Theodoros Karapiperis - Academia.edu (original) (raw)
Papers by Theodoros Karapiperis
The Lancet Neurology, 2021
Drugs: Education, Prevention and Policy, 2018
Nature, 2019
The United Nations' International Law Commission is meeting this month to push forward a 2013 pro... more The United Nations' International Law Commission is meeting this month to push forward a 2013 programme to protect the environment in regions of armed conflict (go.nature.com/2ewdyj). We call on governments to incorporate explicit safeguards for biodiversity, and to use the commission's recommendations to finally deliver a Fifth Geneva Convention to uphold environmental protection during such confrontations. Despite calls for a fifth convention two decades ago, military conflict continues to destroy megafauna, push species to extinction and poison water resources (see, for example, J. C. Brito et al. Conserv. Lett. https://doi.org/ gfhst9; 2018). The uncontrolled circulation of arms exacerbates the situation, for instance by driving unsustainable hunting of wildlife. A Fifth Geneva Convention would provide a multilateral treaty that includes legal instruments for site-based protection of crucial natural resources. Companies and governments need to work together to regulate arms transfer (see go.nature.com/2lgtfx). And the military industry must be held more accountable for the impact of its activities.
European Addiction Research, 2017
Background: Clinicians in the field of drug addiction have started to exploit the growth of Techn... more Background: Clinicians in the field of drug addiction have started to exploit the growth of Technology-Based Interventions (TBIs). However, there is little information on how health personnel evaluate them. Methods: Semi-structured interviews were conducted among 20 European experts. Results: All of the interviewees recognised TBIs as a valuable tool to improve the management of substance-use disorders (SUDs). Most interviewees indicated that combining both traditional face-to-face therapist-patient clinic appointment with TBIs is probably the most effective method. Most interviewees agree that TBIs are valuable tools to overcome both physical and social barriers, and hence significantly facilitate the access to treatment. Poor infrastructure and lack of digital literacy are recognised as major barriers to the diffusion of these tools. Conclusions: The application of various forms of technology in SUD treatment is an interesting development for the European Union. Technical and non-...
The Lancet. Neurology, 2017
on evidence provided by healthcare and systems research, from best diagnostic and care practices ... more on evidence provided by healthcare and systems research, from best diagnostic and care practices in primary care, through dementia-care pathways, to palliative and end-of-life care. At present, this evidence is scarce. We declare no competing interests.
Health Policy and Technology, 2016
Abstract Background There is scarce and fragmented evidence of the European Union׳s policies and ... more Abstract Background There is scarce and fragmented evidence of the European Union׳s policies and strategies being employed in the area of ICT in support of development in LMICs. Methods An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT for LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results One hundred and twenty-one experts responded to the survey. About 30% of the respondents believe that the EU institutions׳ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU׳s support has not improved or has even worsened. The evaluation of the EU׳s cooperation with international organisations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top–down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions The results of this survey can support decision-makers and ICT managers to better plan and implement ICT deployment in LMICs, making a better use of European human and financial resources in this field.
Health Policy and Technology, 2016
Health Promotion International, 2016
Health literacy can be defined as the knowledge, motivation and competence to access, understand,... more Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policymakers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels.
The Lancet Infectious Diseases, 2016
The Ebola virus epidemic has topped media and political agendas for months; several countries in ... more The Ebola virus epidemic has topped media and political agendas for months; several countries in west Africa have faced the worst Ebola epidemic in history. At the beginning of the disease outbreak, European Union (EU) policies were notably absent regarding how to respond to the crisis. Although the epidemic is now receding from public view, this crisis has undoubtedly changed the European public perception of Ebola virus disease, which is no longer regarded as a bizarre entity confined in some unknown corner in Africa. Policy makers and researchers in Europe now have an opportunity to consider the lessons learned. In this Personal View, we discuss the EU's response to the Ebola crisis in west Africa. Unfortunately, although ample resources and opportunities for humanitarian and medical action existed, the EU did not use them to promote a rapid and well coordinated response to the Ebola crisis. Lessons learned from this crisis should be used to improve the role of the EU in similar situations in the future, ensuring that European aid can be effectively deployed to set up an improved emergency response system, and supporting the establishment of sustainable health-care services in west Africa.
