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Mechili EA, Saliaj A, Kamberi F, Girvalaki C, Peto E, Patelarou AE, Bucaj J, Patelarou E. Is the mental health of young students and their family members affected during the quarantine period? Evidence from the COVID-19 pandemic in Albania. J Psychiatr Ment Health Nurs 2021; 28:317-325. [PMID: 32657469 PMCID: PMC7405232 DOI: 10.1111/jpm.12672] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/09/2020] [Accepted: 07/06/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental health is deteriorated during the quarantine period. Mental health status is affected by the quarantine even after the end of it and for an extended period. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Depression levels among nursing/midwifery students during the quarantine period are high. Depression levels among students' family members during the quarantine period are high. Those who are not satisfied with COVID-19 prevention measures and those who believe that COVID-19 and quarantine can cause problems on health, have elevated levels of depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Provision of mental health services during the quarantine period should be a priority for the healthcare system. Offering mental health first aid training and support can improve the mental health status of students and their family members. ABSTRACT: Introduction The use of quarantine method has a significant impact on mental health status. Aim This study aimed to assess the levels of depression among bachelor and master university students (nurses/midwives) and their family members' during the quarantine period of COVID-19 pandemic. Method A cross-sectional study was conducted in Vlora University, Albania. Patient Health Questionnaire (PHQ-9) was used. Institutional e-mails of all active students were used for their recruitment. Results In total, 863 students and 249 family members participated in the study. The mean PHQ-9 score was 6.220 (SD = 5.803) and 6.280 (SD = 5.857) for students and family members, respectively. Being unsatisfied with COVID-19 prevention measures, beliefs that COVID-19 infection and quarantine process can cause problems on their health status were the key factors for students to be screened positive for mental problems in multiple regression analysis. For parents, the last two factors were found to contribute significantly. Discussion Our findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members. Broader population studies are necessary to safeguard these results. Implications for Practice Provision of mental health services during the quarantine period is of paramount significance. Mental health first aid training and support could benefit both students and their parents significantly. Additionally, follow-up services after the end of quarantine are recommended.
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Dolezel J, Zelenikova R, Finotto S, Mecugni D, Patelarou A, Panczyk M, Ruzafa-Martínez M, Ramos-Morcillo AJ, Skela-Savič B, Gotlib J, Patelarou E, Smodiš M, Jarosova D. Core Evidence-Based Practice Competencies and Learning Outcomes for European Nurses: Consensus Statements. Worldviews Evid Based Nurs 2021; 18:226-233. [PMID: 34031973 PMCID: PMC8251814 DOI: 10.1111/wvn.12506] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 11/27/2022]
Abstract
Background Consensus on evidence‐based practice (EBP) competencies and associated learning outcomes for registered nurses has not yet been achieved in the European context. Aims To establish a set of core EBP competencies for nurses and the most important EBP learning outcomes encompassing attitudes, knowledge, and skills dimensions for implementation into nursing education in European countries. Methods A multi‐phase modified Delphi survey was conducted: Phase 1, a literature review; Phase 2, a two‐round consensus of experts; and Phase 3, a Delphi survey. Experts from six European countries participated. Results In Phase 1, 88 records were selected and 835 statements extracted, which were grouped according to the seven steps of EBP. After removing 157 duplicates, the remaining competencies (n = 678) were evaluated in Phase 2. Then, a two‐round expert consensus was reached, with 24 competencies and 120 learning outcomes identified and divided into affective, cognitive, and skills domains. In Phase 3, based on a Delphi survey expert consensus, all evaluated statements were included in a final set of competencies and learning outcomes. Only two learning outcomes were recommended for allocation to a different domain, and four were reformulated as suggested, with no further changes to the others. Linking Evidence to Action The set of EBP competencies and learning outcomes can guide nurse educators, managers, and EBP stakeholders in the development of content that incorporates EBP knowledge, skills, and attitudes into educational programs. Prioritizing the EBP competencies and learning outcomes that are most necessary and adapting them to every context will provide healthcare organizations with guidelines for enhancing the continuing education of nurses. These results could facilitate the development of effective tools for assessing nursing students’ and nurses’ perception of competencies required for EBP processes.
