Dimitra Sifaki-pistolla - Academia.edu (original) (raw)
Papers by Dimitra Sifaki-pistolla
International Journal of Environmental Research and Public Health
(1) Background: Access to laboratory testing services for HIV in Greece is persistently challenge... more (1) Background: Access to laboratory testing services for HIV in Greece is persistently challenged and this impacts both the continuum of care and, potentially, equity in access. (2) Methods: A cross-sectional study with two parts (first part: HIV-positive people/PLWHIV; second part: HIV clinicians) was conducted in Greece to quantify challenges regarding access to laboratory testing for HIV. Data were collected through online surveys, during a one-month period, between 2019 and 2020. The total sample consisted of 153 PLWHIV and 26 HIV clinicians. (3) Results: Access to viral load testing varied significantly according to place of residence (p = 0.029) and year of diagnosis (p = 0.054). Patients diagnosed after 2015 reported worse access to viral load testing (72.7% vs. 85.9%). Over one third of respondents perceived viral load tests as being not at all accessible (11.4%) or somewhat accessible, only after facing multiple systemic obstacles (24.2%). Equally, most of HIV clinicians reported barriers or no access to baseline viral load testing (80%) and baseline genotype resistance tests (96%). (4) Conclusions: Access of people diagnosed with HIV to CD4 lymphocyte tests and genotype resistance screening is significantly challenged in Greece, especially after 2015. Addressing this challenge is critical in removing access barriers and achieving the UNAIDS 95-95-95 HIV elimination goals.
International Journal of Environmental Research and Public Health
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health
Liver cancer is one of the most frequent cancers in Europe and Greece. An increase in specific ri... more Liver cancer is one of the most frequent cancers in Europe and Greece. An increase in specific risk factors, such as metabolic syndrome and obesity, has been observed in Greece. Therefore, exploring temporal trends of liver cancer incidence and mortality is crucial. This study aims to assess the “burden” of malignant liver tumors (MLT) in Crete, Greece, in terms of incidence and mortality rates, and identify the high-risk areas on the island (i.e., municipalities), to suggest public health measures. Data were obtained from the Cancer Registry Center (CRC) and included all cases of MLT for the period 1992–2013 in Crete. Age-standardized incidence rates (ASIR), age-specific incidence rates (ASpIR), age-standardized mortality rates (ASMR), and age-specific mortality rates (ASpMR) were estimated. For the study period (1992–2013), incidence and mortality showed an increasing trend. Mean ASIR was found 15.3/100,000/year and mean ASMR 8.6/100,000/year. Age groups 65–69 and 75–79 years amon...
Background Breast cancer incidence is rising globally. Mortality rates show a heterogenous patter... more Background Breast cancer incidence is rising globally. Mortality rates show a heterogenous pattern, where geographical disparities might indicate influence of health policy, behavior and care provision. Early detection and treatment have been proven to have a profound impact on prognosis. Methods Breast cancer data from Sweden and Crete was derived from registries. Incidence and mortality were expressed as Age-Standardized Incidence Rates (ASIR), Age-Standardized Mortality Rates (ASMR) and survival as intervals of three consecutive enrolling years. Findings Incidence of breast cancer has for decades risen in Sweden and also on Crete. In 2019, ASIR was 217.5 in Sweden and 58.9 on Crete, (p < 0.001). Mortality rates, however, showed opposite trends. ASMR was higher on Crete (25/100.000 person years) than in Sweden (17/100.000 person years) (p = 0.04). ASMR has fallen in Sweden from 25.5 to 16.8 in the period 2005–2019, while on Crete, ASMR continued to rise from 22.1 to 25.3. Since...
Vaccines
Existing research on the association between COVID-19 vaccination and quantitatively measured men... more Existing research on the association between COVID-19 vaccination and quantitatively measured mental health outcomes is scarce. We conducted a cross-sectional telephone survey on a random sample of 1039 adult Greek citizens in June 2021. Among the participants, 39.6% were vaccinated with two doses, 23.1% with one dose, 21.4% were planning to become vaccinated later, and 8.1% refused vaccination. Compared to those fully vaccinated, those against vaccination (“deniers”) and those who planned to do so later on (“not vaccinated yet”) had significantly higher scores across three stress, anxiety, and depression construct scales. Our findings suggest an association between COVID-19 vaccination status and mental health.