Technology in Society, 2015
This Issues and Opinions Essay provides insights on developments and challenges related to respon... more This Issues and Opinions Essay provides insights on developments and challenges related to responsible governance in the field of science and technology (S&T) across Europe, China and India. The Essay presents an overview of policy debates and some key public policy documents in these three geopolitical areas, exploring how responsibility is viewed and outlined in the policy domain. Considerations on the range of processes and actors affecting the relationship between science and society in China and India are also presented. Finally, the Essay introduces 'responsiveness' as a possible area for
The Lancet. Neurology, 2015
Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug w... more Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control.
Technology in Society, 2015
Responsible governance of science and technologies, in particular through the concept of Responsi... more Responsible governance of science and technologies, in particular through the concept of Responsible Research and Innovation (RRI), is becoming increasingly important among policy makers and researchers alike. In this Issues and Opinions Essay we show that influential contributions to this field highlight the need to rethink the relationship between science and society, including rethinking the roles and responsibilities of the different actors in the innovation systems. In this Essay we will focus on the function and practices of assessment of science and technologies. With the Essay we would like to open a discussion with academics, assessment practitioners, policy makers and stakeholders about the potential need for reform of current assessment practices and advisory institutions in light of discussions about responsible governance of science and technology in general and RRI in particular.
The Lancet Global Health, 2014
The Lancet Neurology, 2013
Journal of Public Health Policy, 2013
Health Policy, 2013
Many European governments have abundantly cut down public expenditure on health during the financ... more Many European governments have abundantly cut down public expenditure on health during the financial crisis. Consequences of the financial downturn on health outcomes have begun to emerge. This recession has led to an increase in poor health status, raising rates of anxiety and depression among the economically vulnerable. In addition, the incidence of some communicable diseases along with the rate of suicide has increased significantly. The recession has also driven structural reforms, and affected the priority given to public policies. The purpose of this paper is to analyse how austerity impacts health in Europe and better understand the response of European health systems to the financial crisis. The current economic climate, while challenging, presents an opportunity for reforming and restructuring health promotion actions. More innovative approaches to health should be developed by health professionals and by those responsible for health management. In addition, scientists and experts in public health should promote evidence-based approaches to economic and public health recovery by analyzing the present economic downturn and previous crisis. However, it is governance and leadership that will mostly determine how well health systems are prepared to face the crisis and find ways to mitigate its effects.
Clinical Orthopaedics & Related Research, 2020
In response to recent reports in the lay media and scientific journals about complications associ... more In response to recent reports in the lay media and scientific journals about complications associated with joint arthroplasties and other medical devices [3, 12, 13], the Presidents of the European Knee Society (EKS) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) met with stakeholders in Brussels, Belgium in April 2019 [7] to discuss the European Union’s (EU) new Medical Device Regulation (Regulation 2017/745 of the European Parliament and of the Council 2017/745 of 5 April 2017 [9] concerning medical devices, OJ No L 117/1 of 2017-05-05). This regulation overhauls the current medical device safety regulations in the EU and is scheduled for implementation in May 2020.