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Patelarou A, Mechili EA, Galanis P, Zografakis-Sfakianakis M, Konstantinidis T, Saliaj A, Bucaj J, Alushi E, Carmona-Torres JM, Cobo-Cuenca AI, Laredo-Aguilera JA, Patelarou E. Nursing students, mental health status during COVID-19 quarantine: evidence from three European countries. J Ment Health 2021; 30:164-169. [PMID: 33504241 DOI: 10.1080/09638237.2021.1875420] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The SARS-CoV2 pandemic obligated most of the European countries to implement strict measures and lockdowns to minimize the spread of the virus. Universities closed and on-line classes started. However, COVID-19 epidemic has significant impact on mental health of population. AIM To assess depression level of nursing students (undergraduate and master) in Greece, Spain and Albania during COVID-19 pandemic as well as to identify possible determinants of depression level. METHODS A multicenter cross-sectional study was conducted between April and May 2020. An on-line questionnaire was used to collect the data. The Patient Health Questionnaire-9 was used to evaluate the depression levels of nursing students. RESULTS Seven hundred and eighty-seven nursing students participated in the study out of which 83.9% were of female gender, 92.9% single and 94.7% lived with others. One third of the nursing student population experienced mild depression, with higher depression levels noted for Spanish students (59.1%) followed by Albanian (34.5%) and Greek (21.8%) students. Multivariate linear regression analysis identified that Spanish students experienced more depression than Greek and Albanian (p < 0.001). Also, decreased age was associated with increased depression. CONCLUSION The impact of lockdown and quarantine on nursing students mental health is clear. Provision of university based mental health interventions should be a priority.
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Patelarou E. Acknowledgement of manuscript reviewers 2020. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/132401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Dragoumanaki G, Patelarou A, Vorgia P, Sifaki-Pistolla D, Patelarou E. Validation and Translation of the Greek Version of the “DCDDaily-Q-GR” Questionnaire. Health (London) 2021. [DOI: 10.4236/health.2021.1311090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Patelarou E, Vlasiadis K, Panczyk M, Dolezel J, Jarosova D, Gotlib J, Skela-Savič B, Mecugni D, Finotto S, Ruzafa-Martinez M, Ramos-Morcillo A, Patelarou A. Providing a teaching and learning open and innovative toolkit for evidence-based practice to nursing European curriculum (EBP e-Toolkit): Project rationale and design. POPULATION MEDICINE 2020. [DOI: 10.18332/popmed/128272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Skela-Savič B, Gotlib J, Panczyk M, Patelarou AE, Bole U, Ramos-Morcillo AJ, Finotto S, Mecugni D, Jarosova D, Patelarou E, Dolezel J, Ruzafa-Martínez M. Teaching evidence-based practice (EBP) in nursing curricula in six European countries-A descriptive study. NURSE EDUCATION TODAY 2020; 94:104561. [PMID: 32905986 DOI: 10.1016/j.nedt.2020.104561] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/19/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Teaching evidence-based practice (EBP) in nursing education varies among nurse educators and universities. Lack of nurses' knowledge and skills are among the barriers commonly associated with the limited use of EBP in practice. OBJECTIVES To describe the presence, characteristics and content of courses of EBP in nursing bachelor's, master's, and PhD programs in six European countries. DESIGN A descriptive study design was employed. SETTINGS The study was implemented as part of the EBP e-Toolkit Project as a strategic partnership of six European higher education institutions from six countries in the framework of the Erasmus+ Programme. PARTICIPANTS Census sampling (N = 225) was used. A total of 162 (72%) faculties responded from the following countries: Spain (79), Italy (44), the Czech Republic (15), Poland (12), Greece (7), and Slovenia (5). METHODS Three structured instruments were developed by using the consensus development panel. The research was conducted from December 2018 to March 2019. For names of subjects, a manual narrative Template Analysis was used with open descriptive coding. RESULTS Subjects in "EBP in Nursing or Health Care" are included in 45 (29.2%) bachelor's programs, mostly worth 180 European Credit Transfer System (ECTS) credits, 30 (28%) master's, and 6 (40%) PhD programs. In bachelor's programs, an average of 134 h are spent teaching EBP steps, followed by 127 h in master's programs and 52 h in PhD programs. EBP subjects have different focuses: clear topics in EBP, development of research knowledge, awareness of the need for evidence-based clinical work, and understanding the needs of the profession. CONCLUSIONS Teaching EBP is not yet sufficiently integrated into nursing curricula. For more efficient integration, guidelines on the standardization of teaching approaches and content have to be developed in all three cycles of higher education. Further research is needed on the implementation of teaching at master's and PhD levels of nursing curricula.