Health & Social Care in the Community, 2021
The number of people living with chronic conditions is increasing worldwide with most of these pe... more The number of people living with chronic conditions is increasing worldwide with most of these people receiving the needed healthcare services in primary healthcare (PHC) settings. The objective of this study was to explore the main challenges and barriers that PHC providers confront while treating multimorbid patients. This is a qualitative study utilising semi-structured individual in-depth interviews. The study took place in Vlora City, which is the biggest city located in south Albania. Τhe two biggest PHC centres of the city were enrolled. Purposive sampling method was used to recruit PHC practitioners. Main criteria of participation in the study were being fully employed at the enrolled primary care centres, having worked for at least 1 year and to deal with multimorbid patients in daily practice. Data collection took place from September 2019 to January 2020. In total, 36 semi-structured interviews took place with 23 (63.9%) nurses and 12 (33.3%) physicians (general practitioners/family doctors). Communication problems and disputes, lack of materials/equipment and the inappropriate infrastructure, miscommunication and problems in doctor-nurse relationships, coordination problems, lack of protocols and problems in the referral system were reported as the main challenges and barriers that the PHC personnel confront. The findings of this study are critical in understanding challenges that PHC personnel face when dealing with multimorbid patients in PHC settings. The emerged knowledge contributes significantly in a better understanding of the actual situation and to inform health policy makers on how to deal with the existing problems.
Introduction: Health status measurement with CAT has been proposed for COPD management in the upd... more Introduction: Health status measurement with CAT has been proposed for COPD management in the updated GOLD guidelines. We aimed to investigate CAT score correlation with AECOPD and comorbidity in a Greek cohort of COPD patients Methods: Data were selected from 544 COPD patients from Greece through a prospective cross-sectional study, attending primary health care units. Demographic data, previous treatment, lung function testing,exacerbations and co-morbidity were recorded. Chi-square test, bivariate Pearson r correlation and binary logistic regression were applied on data regarding the CAT score, FEV 1 (% pred.), FEV 1 /FVC (%) and certain clinical parameters of the disease. Results : CAT scores classification percentages showed: 38% mild CAT score, medium impact level 46%, severe score 15% and very severe score 1.0%. 56.9% of the patients with exacerbated disease had medium CAT score while the 19.6% of them a high impact score (p Conclusions : The co-existence of other diseases wi...
Occupational and environmental health, 2021
Η παρούσα διατριβή είχε ως στόχο τη διερεύνηση του φορτίου του καρκίνου του πνεύμονα στην Κρήτη γ... more Η παρούσα διατριβή είχε ως στόχο τη διερεύνηση του φορτίου του καρκίνου του πνεύμονα στην Κρήτη για δύο δεκαετίες, μέσω της χρήσης πληθυσμιακών δεδομένων για την επίπτωση, τη θνησιμότητα και την επιβίωση. Επιπρόσθετα, επιμέρους στόχοι ήσαν: α) η χαρτογράφηση των δεικτών επίπτωσης και θνησιμότητας ανά Δήμο στην Κρήτη και η χωρο-χρονική τους μελέτη, β) η διερεύνηση των χωρο-χρονικών τάσεων και η ανάδειξη των γεωγραφικών συστάδων (spatial clusters) τα νόσου, γ) η αναζήτηση των κύριων παραγόντων κινδύνου, συμπεριλαμβανομένων των δημογραφικών στοιχείων, των κοινωνικών, οικονομικών και συμπεριφοριστικών χαρακτηριστικών, του κλινικού προφίλ των ασθενών και επιλεγμένων περιβαλλοντικών εκθέσεων (outdoor air pollution). Ιδιαίτερη έμφαση δόθηκε στο ρόλο του καπνίσματος και στους υπό μελέτη ρύπους (PM2,5, PM10, PM2,5-10, PM2,5 absorbance, NO2, NOx), καθώς και στο ρόλο της οικονομικής κρίσης στη θνησιμότητα από καρκίνο του πνεύμονα. Χρησιμοποιήθηκαν δεδομένα από το 1992 έως το 2013, τα οποία συλ...