Journal of Public Health, 2018
Background Health systems in the European Union (EU) are being questioned over their effectivenes... more Background Health systems in the European Union (EU) are being questioned over their effectiveness and sustainability. In pursuing both goals, they have to conciliate coexisting, not always aligned, realities. Methods This paper originated from a workshop entitled 'Health systems for the future' held at the European Parliament. Experts and decision makers were asked to discuss measures that may increase the effectiveness and sustainability of health systems, namely: (i) increasing citizens' participation; (ii) the importance of primary care in providing integrated services; (iii) improving the governance and (iv) fostering better data collection and information channels to support the decision making process. Results In the parliamentary debate, was discussed the concept that, in the near future, health systems' effectiveness and sustainability will very much depend on effective access to integrated services where primary care is pivotal, a clearer shift from care-oriented systems to health promotion and prevention, a profound commitment to good governance, particularly to stakeholders participation, and a systematic reuse of data meant to build health data-driven learning systems. Conclusions Many health issues, such as future health systems in the EU, are potentially transformative and hence an intense political issue. It is policy-making leadership that will mostly determine how well EU health systems are prepared to face future challenges.
Health Policy and Technology, 2016
Abstract Background Despite the wide gap between the developed and developing world in terms of I... more Abstract Background Despite the wide gap between the developed and developing world in terms of ICT access, ICT investment in low and middle-income countries (LMICs) has increased due to the rapid development of mobile services. However, the effects of ICTs in LMICs remain debatable. Methods An online survey was conducted to collect feedback from experts. The questionnaire explored the role of ICTs in the economic development of LMICs, investigated the benefits and limits of e-health, and collected evaluations of past EU initiatives on future development policies. Structured interviews were also carried out with ten of the respondents. Results One hundred and forty-five experts responded to the survey. Health and education were considered to be the two main areas where ICTs can support economic development. Poor infrastructure, lack of political support and human capital, and poor affordability were found to be the main obstacles. The shortcomings of donors in fostering the role of ICTs in LMICs development were identified as sustainability of interventions and lack of a coherent approach. The main benefits of e-health technologies in LMICs are their ability to facilitate health information and increase access to health care. Remote data collection, training for healthcare workers and education are the most effective m-health applications. Poor infrastructure and lack of equipment are considered the main barriers to the use of e-health in LMICs. Limited financial resources and lack of policy and regulatory frameworks might prevent the scaling up of e-health. Conclusions The results of this survey can support decision makers and healthcare managers to better plan and implement ICTs in LMICs and make improved use of European resources for development.
The Lancet Neurology, 2021
Drugs: Education, Prevention and Policy, 2018
Nature, 2019
The United Nations' International Law Commission is meeting this month to push forward a 2013 pro... more The United Nations' International Law Commission is meeting this month to push forward a 2013 programme to protect the environment in regions of armed conflict (go.nature.com/2ewdyj). We call on governments to incorporate explicit safeguards for biodiversity, and to use the commission's recommendations to finally deliver a Fifth Geneva Convention to uphold environmental protection during such confrontations. Despite calls for a fifth convention two decades ago, military conflict continues to destroy megafauna, push species to extinction and poison water resources (see, for example, J. C. Brito et al. Conserv. Lett. https://doi.org/ gfhst9; 2018). The uncontrolled circulation of arms exacerbates the situation, for instance by driving unsustainable hunting of wildlife. A Fifth Geneva Convention would provide a multilateral treaty that includes legal instruments for site-based protection of crucial natural resources. Companies and governments need to work together to regulate arms transfer (see go.nature.com/2lgtfx). And the military industry must be held more accountable for the impact of its activities.
European Addiction Research, 2017
Background: Clinicians in the field of drug addiction have started to exploit the growth of Techn... more Background: Clinicians in the field of drug addiction have started to exploit the growth of Technology-Based Interventions (TBIs). However, there is little information on how health personnel evaluate them. Methods: Semi-structured interviews were conducted among 20 European experts. Results: All of the interviewees recognised TBIs as a valuable tool to improve the management of substance-use disorders (SUDs). Most interviewees indicated that combining both traditional face-to-face therapist-patient clinic appointment with TBIs is probably the most effective method. Most interviewees agree that TBIs are valuable tools to overcome both physical and social barriers, and hence significantly facilitate the access to treatment. Poor infrastructure and lack of digital literacy are recognised as major barriers to the diffusion of these tools. Conclusions: The application of various forms of technology in SUD treatment is an interesting development for the European Union. Technical and non-...
