced excess mortality partly attributed to disruptions in essential healthcare services provision. This study aims to estimate the utilization of public primary care and hospital services during the COVID-19 epidemic in Greece and its potential association with excess non-COVID-19 mortality in the country. STUDY DESIGN This is an observational study. METHODS A retrospective analysis of national secondary utilization and mortality data from multiple official sources, covering the first nine months of the COVID-19 epidemic in Greece (February 26th to November 30th, 2020), was carried out. RESULTS Utilization rates of all public healthcare services during the first nine months of the epidemic dropped significantly compared to the average utilization rates of the 2017-19 control period; hospital admissions, hospital surgical procedures, and primary care visits dropped by 17.3% (95% CI: 6.6%-28.0%), 23.1% (95% CI: 7.3%-38.9%), and 24.8% (95% CI: 13.3%-36.3%) respectively. This underutilization of essential public services-mainly due to supply restrictions such as suspension of outpatient care and cancelation of elective surgeries-is most probably related to the 3778 excess non-COVID-19 deaths (representing 62% of all-cause excess deaths) that have been reported during the first 9 months of the epidemic in the country. CONCLUSIONS Greece's healthcare system, deeply wounded by the 2008-18 recession and austerity, was ill-resourced to cope with the challenges of the COVID-19 epidemic. Early and prolonged lockdowns have kept COVID-19 infections and deaths at relatively low levels. However, this "success" seems to have been accomplished at the expense of non-COVID-19 patients. It is important to acknowledge the "hidden epidemic" of unmet non-COVID-19 needs and increased non-COVID-19 deaths in the country and urgently strengthen public healthcare services to address it.

Clinical Nutrition, 2016

the digestive tract. We recommend that nutritive evaluation is necessary among these groups of ga... more the digestive tract. We recommend that nutritive evaluation is necessary among these groups of gastrointestinal patients.

L'Europe était, jusqu'il y a peu, un continent attractif grâce à sa combinaison réussie d... more L'Europe était, jusqu'il y a peu, un continent attractif grâce à sa combinaison réussie d'économies solides et de fortes protections sociales. Mais les temps changent, aujourd'hui tous les Etats sont en difficulté. Les auteurs de cet article montrent que le malheur des uns fait le bonheur des autres, que certains pompiers sont des pyromanes, que la misère augmente et que, heureusement, la colère gronde.

Clinical nephrology, 1999

Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administratio... more Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administration of calcitriol in hemodialysis patients. The current study evaluates the use of i.v. calcitriol dosing in relation to the severity of the HPTH in 35 hemodialysis patients with serum phosphate < 6.5 mg/dl. Arbitrarily, patients with plasma IPTH levels (intact PTH) between 288 and 576 pg/ml (288 pg/ml = four-fold the upper normal limit) were given initially 1 microg i.v. calcitriol at the end of each dialysis (group A, n = 15). Patients with IPTH between 577 and 864 pg/ml received 2 microg i.v. calcitriol (group B, n = 10) and patients with IPTH more than 865 pg/ml were given 3 - 4 microg i.v. calcitriol (group C, n = 10). As IPTH levels decreased, the dose of i.v. calcitriol was also decreased gradually. Patients were followed-up for 4 months after the end of calcitriol treatment. During the i.v. calcitriol treatment period, the observed plasma IPTH concentrations compared with the ba...

Intensive Care Medicine, 2006

To investigate the risk factors associated with nosocomial acquisition of imipenem-resistant Acin... more To investigate the risk factors associated with nosocomial acquisition of imipenem-resistant Acinetobacter baumannii (IRAB) among pediatric intensive care patients. A retrospective case control study was conducted in a pediatric intensive care unit (PICU). Cases were children in whom IRAB was isolated from any clinical specimen obtained at least 48 h following admission to PICU. Controls were children without IRAB matched to cases in 2:1 ratio. Twenty-six cases were matched with 52 controls according to the chronological order of admission. Between July 2001 and December 2003, 52 (62%) of 84 clinical A. baumannii isolates were found nonsusceptible to imipenem (MIC &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 8 microg/ml). Demographic variables, comorbid conditions, clinical picture at admission, invasive procedures, use of antimicrobials and other drugs were analyzed as potential risk factors. Use of carbapenems and other beta-lactams, aminoglycosides, ranitidine, mechanical ventilation, central venous or urinary catheters and length of stay in PICU were among the factors significantly associated with IRAB acquisition in the univariate analysis. By multivariate analysis, however, only aminoglycoside use and length of stay in the PICU were independent risk factors. Acquisition of IRAB by PICU patients was independently associated with aminoglycoside use and prolonged stay in the unit. Studies of evaluation of infection control policies need to be pursued.