Journal of Interprofessional Care, 2019
Interprofessional teamwork in health-care settings is considered a valuable means of enhancing pa... more Interprofessional teamwork in health-care settings is considered a valuable means of enhancing patient management. Literature has highlighted the importance of trust in building effective health-care teams. The present study aimed to investigate and further understand the perceptions of health-care professionals regarding trust and performance within their working team, as well as to assess the association between them and team performance. "TRUST" questionnaire, a valid instrument for measuring the relationship of trust and team performance was distributed to the members of the perioperative teams located in two different hospitals (a University and a General Hospital) in Greece. Two multivariate linear regression models were developed to reveal the significant predictors of high performance per hospital. Among the major findings revealed were 1) trust and performance were closely related 2) slight yet significant variations were observed between the University and the General Hospital and 3) trust level, years of previous experience and number of team members were among the key predictors of effective team performance. This study conveys new knowledge on trust and performance within health-care settings with limited resources and is expected to guide future interventions aiming to enhance team performance.
Microscopy Research and Technique, 2016
The Local Polynomial Approximation (LPA) is a nonparametric filter that performs pixel-wise polyn... more The Local Polynomial Approximation (LPA) is a nonparametric filter that performs pixel-wise polynomial fit on a certain neighborhood. This filter can be supported by the Intersection of Confidence Interval rule (ICI) as an adaptation algorithm to identify the most suited neighborhood at which the polynomial assumptions provide superior fit for the observations. However, the LPA-ICI is considered to be a near-optimal de-noising filter. Moreover, the ICI rule has several parameters that affect its performance. The current study applied an optimization algorithm, namely the Particle swarm optimization (PSO) to determine the optimal ICI parameter values for microscopic images de-noising. As the ICI parameters are image's structure based, bag-of-features classifier is used to classify the images based on their structure into different classes. Afterward, a generated optimal ICI parameters' table was created using the LPA-ICI-PSO for further direct use without optimization. This table included the optimal ICI parameters based on the image structure. Based on the image category, the generated table can be used to attain the suitable ICI optimal parameters without using PSO. This guarantees less computational time along with the optimal de-noising compared to the LPA-ICI as established by the performance metrics. The experimental results established the superiority of the proposed LPA-ICI-PSO over the classical LPA-ICI filter.
Social Psychiatry and Psychiatric Epidemiology, 2016
Purpose During the European refugee crisis, numerous Greek and international rescue workers are o... more Purpose During the European refugee crisis, numerous Greek and international rescue workers are operating in Lesvos, offering search, rescue, and first aid services. Exposure to stressful life events while engaging in this rescue work can result in developing Post-Traumatic Stress Disorder (PTSD). The study aimed to assess the prevalence of PTSD and explore potential differences between different categories of rescuers. Methods A cross-sectional study was conducted among 217 rescue workers. Participants were grouped according to affiliation: ''Greek Professionals Rescuers/GPR'', ''International Professionals Rescuers/IPR'' and ''Volunteer Rescuers/VR''. The PTSD Checklist-Civilian Version (PCL-C) was utilized. All tests were two-tailed (a = 0.05). Mann-Whitney, Kruskal-Wallis, and multivariate logistic regression were performed. Results Overall probable PTSD prevalence found was 17.1%. Rates varied significantly per rescuer's category; 23.1% in GPR, 11.8% in IPR, and 14.6% in VR (p = 0.02). GPR demonstrated the highest risk compared to IPR and VR (p \ 0.001). Females had approximately two times higher risk. Other significant risk factors included marital status, age, and number of children. Lack of previous experience, longer operation period, longer shift hours, and handling dead refugees and dead children were also considered major risk factors. Conclusions Rescue workers providing substantial aid to the refugees and migrants at Lesvos experience significant psychological distress. The present findings indicate the urgent need for targeted interventions. Further studies are needed to address long-term effects of the refugee crisis on rescuers, and explore effective measures to prevent PTSD.