The Lancet. Neurology, 2017
on evidence provided by healthcare and systems research, from best diagnostic and care practices ... more on evidence provided by healthcare and systems research, from best diagnostic and care practices in primary care, through dementia-care pathways, to palliative and end-of-life care. At present, this evidence is scarce. We declare no competing interests.
Health Policy and Technology, 2016
Abstract Background There is scarce and fragmented evidence of the European Union׳s policies and ... more Abstract Background There is scarce and fragmented evidence of the European Union׳s policies and strategies being employed in the area of ICT in support of development in LMICs. Methods An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT for LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results One hundred and twenty-one experts responded to the survey. About 30% of the respondents believe that the EU institutions׳ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU׳s support has not improved or has even worsened. The evaluation of the EU׳s cooperation with international organisations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top–down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions The results of this survey can support decision-makers and ICT managers to better plan and implement ICT deployment in LMICs, making a better use of European human and financial resources in this field.
Health Policy and Technology, 2016
Health Promotion International, 2016
Health literacy can be defined as the knowledge, motivation and competence to access, understand,... more Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policymakers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels.
The Lancet Infectious Diseases, 2016
The Ebola virus epidemic has topped media and political agendas for months; several countries in ... more The Ebola virus epidemic has topped media and political agendas for months; several countries in west Africa have faced the worst Ebola epidemic in history. At the beginning of the disease outbreak, European Union (EU) policies were notably absent regarding how to respond to the crisis. Although the epidemic is now receding from public view, this crisis has undoubtedly changed the European public perception of Ebola virus disease, which is no longer regarded as a bizarre entity confined in some unknown corner in Africa. Policy makers and researchers in Europe now have an opportunity to consider the lessons learned. In this Personal View, we discuss the EU's response to the Ebola crisis in west Africa. Unfortunately, although ample resources and opportunities for humanitarian and medical action existed, the EU did not use them to promote a rapid and well coordinated response to the Ebola crisis. Lessons learned from this crisis should be used to improve the role of the EU in similar situations in the future, ensuring that European aid can be effectively deployed to set up an improved emergency response system, and supporting the establishment of sustainable health-care services in west Africa.
Technology in Society, 2015
This Issues and Opinions Essay provides insights on developments and challenges related to respon... more This Issues and Opinions Essay provides insights on developments and challenges related to responsible governance in the field of science and technology (S&T) across Europe, China and India. The Essay presents an overview of policy debates and some key public policy documents in these three geopolitical areas, exploring how responsibility is viewed and outlined in the policy domain. Considerations on the range of processes and actors affecting the relationship between science and society in China and India are also presented. Finally, the Essay introduces 'responsiveness' as a possible area for
The Lancet. Neurology, 2015
Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug w... more Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control.
Technology in Society, 2015
Responsible governance of science and technologies, in particular through the concept of Responsi... more Responsible governance of science and technologies, in particular through the concept of Responsible Research and Innovation (RRI), is becoming increasingly important among policy makers and researchers alike. In this Issues and Opinions Essay we show that influential contributions to this field highlight the need to rethink the relationship between science and society, including rethinking the roles and responsibilities of the different actors in the innovation systems. In this Essay we will focus on the function and practices of assessment of science and technologies. With the Essay we would like to open a discussion with academics, assessment practitioners, policy makers and stakeholders about the potential need for reform of current assessment practices and advisory institutions in light of discussions about responsible governance of science and technology in general and RRI in particular.