BMC Health Services Research, 2011

Background: Empirical evidence on how ownership type affects the quality and cost of medical care... more Background: Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. Methods: Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. Results: PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities.

ABSTRACT OBJECTIVE Although valid instruments are available for measuring the educational environ... more ABSTRACT OBJECTIVE Although valid instruments are available for measuring the educational environment during the 6-year period of undergraduate medical study, there was no tool for measuring the end-product of the medical curriculum, i.e. the abilities of the “medical graduate”. The I CAN! questionnaire, based on the tuning-medicine project, is an instrument designed to measure this. The construction and validation of the questionnaire Greek, and graduates’ answers to the open question “if you could change one thing in your school, what would this be?” have been described elsewhere. The aim of this paper was to present how of the instrument works and the responses of medical graduates to its closed questions. METHOD The I CAN! questionnaire consists of 104 randomly arranged closed questions, based on the tuning-medicine level-two learning outcomes for undergraduate medical education in Europe, organized into 16 level-one outcomes, 12 for medical competencies and 4 for professionalism. The questionnaire was distributed to the graduates of Greek medical schools during the summer and autumn 2009 graduation. Their responses were coded (disagree absolutely=0, disagree=20, disagree moderately=40, agree moderately=60, agree=80, agree absolutely=100). The mean question, level-one outcomes and overall scores were calculated, and interpreted as: &lt;50 very poor, 50−60.9 poor, 61−70.9 fairly poor, 71−78.9 fairly good, 79−88.9 good, 89−100 very good. RESULTS Completed questionnaires were provided by 408 graduates of 6 medical schools, representing 55% of the total graduate population: 45% male, 55% female. They were graduates of the Universities of: Athens 148 (48% of graduates), Thessaloniki 147 (71%), Thrace 38 (81%), Ioannina 12 (17%), Crete 32 (47%), and Thessaly 31 (100%). On average they self-assessed their overall ability at 74% (i.e., in the “moderately good” interpretation zone), their ability to prescribe drugs 65% and to apply evidence-based medicine 68%, being a global doctor 80% and possessing professional atributes 83%. They considered themselves weaker in specific areas: Carrying out blood transfusion (37%), requesting autopsy (52%), administering intravenous therapy and using infusion devices (55%), completing correctly a death certificate (57%), matching appropriate drugs and other treatment to the clinical context (58%), and using diagnostic and therapeutic options available through other health professions (59%). They reported strength in: messuring blood pressure (96%), carrying out electrocardiography (92%), will to succeed (92%), maintaining confidentiality (91%), recognizing their own limits and asking for help (88%). CONCLUSIONS The I CAN! self-assessment questionnaire can identify the perceived strengths and weaknesses of medical graduates, offering the basis for implementation of a SWOT analysis (strengths, weaknesses, opportunities, threats) and evidence-based educational policy. Medical schools could use the instrument to monitor progress towards competence of tomorrow’s doctors, and to assess effectiveness of policy changes. If all Εuropean medical schools were to use it on every graduate cohort, a time series database could be created to serve administrative, research and other purposes.

Universal Journal of Educational Research, 2014

The Tuning-Medicine Project produced a set of 'level one' and 'level two' learning outcomes/ comp... more 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 2 nd-year, 4 th-year, 6 th-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.

JMIR Research Protocols, 2019

Hippokratia, 2011

BACKGROUND AND AIM Cervical cancer is one of the most common causes of cancer mortality among wom... more BACKGROUND AND AIM Cervical cancer is one of the most common causes of cancer mortality among women worldwide but it is one of the most preventable cancers due to the Pap smear test. The aim of this study was to estimate the participation rate of females in screening of cervical cancer with Pap smear test. METHODS The study took place in a hospital in Rural Northern Greece during April and May 2007. Convenience sampling was performed and questionnaires were completed by 214 eligible females aged 20-64 years. RESULTS One hundred and twenty four (57.9%) of the participants had had a Pap-test at some point in their lifetime. 72 of them (33.65%) had the test performed for the first time according to current guidelines. 13.6% were unaware about the recommended onset age of the test, 16.4% did not know the proper intervals, while 22.4% did not know the recommended upper age limit. 32.6% were informed by mass media, family members and friends. The take-up rates, the source of information a...