Primary Care Diabetes, 2020
AIMS To determine the prevalence of type-2 diabetes patients that were initially and currently be... more AIMS To determine the prevalence of type-2 diabetes patients that were initially and currently being treated by primary care physicians (PCPs) or diabetes specialists and assess predictors influencing their choice. METHODS This cross-sectional study was conducted in nine Greek primary healthcare units. Patients' choices were modeled using a bivariate probit analysis. RESULTS A total of 225 patients participated (84% response rate). Only 15.9% and 11.9% of the respondents acknowledged having chosen a diabetes specialist for their initial or current treatment, respectively. The family history of diabetes in siblings and the screening for diabetic retinopathy during the past year were significantly positively associated with choosing a diabetes specialist (initially p=0.033 or currently p=0.007), and resulted in a statistically significant reduction of the joint probabilities of choosing a PCP by 15.6% and 13.6%, respectively. Younger age (p=0.040), female sex (p=0.017), higher HbA1c (p=0.004), experience of hypoglycemia (p=0.029) and low cardiovascular morbidity index (p=0.016) emerged as important predictors for choosing a diabetes specialist for their treatment. CONCLUSIONS Our findings provide a better insight in diabetes patients' choices regarding the category of their treating physicians and their predictors. More studies are required to replicate them and identify patient subpopulations that may favor diabetes specialists' guidance.
Optimal processes workflows for patients in need of home care services. Distributed the optimal p... more Optimal processes workflows for patients in need of home care services. Distributed the optimal patient flows within the PHC units (i.e. home care), as they are proposed by the project. It depicts the processes workflows of patients in need of home care service. (JPEG 4616 kb)
Optimal processes workflow for patients with chronic disease. Distributed the optimal patient flo... more Optimal processes workflow for patients with chronic disease. Distributed the optimal patient flows within the PHC units, as they are proposed by the project. It depicts the processes workflows of patients with chronic conditions seeking for PHC services. (JPEG 150 kb)
Acta of bioengineering and biomechanics, 2017
PURPOSE The present study aims to explore relationships between footedness and posturographic ass... more PURPOSE The present study aims to explore relationships between footedness and posturographic assessment in children aged from 4 to 10. A real-time computerised device was used on a force plate for movement analysis. It requires a static posturography to assess postural control of children with the same handedness and footedness. METHODS Thirty eight right-handed and right-footed children organized in three age groups of 4 to 6 years old, 6 to 8 years old and 8 to 10 years old participated in the study. Two statical tests, the Unilateral Stance (US) and the Weight Bearing Squat (WBS) were performed, jointly with a dynamic balance examination (Limits of Stability (LOS)). All these tests were executed to explore the body capability of the right/left side. RESULTS The study demonstrated significant differences involving the right/left side among the three age groups. Better performance on the youngest children's right part and on the oldest children's left part was observed. Di...
BMC Pulmonary Medicine, 2020
Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treat... more Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treatment goals, health status and disease control in chronic obstructive pulmonary disease (COPD). Aim of the study was to assess levels of adherence to inhalers, comorbidities and associations with COPD outcomes in patients residing in rural and semi-urban areas of Greece. Methods Two hundred fifty-seven COPD patients were enrolled from primary health care in 2015–2016. Physicians used structured interviews and questionnaires to assess quality of life and disease status. Patients were classified into groups according to GOLD 2019 guidelines (based on CAT and mMRC). Adherence to inhalers was measured with the Test of Adherence to Inhalers (TAI). Multivariate linear and logistics regression models were used to assess associations between comorbidities and adherence to inhalers with COPD outcomes, including CAT and mMRC scores, exacerbations and GOLD A-D status. Results 74.1% of COPD patients ...
npj Primary Care Respiratory Medicine, 2020
An amendment to this paper has been published and can be accessed via a link at the top of the pa... more An amendment to this paper has been published and can be accessed via a link at the top of the paper.