The Lancet Global Health, 2014
The Lancet Neurology, 2013
Journal of Public Health Policy, 2013
Health Policy, 2013
Many European governments have abundantly cut down public expenditure on health during the financ... more Many European governments have abundantly cut down public expenditure on health during the financial crisis. Consequences of the financial downturn on health outcomes have begun to emerge. This recession has led to an increase in poor health status, raising rates of anxiety and depression among the economically vulnerable. In addition, the incidence of some communicable diseases along with the rate of suicide has increased significantly. The recession has also driven structural reforms, and affected the priority given to public policies. The purpose of this paper is to analyse how austerity impacts health in Europe and better understand the response of European health systems to the financial crisis. The current economic climate, while challenging, presents an opportunity for reforming and restructuring health promotion actions. More innovative approaches to health should be developed by health professionals and by those responsible for health management. In addition, scientists and experts in public health should promote evidence-based approaches to economic and public health recovery by analyzing the present economic downturn and previous crisis. However, it is governance and leadership that will mostly determine how well health systems are prepared to face the crisis and find ways to mitigate its effects.
Clinical Orthopaedics & Related Research, 2020
In response to recent reports in the lay media and scientific journals about complications associ... more In response to recent reports in the lay media and scientific journals about complications associated with joint arthroplasties and other medical devices [3, 12, 13], the Presidents of the European Knee Society (EKS) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) met with stakeholders in Brussels, Belgium in April 2019 [7] to discuss the European Union’s (EU) new Medical Device Regulation (Regulation 2017/745 of the European Parliament and of the Council 2017/745 of 5 April 2017 [9] concerning medical devices, OJ No L 117/1 of 2017-05-05). This regulation overhauls the current medical device safety regulations in the EU and is scheduled for implementation in May 2020.
Journal of Public Health, 2018
Background Health systems in the European Union (EU) are being questioned over their effectivenes... more Background Health systems in the European Union (EU) are being questioned over their effectiveness and sustainability. In pursuing both goals, they have to conciliate coexisting, not always aligned, realities. Methods This paper originated from a workshop entitled 'Health systems for the future' held at the European Parliament. Experts and decision makers were asked to discuss measures that may increase the effectiveness and sustainability of health systems, namely: (i) increasing citizens' participation; (ii) the importance of primary care in providing integrated services; (iii) improving the governance and (iv) fostering better data collection and information channels to support the decision making process. Results In the parliamentary debate, was discussed the concept that, in the near future, health systems' effectiveness and sustainability will very much depend on effective access to integrated services where primary care is pivotal, a clearer shift from care-oriented systems to health promotion and prevention, a profound commitment to good governance, particularly to stakeholders participation, and a systematic reuse of data meant to build health data-driven learning systems. Conclusions Many health issues, such as future health systems in the EU, are potentially transformative and hence an intense political issue. It is policy-making leadership that will mostly determine how well EU health systems are prepared to face future challenges.
Health Policy and Technology, 2016
Abstract Background Despite the wide gap between the developed and developing world in terms of I... more Abstract Background Despite the wide gap between the developed and developing world in terms of ICT access, ICT investment in low and middle-income countries (LMICs) has increased due to the rapid development of mobile services. However, the effects of ICTs in LMICs remain debatable. Methods An online survey was conducted to collect feedback from experts. The questionnaire explored the role of ICTs in the economic development of LMICs, investigated the benefits and limits of e-health, and collected evaluations of past EU initiatives on future development policies. Structured interviews were also carried out with ten of the respondents. Results One hundred and forty-five experts responded to the survey. Health and education were considered to be the two main areas where ICTs can support economic development. Poor infrastructure, lack of political support and human capital, and poor affordability were found to be the main obstacles. The shortcomings of donors in fostering the role of ICTs in LMICs development were identified as sustainability of interventions and lack of a coherent approach. The main benefits of e-health technologies in LMICs are their ability to facilitate health information and increase access to health care. Remote data collection, training for healthcare workers and education are the most effective m-health applications. Poor infrastructure and lack of equipment are considered the main barriers to the use of e-health in LMICs. Limited financial resources and lack of policy and regulatory frameworks might prevent the scaling up of e-health. Conclusions The results of this survey can support decision makers and healthcare managers to better plan and implement ICTs in LMICs and make improved use of European resources for development.