Public Health, 2021

Objectives: Ensuring access to care for all patients - especially those with life threatening and... more Objectives: Ensuring access to care for all patients - especially those with life threatening and chronic conditions - during a pandemic is a challenge for all healthcare systems. During the COVID-19 pandemic many countries faced excess mortality partly attributed to disruptions in essential healthcare services provision. This study aimed to estimate the utilization of public primary care and hospital services during the COVID-19 epidemic in Greece and its potential association with excess non-COVID-19 mortality in the country. Study design: Observational study Methods: Retrospective analysis of national secondary utilization and mortality data from multiple official sources, covering the first nine months of the COVID-19 epidemic in Greece (February 26th to November 30th, 2020). Results: Utilization rates of all public healthcare services during the first nine months of the epidemic dropped significantly compared to the average utilization rates of the 2017-19 control period; hospi...

The actual European answers to the world-wide crisis are premised on the strengthening of market,... more The actual European answers to the world-wide crisis are premised on the strengthening of market, mechanisms, combined with competition between countries to lower production costs, fiscal policies aimed at bailing out banks and corporations and ‘social dumping’. The inevitable consequences have been decreasing purchasing power of the population, decreasing public investments and a steady breakdown of social protection mechanisms. The dramatic public debt and the supposed ‘unsustainability’ of health and social security system is used as an argument to push for further privatization. An overview is given of the consequences of these policies in different European countries, and the case of Greece is analyzed in more depth. In order to express in practical terms a right to health in the structural adjustment era, a health system should be seen as a commons, not as a market, where priorities are set for the public good, risk is shared, and health providers are accountable to their comm...

ABSTRACT Starting in 1995, we follow for three years the 120 most important companies listed on t... more ABSTRACT Starting in 1995, we follow for three years the 120 most important companies listed on the paris Bourse and examine the link between stock trading characteristics and different measures of earnings&#39; surprises during annual and semi-annual public disclosures. After a short discussion of market organization and the regulation of financial disclosure in France, we assess intraday data to find analysts are overly optimistic of EPS and small companies are less analyzed than large ones. Studying further the evolution of portfolios sorted according to various unexpected earnings&#39; criteria we find that, in some cases, there is a small pre-announcement drift. The study further reveals that there is a strong negative drift in prices before a negative EPS announcement and bad news agitate markets more than good news. More importantly, we find the market responds to a hierarchy of announcement surprises: a positive EPS is not enough to make investors bullish if it is decreasing. Even an increasing EPS is not engough if analysts&#39; expectations are not met. Finally, prices adjust very quickly to public information but there is an imbalance between volume and trading intensity for the time necessary to settle back to their normal levels. This suggests institutional investors follow news more closely than small investors.

Statistical Methodology, 2004

We evaluate the performance of an extensive family of ARCH models in modelling daily Valueat-Risk... more We evaluate the performance of an extensive family of ARCH models in modelling daily Valueat-Risk (VaR) of perfectly diversified portfolios in five stock indices, using a number of distributional assumptions and sample sizes. We find, first, that leptokurtic distributions are able to produce better one-step-ahead VaR forecasts; second, the choice of sample size is important for the accuracy of the forecast, whereas the specification of the conditional mean is indifferent. Finally, the ARCH structure producing the most accurate forecasts is different for every portfolio and specific to each equity index.

Education for Primary Care, 2016

In the spirit of this special WONCA edition we would like to encourage readers to consider sharin... more In the spirit of this special WONCA edition we would like to encourage readers to consider sharing best educational practice across geographical, socioeconomic and cultural boundaries through internet-based collaborative working technologies.

Journal of Health Organization and Management, 2005

PurposeThe emotionally taxing nature of health‐care work has been increasingly recognized. In par... more PurposeThe emotionally taxing nature of health‐care work has been increasingly recognized. In parallel, the field of work and family has been searching for more specific antecedents of both work interference with family (WFI) and family interference with work (FWI). The current study aims to examine the relationship between surface acting and hiding negative emotions with WFI and FWI among Greek health‐care professionals.Design/methodology/approachThe research is a cross‐sectional study of 180 Greek doctors and 84 nurses using self‐report measures.FindingsResults indicated that, for doctors, surface acting at work was positively related to WFI and, for nurses, surface acting at home was positively related to FWI.Research limitations/implicationsThe respondents were sampled on a convenience basis and the non‐random procedure may have introduced unmeasured selection effects. The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally.Pract...