International Journal of Environmental Research and Public Health
(1) Background: Access to laboratory testing services for HIV in Greece is persistently challenge... more (1) Background: Access to laboratory testing services for HIV in Greece is persistently challenged and this impacts both the continuum of care and, potentially, equity in access. (2) Methods: A cross-sectional study with two parts (first part: HIV-positive people/PLWHIV; second part: HIV clinicians) was conducted in Greece to quantify challenges regarding access to laboratory testing for HIV. Data were collected through online surveys, during a one-month period, between 2019 and 2020. The total sample consisted of 153 PLWHIV and 26 HIV clinicians. (3) Results: Access to viral load testing varied significantly according to place of residence (p = 0.029) and year of diagnosis (p = 0.054). Patients diagnosed after 2015 reported worse access to viral load testing (72.7% vs. 85.9%). Over one third of respondents perceived viral load tests as being not at all accessible (11.4%) or somewhat accessible, only after facing multiple systemic obstacles (24.2%). Equally, most of HIV clinicians reported barriers or no access to baseline viral load testing (80%) and baseline genotype resistance tests (96%). (4) Conclusions: Access of people diagnosed with HIV to CD4 lymphocyte tests and genotype resistance screening is significantly challenged in Greece, especially after 2015. Addressing this challenge is critical in removing access barriers and achieving the UNAIDS 95-95-95 HIV elimination goals.
International Journal of Environmental Research and Public Health
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
International Journal of Environmental Research and Public Health
Liver cancer is one of the most frequent cancers in Europe and Greece. An increase in specific ri... more Liver cancer is one of the most frequent cancers in Europe and Greece. An increase in specific risk factors, such as metabolic syndrome and obesity, has been observed in Greece. Therefore, exploring temporal trends of liver cancer incidence and mortality is crucial. This study aims to assess the “burden” of malignant liver tumors (MLT) in Crete, Greece, in terms of incidence and mortality rates, and identify the high-risk areas on the island (i.e., municipalities), to suggest public health measures. Data were obtained from the Cancer Registry Center (CRC) and included all cases of MLT for the period 1992–2013 in Crete. Age-standardized incidence rates (ASIR), age-specific incidence rates (ASpIR), age-standardized mortality rates (ASMR), and age-specific mortality rates (ASpMR) were estimated. For the study period (1992–2013), incidence and mortality showed an increasing trend. Mean ASIR was found 15.3/100,000/year and mean ASMR 8.6/100,000/year. Age groups 65–69 and 75–79 years amon...
Background Breast cancer incidence is rising globally. Mortality rates show a heterogenous patter... more Background Breast cancer incidence is rising globally. Mortality rates show a heterogenous pattern, where geographical disparities might indicate influence of health policy, behavior and care provision. Early detection and treatment have been proven to have a profound impact on prognosis. Methods Breast cancer data from Sweden and Crete was derived from registries. Incidence and mortality were expressed as Age-Standardized Incidence Rates (ASIR), Age-Standardized Mortality Rates (ASMR) and survival as intervals of three consecutive enrolling years. Findings Incidence of breast cancer has for decades risen in Sweden and also on Crete. In 2019, ASIR was 217.5 in Sweden and 58.9 on Crete, (p < 0.001). Mortality rates, however, showed opposite trends. ASMR was higher on Crete (25/100.000 person years) than in Sweden (17/100.000 person years) (p = 0.04). ASMR has fallen in Sweden from 25.5 to 16.8 in the period 2005–2019, while on Crete, ASMR continued to rise from 22.1 to 25.3. Since...
Vaccines
Existing research on the association between COVID-19 vaccination and quantitatively measured men... more Existing research on the association between COVID-19 vaccination and quantitatively measured mental health outcomes is scarce. We conducted a cross-sectional telephone survey on a random sample of 1039 adult Greek citizens in June 2021. Among the participants, 39.6% were vaccinated with two doses, 23.1% with one dose, 21.4% were planning to become vaccinated later, and 8.1% refused vaccination. Compared to those fully vaccinated, those against vaccination (“deniers”) and those who planned to do so later on (“not vaccinated yet”) had significantly higher scores across three stress, anxiety, and depression construct scales. Our findings suggest an association between COVID-19 vaccination status and mental health.
