BackgroundChronic pain constitutes one of the most common reasons for seeking health care services and may even lead to disability. Chronic pain has been associated with depression and deterioration of the quality of life. The aim of our study is to outline the burden of chronic pain in the context of a primary health care (PHC) setting in Greece and to investigate its association with depression and quality of life.MethodsA cross-sectional study was conducted from September 2016 to November 2016. The subjects of the study comprised 200 individuals who visited the regional medical center of Ag. Theodoroi, Greece. The collected data were from a representative sample of 200 adults and included demographic data, social and medical history, presence and characteristics of chronic pain and questions from three questionnaires for the assessment of pain (BPI- short form), the investigation of depression (PHQ-9) and the evaluation of the quality of life (EuroQ-5D) validated in Greek language. Multiple regression analysis was used in order to find associated factors with quality of life, depression and chronic pain.ResultsA percentage of 56.8% of the participants, the majority of whom (62%) were women, reported chronic pain. Among individuals with pain, lower back area was the most common location. Based on the given questionnaire, depression was detected in 22. 5% of the participants who claimed chronic pain. Regression analyses revealed that women and respondents with chronic mental disorders like depression and anxiety had significantly higher scores on the pain scale and suffered pain which had a greater impact on their daily activities. According to regression analysis decreased quality of life was expressed by women, as well as participants with a chronic mental disorder. A significant reverse correlation emerged between the quality of life, depression and pain scales.ConclusionChronic pain, as it has been studied within this PHC setting, is a common health care problem. Individuals who had experienced chronic pain and depression had a lower health-related quality of life.

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Like organizations striving for growth, Hellenic Navy is facing rising pressure to increase the value added by its services. To meet this challenge in an era of scarcity of resources Hellenic Navy's education and training will need to undergo fundamental changes in the way they operate and continuously seek ways to create future value. This paper explores and discusses the potential applicability of Balanced Scorecard in Hellenic Navy's education and training in order to stimulate and sustain continuous improvement. Favorable results were reported in the for-profit and government organizations supporting the aforementioned applicability.Keywords: Hellenic Navy's Education and Training, Scorecard to Hellenic Navy's Education and Training, Balanced Scorecard IntroductionNowadays there is an increased trend for government departments and public entities for reform especially in the area of management and budgeting. This reform along with the decreased government funding have resulted the need for delivering agreed outputs as efficiently as possible. In turn, this need has as an effect the adoption of private sector management practices one of which is performance measurement (Niven 2008; Holmes et al 2006;Pallot 1991;Suppanz 1996).Traditionally, performance measurement systems have been based on financial results which have a limited effect on the criteria used to measure, to assess or even more to drive performance. In the past, various systems for performance measurement that overcome this limitation have been suggested. One of these, the Balanced Scorecard (BSC) has met worldwide acceptance as a management tool that measures and drive performance based on financial and non-financial indicators. BackgroundThe concept of the balanced scorecard was first introduced by Robert S. Kaplan and David P. Norton (1992) in their now well known Harvard Business Review article "The Balanced Scorecard -Measures That Drive Performance". The idea of BSC has met enormous success worldwide especially in private sector organizations. For instance, Kaplan and Norton (2001) reported that by 2001 about 50% of the Fortune 1000 companies in North America and 40% to 45% of companies in Europe were using the BSC.The core argument of BSC is that financial results alone cannot capture value-creating activities (Kaplan & Norton, 2001a). That means that financial measures are lagging indicators and, as such are not effective in identifying the drivers or activities that affect financial results. Also, Kaplan and Norton (1992) suggested that organizations, while using financial measures, should develop a comprehensive set of additional measures to use as leading indicators of financial performance.The BSC is based on balanced set of measures covering financial, customer, innovation and learning process areas to manage effectively. In addition, the BSC is used to translate an organization's mission and strategy into a comprehensive set of performance measures that enables organizations to track short-term financial results while simu...

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