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Patelarou AE, Mechili EA, Ruzafa-Martinez M, Dolezel J, Gotlib J, Skela-Savič B, Ramos-Morcillo AJ, Finotto S, Jarosova D, Smodiš M, Mecugni D, Panczyk M, Patelarou E. Educational Interventions for Teaching Evidence-Based Practice to Undergraduate Nursing Students: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176351. [PMID: 32878256 PMCID: PMC7503534 DOI: 10.3390/ijerph17176351] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022]
Abstract
Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours, EBP beliefs, use, practice, level of evidence, critical thinking and future use of EBP were mentioned and assessed in different studies. Conclusions: EBP training can improve nursing students’ capacity in healthcare provision. Teaching EBP competencies along undergraduate nursing curricula should be a high priority at nursing programmes. The use of innovative approaches seems to be more effective than traditional ways. Education of EBP increases its future use and critical thinking and EBP programs improve self-efficacy and the level of evidence utilization.
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Spanakis M, Patelarou AE, Patelarou E. Nursing Personnel in the Era of Personalized Healthcare in Clinical Practice. J Pers Med 2020; 10:E56. [PMID: 32610469 PMCID: PMC7565499 DOI: 10.3390/jpm10030056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/27/2022] Open
Abstract
Personalized, stratified, or precision medicine (PM) introduces a new era in healthcare that tries to identify and predict optimum treatment outcomes for a patient or a cohort. It also introduces new scientific terminologies regarding therapeutic approaches and the need of their adoption from healthcare providers. Till today, evidence-based practice (EBP) was focusing on population averages and their variances among cohorts for clinical values that are essential for optimizing healthcare outcome. It can be stated that EBP and PM are complementary approaches for a modern healthcare system. Healthcare providers through EBP often see the forest (population averages) but miss the trees (individual patients), whereas utilization of PM may not see the forest for the trees. Nursing personnel (NP) play an important role in modern healthcare since they are consulting, educating, and providing care to patients whose needs often needs to be individualized (personalized nursing care, PNC). Based on the clinical issues earlier addressed from clinical pharmacology, EBP, and now encompassed in PM, this review tries to describe the challenges that NP have to face in order to meet the requisites of the new era in healthcare. It presents the demands that should be met for upgrading the provided education and expertise of NP toward an updated role in a modern healthcare system.
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Kotsyfakis M, Zarogiannis S, Patelarou E. The health impact of Saharan dust exposure. Int J Occup Med Environ Health 2019; 32:749-760. [DOI: 10.13075/ijomeh.1896.01466] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Patelarou E. Population medicine: A step forward in closing the
research gap. POPULATION MEDICINE 2019. [DOI: 10.18332/popmed/108431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kotsyfakis M, Patelarou E. MicroRNAs as biomarkers of harmful environmental and occupational exposures: a systematic review. Biomarkers 2019; 24:623-630. [PMID: 31373233 DOI: 10.1080/1354750x.2019.1652348] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Environmental exposure is a growing public health burden associated with several negative health effects. An estimated 4.2 million deaths occur each year from ambient air pollution alone. Biomarkers that reflect specific exposures have the potential to measure the real integrated internal dose from all routes of complex environmental exposure. MicroRNAs (miRNAs), small non-coding RNAs that regulate gene expression, have been studied as biomarkers in various diseases and have also shown potential as environmental exposure biomarkers. Here, we review the available human epidemiological and experimental evidence of miRNA expression changes in response to specific environmental exposures including airborne particulate matter. In doing so, we establish that miRNA exposure biomarker development remains in its infancy and future studies will need to carefully consider biological and analytical 'design rules' in order to facilitate clinical translation.