Health & Social Care in the Community, 2021
The number of people living with chronic conditions is increasing worldwide with most of these pe... more The number of people living with chronic conditions is increasing worldwide with most of these people receiving the needed healthcare services in primary healthcare (PHC) settings. The objective of this study was to explore the main challenges and barriers that PHC providers confront while treating multimorbid patients. This is a qualitative study utilising semi-structured individual in-depth interviews. The study took place in Vlora City, which is the biggest city located in south Albania. Τhe two biggest PHC centres of the city were enrolled. Purposive sampling method was used to recruit PHC practitioners. Main criteria of participation in the study were being fully employed at the enrolled primary care centres, having worked for at least 1 year and to deal with multimorbid patients in daily practice. Data collection took place from September 2019 to January 2020. In total, 36 semi-structured interviews took place with 23 (63.9%) nurses and 12 (33.3%) physicians (general practitioners/family doctors). Communication problems and disputes, lack of materials/equipment and the inappropriate infrastructure, miscommunication and problems in doctor-nurse relationships, coordination problems, lack of protocols and problems in the referral system were reported as the main challenges and barriers that the PHC personnel confront. The findings of this study are critical in understanding challenges that PHC personnel face when dealing with multimorbid patients in PHC settings. The emerged knowledge contributes significantly in a better understanding of the actual situation and to inform health policy makers on how to deal with the existing problems.
Introduction: Health status measurement with CAT has been proposed for COPD management in the upd... more Introduction: Health status measurement with CAT has been proposed for COPD management in the updated GOLD guidelines. We aimed to investigate CAT score correlation with AECOPD and comorbidity in a Greek cohort of COPD patients Methods: Data were selected from 544 COPD patients from Greece through a prospective cross-sectional study, attending primary health care units. Demographic data, previous treatment, lung function testing,exacerbations and co-morbidity were recorded. Chi-square test, bivariate Pearson r correlation and binary logistic regression were applied on data regarding the CAT score, FEV 1 (% pred.), FEV 1 /FVC (%) and certain clinical parameters of the disease. Results : CAT scores classification percentages showed: 38% mild CAT score, medium impact level 46%, severe score 15% and very severe score 1.0%. 56.9% of the patients with exacerbated disease had medium CAT score while the 19.6% of them a high impact score (p Conclusions : The co-existence of other diseases wi...
Occupational and environmental health, 2021
Η παρούσα διατριβή είχε ως στόχο τη διερεύνηση του φορτίου του καρκίνου του πνεύμονα στην Κρήτη γ... more Η παρούσα διατριβή είχε ως στόχο τη διερεύνηση του φορτίου του καρκίνου του πνεύμονα στην Κρήτη για δύο δεκαετίες, μέσω της χρήσης πληθυσμιακών δεδομένων για την επίπτωση, τη θνησιμότητα και την επιβίωση. Επιπρόσθετα, επιμέρους στόχοι ήσαν: α) η χαρτογράφηση των δεικτών επίπτωσης και θνησιμότητας ανά Δήμο στην Κρήτη και η χωρο-χρονική τους μελέτη, β) η διερεύνηση των χωρο-χρονικών τάσεων και η ανάδειξη των γεωγραφικών συστάδων (spatial clusters) τα νόσου, γ) η αναζήτηση των κύριων παραγόντων κινδύνου, συμπεριλαμβανομένων των δημογραφικών στοιχείων, των κοινωνικών, οικονομικών και συμπεριφοριστικών χαρακτηριστικών, του κλινικού προφίλ των ασθενών και επιλεγμένων περιβαλλοντικών εκθέσεων (outdoor air pollution). Ιδιαίτερη έμφαση δόθηκε στο ρόλο του καπνίσματος και στους υπό μελέτη ρύπους (PM2,5, PM10, PM2,5-10, PM2,5 absorbance, NO2, NOx), καθώς και στο ρόλο της οικονομικής κρίσης στη θνησιμότητα από καρκίνο του πνεύμονα. Χρησιμοποιήθηκαν δεδομένα από το 1992 έως το 2013, τα οποία συλ...