BioMed Research International, 2015

The aim of this study was to estimate the short term consequences of job insecurity associated wi... more The aim of this study was to estimate the short term consequences of job insecurity associated with a newly introduced mobility framework in Greece. In specific, the study examined the impact of job insecurity on anxiety, depression, and psychosomatic and musculoskeletal symptoms, two months after the announcement of the mobility framework. In addition the study also examined the “spill over” effects of job insecurity on employees not directly affected by the mobility framework. Personal interviews using a structured questionnaire were conducted for 36 university administrative employees awaiting repositioning, 36 coworkers not at risk, and 28 administrative employees of a local hospital not at risk. Compared to both control groups the employees in the anticipation phase of labor mobility had significantly worse scores for perceived stress, anxiety, depression, positive affect, negative affect, social support, marital discord, common somatic symptoms, and frequency of musculoskeleta...

Archives of Hellenic Medicine, 1999

ABSTRACT

Public Health, 2021

OBJECTIVES Ensuring access to care for all patients-especially those with life-threatening and ch... more OBJECTIVES Ensuring access to care for all patients-especially those with life-threatening and chronic conditions-during a pandemic is a challenge for all healthcare systems. During the COVID-19 pandemic, many countries faced excess mortality partly attributed to disruptions in essential healthcare services provision. This study aims to estimate the utilization of public primary care and hospital services during the COVID-19 epidemic in Greece and its potential association with excess non-COVID-19 mortality in the country. STUDY DESIGN This is an observational study. METHODS A retrospective analysis of national secondary utilization and mortality data from multiple official sources, covering the first nine months of the COVID-19 epidemic in Greece (February 26th to November 30th, 2020), was carried out. RESULTS Utilization rates of all public healthcare services during the first nine months of the epidemic dropped significantly compared to the average utilization rates of the 2017-19 control period; hospital admissions, hospital surgical procedures, and primary care visits dropped by 17.3% (95% CI: 6.6%-28.0%), 23.1% (95% CI: 7.3%-38.9%), and 24.8% (95% CI: 13.3%-36.3%) respectively. This underutilization of essential public services-mainly due to supply restrictions such as suspension of outpatient care and cancelation of elective surgeries-is most probably related to the 3778 excess non-COVID-19 deaths (representing 62% of all-cause excess deaths) that have been reported during the first 9 months of the epidemic in the country. CONCLUSIONS Greece's healthcare system, deeply wounded by the 2008-18 recession and austerity, was ill-resourced to cope with the challenges of the COVID-19 epidemic. Early and prolonged lockdowns have kept COVID-19 infections and deaths at relatively low levels. However, this "success" seems to have been accomplished at the expense of non-COVID-19 patients. It is important to acknowledge the "hidden epidemic" of unmet non-COVID-19 needs and increased non-COVID-19 deaths in the country and urgently strengthen public healthcare services to address it.

Clinical Nutrition, 2016

the digestive tract. We recommend that nutritive evaluation is necessary among these groups of ga... more the digestive tract. We recommend that nutritive evaluation is necessary among these groups of gastrointestinal patients.

L'Europe était, jusqu'il y a peu, un continent attractif grâce à sa combinaison réussie d... more L'Europe était, jusqu'il y a peu, un continent attractif grâce à sa combinaison réussie d'économies solides et de fortes protections sociales. Mais les temps changent, aujourd'hui tous les Etats sont en difficulté. Les auteurs de cet article montrent que le malheur des uns fait le bonheur des autres, que certains pompiers sont des pyromanes, que la misère augmente et que, heureusement, la colère gronde.

Clinical nephrology, 1999

Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administratio... more Effective treatment of secondary hyperparathyroidism (HPTH) with intravenous (i.v.) administration of calcitriol in hemodialysis patients. The current study evaluates the use of i.v. calcitriol dosing in relation to the severity of the HPTH in 35 hemodialysis patients with serum phosphate < 6.5 mg/dl. Arbitrarily, patients with plasma IPTH levels (intact PTH) between 288 and 576 pg/ml (288 pg/ml = four-fold the upper normal limit) were given initially 1 microg i.v. calcitriol at the end of each dialysis (group A, n = 15). Patients with IPTH between 577 and 864 pg/ml received 2 microg i.v. calcitriol (group B, n = 10) and patients with IPTH more than 865 pg/ml were given 3 - 4 microg i.v. calcitriol (group C, n = 10). As IPTH levels decreased, the dose of i.v. calcitriol was also decreased gradually. Patients were followed-up for 4 months after the end of calcitriol treatment. During the i.v. calcitriol treatment period, the observed plasma IPTH concentrations compared with the ba...