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Homeyard C, Patelarou E. To what extent are midwives adapting antenatal information for pregnant women with intellectual disabilities? A survey of NHS trusts in England. Public Health 2018. [DOI: 10.1016/j.puhe.2018.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Matalliotakis M, Matalliotaki C, Goulielmos GN, Patelarou E, Tzardi M, Spandidos DA, Arici A, Matalliotakis I. Association between ovarian cancer and advanced endometriosis. Oncol Lett 2018; 15:7689-7692. [PMID: 29725467 PMCID: PMC5920362 DOI: 10.3892/ol.2018.8287] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/15/2018] [Indexed: 12/28/2022] Open
Abstract
We retrospectively analyzed clinicopathological data in two different countries over the past years on the association between ovarian endometriosis and ovarian carcinoma. Medical and pathological reports were evaluated from 1,000 patients with endometriosis from two different geographical areas. The prevalence and women characteristics of cases were analyzed. Endometriosis-associated ovarian cancer was present in 20 (2%) cases, among the study subjects. The observed prevalence was 12 (60%) for endometrioid carcinoma, 4 (20%) for clear cell ovarian carcinoma, 2 (10%) for serous and 2 (10%) for mucinous adenocarcinoma. A higher proportion of endometrioid carcinoma cases were noted in comparison with other types (P<0.001). We found only 3/20 (15%) postmenopausal cases. In all cases, we reported advanced stage of endometriosis (stage III or IV). Left-sided endometrioid carcinoma were notably more common than right-sided ones (P<0.001). In the majority of cases, malignant transformation of endometriosis was observed in endometrioid carcinoma or clear cell carcinoma of the ovary. Further research is required to establish the relationship between endometriosis and ovarian cancer.
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Sfantou DF, Laliotis A, Patelarou AE, Sifaki-Pistolla D, Matalliotakis M, Patelarou E. Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel) 2017; 5:E73. [PMID: 29036901 PMCID: PMC5746707 DOI: 10.3390/healthcare5040073] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/15/2017] [Accepted: 09/25/2017] [Indexed: 01/20/2023] Open
Abstract
Effective leadership of healthcare professionals is critical for strengthening quality and integration of care. This study aimed to assess whether there exist an association between different leadership styles and healthcare quality measures. The search was performed in the Medline (National Library of Medicine, PubMed interface) and EMBASE databases for the time period 2004-2015. The research question that guided this review was posed as: "Is there any relationship between leadership style in healthcare settings and quality of care?" Eighteen articles were found relevant to our research question. Leadership styles were found to be strongly correlated with quality care and associated measures. Leadership was considered a core element for a well-coordinated and integrated provision of care, both from the patients and healthcare professionals.
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Patelarou AE, Kyriakoulis KG, Stamou AA, Laliotis A, Sifaki-Pistolla D, Matalliotakis M, Prokopakis E, Patelarou E. Approaches to teach evidence-based practice among health professionals: an overview of the existing evidence. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2017; 8:455-464. [PMID: 28740443 PMCID: PMC5508813 DOI: 10.2147/amep.s134475] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Health care professionals' adoption of evidence-based practice (EBP) remains limited, although most health care professionals are familiar with EBP and believe in its value. This systematic review aimed to bring together the best methods used to teach EBP to health professionals. The authors conducted a systematic search for the period 2005-2015 (an update of the search took place in October 2016) using PubMed interface (Medline). MeSH terms as well as free-text keywords were used. Studies were analyzed and evaluated by title and abstract. Those studies which fulfilled the inclusion criteria were assessed by full text. References of articles were also taken into consideration for identifying relevant studies not found through algorithm search. Twenty articles were found to be relevant. The majority of the studies were conducted among nurses (n=7) and physicians (n=6), and only a few among professionals from mixed disciplines (n=5). Two studies were conducted among chiropractors (n=1) and faculty members from a naturopathic and classical Chinese medicine institution (n=1). Researchers used a variety of different approaches, which varied with respect to duration and organization. We divided interventions into two categories. Single interventions included either a workshop, or a journal club, or a conference, or a lecture, or online learning tools, whereas multiple interventions included a combination of these approaches. An increase in EBP competencies and attitudes was reported in nine studies. Teaching methods for optimizing EBP among health professionals could become a robust standardized procedure of the medical educational curricula and lifelong learning of health care professionals.