Journal of Interprofessional Care, 2019
Interprofessional teamwork in health-care settings is considered a valuable means of enhancing pa... more Interprofessional teamwork in health-care settings is considered a valuable means of enhancing patient management. Literature has highlighted the importance of trust in building effective health-care teams. The present study aimed to investigate and further understand the perceptions of health-care professionals regarding trust and performance within their working team, as well as to assess the association between them and team performance. "TRUST" questionnaire, a valid instrument for measuring the relationship of trust and team performance was distributed to the members of the perioperative teams located in two different hospitals (a University and a General Hospital) in Greece. Two multivariate linear regression models were developed to reveal the significant predictors of high performance per hospital. Among the major findings revealed were 1) trust and performance were closely related 2) slight yet significant variations were observed between the University and the General Hospital and 3) trust level, years of previous experience and number of team members were among the key predictors of effective team performance. This study conveys new knowledge on trust and performance within health-care settings with limited resources and is expected to guide future interventions aiming to enhance team performance.
Microscopy Research and Technique, 2016
The Local Polynomial Approximation (LPA) is a nonparametric filter that performs pixel-wise polyn... more The Local Polynomial Approximation (LPA) is a nonparametric filter that performs pixel-wise polynomial fit on a certain neighborhood. This filter can be supported by the Intersection of Confidence Interval rule (ICI) as an adaptation algorithm to identify the most suited neighborhood at which the polynomial assumptions provide superior fit for the observations. However, the LPA-ICI is considered to be a near-optimal de-noising filter. Moreover, the ICI rule has several parameters that affect its performance. The current study applied an optimization algorithm, namely the Particle swarm optimization (PSO) to determine the optimal ICI parameter values for microscopic images de-noising. As the ICI parameters are image's structure based, bag-of-features classifier is used to classify the images based on their structure into different classes. Afterward, a generated optimal ICI parameters' table was created using the LPA-ICI-PSO for further direct use without optimization. This table included the optimal ICI parameters based on the image structure. Based on the image category, the generated table can be used to attain the suitable ICI optimal parameters without using PSO. This guarantees less computational time along with the optimal de-noising compared to the LPA-ICI as established by the performance metrics. The experimental results established the superiority of the proposed LPA-ICI-PSO over the classical LPA-ICI filter.
Social Psychiatry and Psychiatric Epidemiology, 2016
Purpose During the European refugee crisis, numerous Greek and international rescue workers are o... more Purpose During the European refugee crisis, numerous Greek and international rescue workers are operating in Lesvos, offering search, rescue, and first aid services. Exposure to stressful life events while engaging in this rescue work can result in developing Post-Traumatic Stress Disorder (PTSD). The study aimed to assess the prevalence of PTSD and explore potential differences between different categories of rescuers. Methods A cross-sectional study was conducted among 217 rescue workers. Participants were grouped according to affiliation: ''Greek Professionals Rescuers/GPR'', ''International Professionals Rescuers/IPR'' and ''Volunteer Rescuers/VR''. The PTSD Checklist-Civilian Version (PCL-C) was utilized. All tests were two-tailed (a = 0.05). Mann-Whitney, Kruskal-Wallis, and multivariate logistic regression were performed. Results Overall probable PTSD prevalence found was 17.1%. Rates varied significantly per rescuer's category; 23.1% in GPR, 11.8% in IPR, and 14.6% in VR (p = 0.02). GPR demonstrated the highest risk compared to IPR and VR (p \ 0.001). Females had approximately two times higher risk. Other significant risk factors included marital status, age, and number of children. Lack of previous experience, longer operation period, longer shift hours, and handling dead refugees and dead children were also considered major risk factors. Conclusions Rescue workers providing substantial aid to the refugees and migrants at Lesvos experience significant psychological distress. The present findings indicate the urgent need for targeted interventions. Further studies are needed to address long-term effects of the refugee crisis on rescuers, and explore effective measures to prevent PTSD.
