Major changes are needed regarding human resource management, work incentives and dynamics of teamwork in order to improve working conditions in Greek public hospitals.

Better communication, fair management practices and clear job descriptions and expectations may be needed in order to facilitate change and reverse the negative atmosphere that exists. Further education in conflict management for physicians, nurses and their managers may also be needed.

Background. The aim of the current study was to investigate physicians' perceptions and adherence to the European guidelines for the management of hypertension. Methods. This is a national, multicentre, prospective, observational study, conducted between November 2007 and June 2008, in Cyprus. Consecutive hypertensive patients have been recruited by a random sample of physicians. The physicians' recommendations for every single patient have been recorded and compared with the 2007 ESH/ESC guidelines. Results. Of the total of 654 patients, 477 (72.9%) were correctly advised by their physician to receive antihypertensive treatment to control their blood pressure, while 396 (60.5%) correctly got advices to adopt only lifestyle changes. The overall adherence of physicians to the European guidelines (overall agreement rate) was 70.4% (k = 0.258, P < 0.001). Of the total of 68 physicians, 65 (95.6%) reported that they were aware of some guidelines. There was no statistically significant effect of specific physicians' characteristics on the overall adherence to guidelines, but there was in the percentage of patients achieving medication guidelines. Conclusions. The study demonstrated that although Cypriot physicians declared that they were aware of the clinical guidelines for the management of hypertension, more than one-fourth of high risk hypertensive patients remained untreated and 40% of low risk patients received inappropriate medication.

A limited number of studies have investigated the distress during the COVID-19 pandemic and the lockdown measures in the general population. We studied psychological distress during the COVID-19 pandemic and the lockdown measures in the general population in Greece and Cyprus. Also, we investigated several demographic, clinical and job characteristics of the participants as possible determinants of distress. Data collection was performed during lockdown measures in Greece and Cyprus (from April 21st to May 4th 2020). All participants provided informed consent to participate in the study. We used the Impact of Event Scale-Revised (IES-R) to measure the psychological distress in response to the COVID-19 pandemic and lockdown measures. Seventeen point four percent of the participants had overall IES-R score from 24 to 32 indicating that posttraumatic stress disorder (PTSD) is a clinical concern, while 33.5% had overall IES-R score >32 indicating that PTSD is a probable diagnosis. Females, Cyprus residents, participants that live with elderly people or patients with a chronic disease in home, participants with a mental health disease or/and chronic disease, participants under pharmaceutical treatment, participants that lost their work due to the pandemic and participants that work in hospital experienced greater distress. Also, increased age and decreased educational level was associated with increased distress. Findings suggest that our sample experienced great distress and this distress was affected by several demographic, clinical and job characteristics. Appropriate interventions should be established in order to support psychologically high risk groups and decrease their distress. Keywords: distress, COVID-19, posttraumatic stress disorder, cross-sectional study, on-line survey, public health

Background The public primary healthcare system in Greece has not been fully developed and is delivered by urban and rural health centers, outpatient departments in public hospitals and the recently established first-contact and decentralized local primary care units. The aim of this study was to develop a valid and reliable measurement tool for conducting periodic user experience evaluation surveys in public Primary HealthCare facilities in Greece such as outpatient clinics of public hospitals and health centers. Methods A mixed methods approach was applied. In particular, the methodology of developing and validating the tools included three steps: (a) establishment of the theoretical background/literature review, (b) qualitative study: development of the tools items and establishment of the face validity and (c) quantitative study: pilot testing and establishment of the structural validity and estimation of the internal consistency of the tools. Two patient focus groups participated in qualitative study: one visiting health centres and the other visiting the outpatient clinics of public hospitals. Quantitative study included 733 Primary Health Care services’ users/patients and was conducted during August–October 2017. Exploratory and confirmatory factor analysis was performed to check for structural validity of the tools, while Cronbach’s alpha coefficients were estimated to check for reliability. Results Confirmatory factor analysis confirmed almost perfectly the presumed theoretical model and the following six factors were identified through the tools: (a) accessibility (three items, e.g. opening hours), (b) continuity and coordination of care (three items, e.g. doctor asks for medical history), (c) comprehensiveness of care (three items, e.g. doctor provides advices for healthy life), (d) quality of medical care (four items, e.g. sufficient examination time), (e) facility (four items, e.g. comfortable waiting room) and (f) quality of care provided by nurses and other health professionals (four items, e.g. polite nurses). Conclusions We have developed reliable and valid tools to measure users’ experiences in public Primary HealthCare facilities in Greece. These tools could be very useful in examining differences between different types of public Primary Health Care facilities and different populations. Electronic supplementary material The online version of this article (10.1186/s12875-019-0935-6) contains supplementary material, which is available to authorized users.

Introduction: The World Health Organization has estimated that 12 million deaths occur worldwide, every year due to Heart diseases. Half the deaths in the developed countries are due to cardiovascular diseases. The early prognosis of cardiovascular diseases can aid in making decisions on lifestyle changes in high risk patients. Aim: The aim of this paper is to build and compare classification techniques for cardiovascular diseases. Methods: The dataset contained 4270 patients and 14 attributes and it is available on the UCI data repository. The prediction is a binary outcome (event and no event). Variables of each attribute is a potential risk factor. There are both demographic, behavioral and medical risk factors. The classification goal is to predict whether the patient has 10-year risk of future coronary heart disease (CHD). Results: Different classifiers were tested. The SMOTE technique was used in order to solve the class imbalance. The cross-validation method was used in order to estimate how accurately our predictive models will perform. We evaluate our classifiers by using the following metrics: precision, recall, F1-score, Accuracy, AUC (Area Under Curve). Conclusions: Based on the resluts, the best scores have the Random Forest and Decision Tree classifiers.

Aims. Worldwide, cervical cancer is the fifth most deadly cancer in women, but screening prevents cancer by detecting precancerous lesions. The purpose of this study is to present the treatment profile for precancerous lesions of the uterine cervix, according to demographic data. Methods. An annual retrospective study was conducted in two public primary health care centres in Greece. The total number of Pap smears and colposcopies performed as well as the management of women with cervical intraepithelial neoplasia was collected and analysed. Results. Demographic characteristics and correlations with levels of Cervical Intraepithelial Neoplasia (CIN) and treatment path are presented. For each case, we noted the patients' age, the marital and educational status, and the professional and insurance type. From a total of 238 diagnostic procedures, 118 (49.5%) showed precancerous lesions, 83.3% of these were high grade while 16.7% were low grade. Conclusions. This study provides an estimate of the extensiveness of precancerous lesions of the uterine cervix. Management of CIN should be accounted for when balancing the benefits and unfavourable effects of this screening.

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