Intensive Care Medicine, 2006

To investigate the risk factors associated with nosocomial acquisition of imipenem-resistant Acin... more To investigate the risk factors associated with nosocomial acquisition of imipenem-resistant Acinetobacter baumannii (IRAB) among pediatric intensive care patients. A retrospective case control study was conducted in a pediatric intensive care unit (PICU). Cases were children in whom IRAB was isolated from any clinical specimen obtained at least 48 h following admission to PICU. Controls were children without IRAB matched to cases in 2:1 ratio. Twenty-six cases were matched with 52 controls according to the chronological order of admission. Between July 2001 and December 2003, 52 (62%) of 84 clinical A. baumannii isolates were found nonsusceptible to imipenem (MIC &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 8 microg/ml). Demographic variables, comorbid conditions, clinical picture at admission, invasive procedures, use of antimicrobials and other drugs were analyzed as potential risk factors. Use of carbapenems and other beta-lactams, aminoglycosides, ranitidine, mechanical ventilation, central venous or urinary catheters and length of stay in PICU were among the factors significantly associated with IRAB acquisition in the univariate analysis. By multivariate analysis, however, only aminoglycoside use and length of stay in the PICU were independent risk factors. Acquisition of IRAB by PICU patients was independently associated with aminoglycoside use and prolonged stay in the unit. Studies of evaluation of infection control policies need to be pursued.

BMC Health Services Research, 2011

Background: Empirical evidence on how ownership type affects the quality and cost of medical care... more Background: Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. Methods: Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. Results: PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities.

ABSTRACT OBJECTIVE Although valid instruments are available for measuring the educational environ... more ABSTRACT OBJECTIVE Although valid instruments are available for measuring the educational environment during the 6-year period of undergraduate medical study, there was no tool for measuring the end-product of the medical curriculum, i.e. the abilities of the “medical graduate”. The I CAN! questionnaire, based on the tuning-medicine project, is an instrument designed to measure this. The construction and validation of the questionnaire Greek, and graduates’ answers to the open question “if you could change one thing in your school, what would this be?” have been described elsewhere. The aim of this paper was to present how of the instrument works and the responses of medical graduates to its closed questions. METHOD The I CAN! questionnaire consists of 104 randomly arranged closed questions, based on the tuning-medicine level-two learning outcomes for undergraduate medical education in Europe, organized into 16 level-one outcomes, 12 for medical competencies and 4 for professionalism. The questionnaire was distributed to the graduates of Greek medical schools during the summer and autumn 2009 graduation. Their responses were coded (disagree absolutely=0, disagree=20, disagree moderately=40, agree moderately=60, agree=80, agree absolutely=100). The mean question, level-one outcomes and overall scores were calculated, and interpreted as: &lt;50 very poor, 50−60.9 poor, 61−70.9 fairly poor, 71−78.9 fairly good, 79−88.9 good, 89−100 very good. RESULTS Completed questionnaires were provided by 408 graduates of 6 medical schools, representing 55% of the total graduate population: 45% male, 55% female. They were graduates of the Universities of: Athens 148 (48% of graduates), Thessaloniki 147 (71%), Thrace 38 (81%), Ioannina 12 (17%), Crete 32 (47%), and Thessaly 31 (100%). On average they self-assessed their overall ability at 74% (i.e., in the “moderately good” interpretation zone), their ability to prescribe drugs 65% and to apply evidence-based medicine 68%, being a global doctor 80% and possessing professional atributes 83%. They considered themselves weaker in specific areas: Carrying out blood transfusion (37%), requesting autopsy (52%), administering intravenous therapy and using infusion devices (55%), completing correctly a death certificate (57%), matching appropriate drugs and other treatment to the clinical context (58%), and using diagnostic and therapeutic options available through other health professions (59%). They reported strength in: messuring blood pressure (96%), carrying out electrocardiography (92%), will to succeed (92%), maintaining confidentiality (91%), recognizing their own limits and asking for help (88%). CONCLUSIONS The I CAN! self-assessment questionnaire can identify the perceived strengths and weaknesses of medical graduates, offering the basis for implementation of a SWOT analysis (strengths, weaknesses, opportunities, threats) and evidence-based educational policy. Medical schools could use the instrument to monitor progress towards competence of tomorrow’s doctors, and to assess effectiveness of policy changes. If all Εuropean medical schools were to use it on every graduate cohort, a time series database could be created to serve administrative, research and other purposes.