Primary Care Diabetes, 2020
AIMS To determine the prevalence of type-2 diabetes patients that were initially and currently be... more AIMS To determine the prevalence of type-2 diabetes patients that were initially and currently being treated by primary care physicians (PCPs) or diabetes specialists and assess predictors influencing their choice. METHODS This cross-sectional study was conducted in nine Greek primary healthcare units. Patients' choices were modeled using a bivariate probit analysis. RESULTS A total of 225 patients participated (84% response rate). Only 15.9% and 11.9% of the respondents acknowledged having chosen a diabetes specialist for their initial or current treatment, respectively. The family history of diabetes in siblings and the screening for diabetic retinopathy during the past year were significantly positively associated with choosing a diabetes specialist (initially p=0.033 or currently p=0.007), and resulted in a statistically significant reduction of the joint probabilities of choosing a PCP by 15.6% and 13.6%, respectively. Younger age (p=0.040), female sex (p=0.017), higher HbA1c (p=0.004), experience of hypoglycemia (p=0.029) and low cardiovascular morbidity index (p=0.016) emerged as important predictors for choosing a diabetes specialist for their treatment. CONCLUSIONS Our findings provide a better insight in diabetes patients' choices regarding the category of their treating physicians and their predictors. More studies are required to replicate them and identify patient subpopulations that may favor diabetes specialists' guidance.
Optimal processes workflows for patients in need of home care services. Distributed the optimal p... more Optimal processes workflows for patients in need of home care services. Distributed the optimal patient flows within the PHC units (i.e. home care), as they are proposed by the project. It depicts the processes workflows of patients in need of home care service. (JPEG 4616 kb)
Optimal processes workflow for patients with chronic disease. Distributed the optimal patient flo... more Optimal processes workflow for patients with chronic disease. Distributed the optimal patient flows within the PHC units, as they are proposed by the project. It depicts the processes workflows of patients with chronic conditions seeking for PHC services. (JPEG 150 kb)
Acta of bioengineering and biomechanics, 2017
PURPOSE The present study aims to explore relationships between footedness and posturographic ass... more PURPOSE The present study aims to explore relationships between footedness and posturographic assessment in children aged from 4 to 10. A real-time computerised device was used on a force plate for movement analysis. It requires a static posturography to assess postural control of children with the same handedness and footedness. METHODS Thirty eight right-handed and right-footed children organized in three age groups of 4 to 6 years old, 6 to 8 years old and 8 to 10 years old participated in the study. Two statical tests, the Unilateral Stance (US) and the Weight Bearing Squat (WBS) were performed, jointly with a dynamic balance examination (Limits of Stability (LOS)). All these tests were executed to explore the body capability of the right/left side. RESULTS The study demonstrated significant differences involving the right/left side among the three age groups. Better performance on the youngest children's right part and on the oldest children's left part was observed. Di...
BMC Pulmonary Medicine, 2020
Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treat... more Background Comorbidities and adherence to inhaled therapy appears to have a major impact on treatment goals, health status and disease control in chronic obstructive pulmonary disease (COPD). Aim of the study was to assess levels of adherence to inhalers, comorbidities and associations with COPD outcomes in patients residing in rural and semi-urban areas of Greece. Methods Two hundred fifty-seven COPD patients were enrolled from primary health care in 2015–2016. Physicians used structured interviews and questionnaires to assess quality of life and disease status. Patients were classified into groups according to GOLD 2019 guidelines (based on CAT and mMRC). Adherence to inhalers was measured with the Test of Adherence to Inhalers (TAI). Multivariate linear and logistics regression models were used to assess associations between comorbidities and adherence to inhalers with COPD outcomes, including CAT and mMRC scores, exacerbations and GOLD A-D status. Results 74.1% of COPD patients ...
npj Primary Care Respiratory Medicine, 2020
An amendment to this paper has been published and can be accessed via a link at the top of the pa... more An amendment to this paper has been published and can be accessed via a link at the top of the paper.