Universal Journal of Educational Research, 2014

The Tuning-Medicine Project produced a set of 'level one' and 'level two' learning outcomes/ comp... more 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 2 nd-year, 4 th-year, 6 th-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.

JMIR Research Protocols, 2019

Hippokratia, 2011

BACKGROUND AND AIM Cervical cancer is one of the most common causes of cancer mortality among wom... more BACKGROUND AND AIM Cervical cancer is one of the most common causes of cancer mortality among women worldwide but it is one of the most preventable cancers due to the Pap smear test. The aim of this study was to estimate the participation rate of females in screening of cervical cancer with Pap smear test. METHODS The study took place in a hospital in Rural Northern Greece during April and May 2007. Convenience sampling was performed and questionnaires were completed by 214 eligible females aged 20-64 years. RESULTS One hundred and twenty four (57.9%) of the participants had had a Pap-test at some point in their lifetime. 72 of them (33.65%) had the test performed for the first time according to current guidelines. 13.6% were unaware about the recommended onset age of the test, 16.4% did not know the proper intervals, while 22.4% did not know the recommended upper age limit. 32.6% were informed by mass media, family members and friends. The take-up rates, the source of information a...

Public Health, 2021

Objectives: Ensuring access to care for all patients - especially those with life threatening and... more Objectives: Ensuring access to care for all patients - especially those with life threatening and chronic conditions - during a pandemic is a challenge for all healthcare systems. During the COVID-19 pandemic many countries faced excess mortality partly attributed to disruptions in essential healthcare services provision. This study aimed to estimate the utilization of public primary care and hospital services during the COVID-19 epidemic in Greece and its potential association with excess non-COVID-19 mortality in the country. Study design: Observational study Methods: Retrospective analysis of national secondary utilization and mortality data from multiple official sources, covering the first nine months of the COVID-19 epidemic in Greece (February 26th to November 30th, 2020). Results: Utilization rates of all public healthcare services during the first nine months of the epidemic dropped significantly compared to the average utilization rates of the 2017-19 control period; hospi...

The actual European answers to the world-wide crisis are premised on the strengthening of market,... more The actual European answers to the world-wide crisis are premised on the strengthening of market, mechanisms, combined with competition between countries to lower production costs, fiscal policies aimed at bailing out banks and corporations and ‘social dumping’. The inevitable consequences have been decreasing purchasing power of the population, decreasing public investments and a steady breakdown of social protection mechanisms. The dramatic public debt and the supposed ‘unsustainability’ of health and social security system is used as an argument to push for further privatization. An overview is given of the consequences of these policies in different European countries, and the case of Greece is analyzed in more depth. In order to express in practical terms a right to health in the structural adjustment era, a health system should be seen as a commons, not as a market, where priorities are set for the public good, risk is shared, and health providers are accountable to their comm...

ABSTRACT Starting in 1995, we follow for three years the 120 most important companies listed on t... more ABSTRACT Starting in 1995, we follow for three years the 120 most important companies listed on the paris Bourse and examine the link between stock trading characteristics and different measures of earnings&#39; surprises during annual and semi-annual public disclosures. After a short discussion of market organization and the regulation of financial disclosure in France, we assess intraday data to find analysts are overly optimistic of EPS and small companies are less analyzed than large ones. Studying further the evolution of portfolios sorted according to various unexpected earnings&#39; criteria we find that, in some cases, there is a small pre-announcement drift. The study further reveals that there is a strong negative drift in prices before a negative EPS announcement and bad news agitate markets more than good news. More importantly, we find the market responds to a hierarchy of announcement surprises: a positive EPS is not enough to make investors bullish if it is decreasing. Even an increasing EPS is not engough if analysts&#39; expectations are not met. Finally, prices adjust very quickly to public information but there is an imbalance between volume and trading intensity for the time necessary to settle back to their normal levels. This suggests institutional investors follow news more closely than small investors.

Statistical Methodology, 2004

We evaluate the performance of an extensive family of ARCH models in modelling daily Valueat-Risk... more We evaluate the performance of an extensive family of ARCH models in modelling daily Valueat-Risk (VaR) of perfectly diversified portfolios in five stock indices, using a number of distributional assumptions and sample sizes. We find, first, that leptokurtic distributions are able to produce better one-step-ahead VaR forecasts; second, the choice of sample size is important for the accuracy of the forecast, whereas the specification of the conditional mean is indifferent. Finally, the ARCH structure producing the most accurate forecasts is different for every portfolio and specific to each equity index.

Lancet - University of Oslo Commission on Global Governance for Health, 2013