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Giorgis-Allemand L, Pedersen M, Bernard C, Aguilera I, Beelen RMJ, Chatzi L, Cirach M, Danileviciute A, Dedele A, van Eijsden M, Estarlich M, Fernández-Somoano A, Fernández MF, Forastiere F, Gehring U, Grazuleviciene R, Gruzieva O, Heude B, Hoek G, de Hoogh K, van den Hooven EH, Håberg SE, Iñiguez C, Jaddoe VWV, Korek M, Lertxundi A, Lepeule J, Nafstad P, Nystad W, Patelarou E, Porta D, Postma D, Raaschou-Nielsen O, Rudnai P, Siroux V, Sunyer J, Stephanou E, Sørensen M, Eriksen KT, Tuffnell D, Varró MJ, Vrijkotte TGM, Wijga A, Wright J, Nieuwenhuijsen MJ, Pershagen G, Brunekreef B, Kogevinas M, Slama R. The Influence of Meteorological Factors and Atmospheric Pollutants on the Risk of Preterm Birth. Am J Epidemiol 2017; 185:247-258. [PMID: 28087514 DOI: 10.1093/aje/kww141] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/20/2016] [Indexed: 12/13/2022] Open
Abstract
Atmospheric pollutants and meteorological conditions are suspected to be causes of preterm birth. We aimed to characterize their possible association with the risk of preterm birth (defined as birth occurring before 37 completed gestational weeks). We pooled individual data from 13 birth cohorts in 11 European countries (71,493 births from the period 1994-2011, European Study of Cohorts for Air Pollution Effects (ESCAPE)). City-specific meteorological data from routine monitors were averaged over time windows spanning from 1 week to the whole pregnancy. Atmospheric pollution measurements (nitrogen oxides and particulate matter) were combined with data from permanent monitors and land-use data into seasonally adjusted land-use regression models. Preterm birth risks associated with air pollution and meteorological factors were estimated using adjusted discrete-time Cox models. The frequency of preterm birth was 5.0%. Preterm birth risk tended to increase with first-trimester average atmospheric pressure (odds ratio per 5-mbar increase = 1.06, 95% confidence interval: 1.01, 1.11), which could not be distinguished from altitude. There was also some evidence of an increase in preterm birth risk with first-trimester average temperature in the -5°C to 15°C range, with a plateau afterwards (spline coding, P = 0.08). No evidence of adverse association with atmospheric pollutants was observed. Our study lends support for an increase in preterm birth risk with atmospheric pressure.
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Vivilaki VG, Diamanti A, Tzeli M, Patelarou E, Bick D, Papadakis S, Lykeridou K, Katsaounou P. Exposure to active and passive smoking among Greek pregnant women. Tob Induc Dis 2016; 14:12. [PMID: 27051356 PMCID: PMC4820879 DOI: 10.1186/s12971-016-0077-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 03/29/2016] [Indexed: 11/26/2022] Open
Abstract
Background Active smoking and exposure to passive smoke are responsible for numerous adverse pregnancy outcomes for women and their infants. The aim of this study was to explore the perceptions, attitudes, patterns of personal tobacco use and exposure to environmental smoke among a sample of pregnant women in Greece. Method A cross sectional survey was undertaken of 300 women identified from the perinatal care records of the Maternity Departments of two hospitals in Athens between February 2013 and May 2013. Data on active and passive maternal smoking status in the first, second, and third trimesters of pregnancy, fetal and neonatal tobacco related complications, exposure to environmental tobacco smoke during pregnancy, quit attempts, behaviors towards avoiding passive smoking and beliefs towards smoking cessation during pregnancy were collected using self-administered questionnaires on the 3rd postnatal day. Women also completed the Edinburgh Postnatal Depression Scale (EPDS). Results Of 300 women recruited to the study 48 % reported tobacco use during the first trimester of pregnancy. Amongst participants who were tobacco users, 83.3 % reported making an attempt to quit but less than half (45.1 %) were successful. Among women who continued to smoke during pregnancy the majority (55.8 %) reported that they felt unable to quit, and 9.3 % reported that they considered smoking cessation was not an important health issue for them. Participants who continued to smoke during pregnancy were more likely to report fetal (χ2 = 11.41; df = 5; p < 0.05) and newborn complications (χ2 = 6.41; df = 2; p < 0.05), including preterm birth and low birth weight. Participants who reported that their partners were smokers were more likely to smoke throughout their pregnancy (χ2 = 14.62; df = 1; p < 0.001). High rates of second-hand smoke exposure were reported among both smoking and non-smoking women. Pregnant smokers had significantly higher levels of postnatal depressive and anxiety symptomatology, as measured using the EPDS, than non-smokers. Conclusion Our data supports the importance of ensuring that pregnant women, their partners and close relatives are educated on the health risks of active and passive smoking and how these could have an adverse effect to their fetus and infants, as well as the pregnant women themselves.
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Vardavas CI, Hohmann C, Patelarou E, Martinez D, Henderson AJ, Granell R, Sunyer J, Torrent M, Fantini MP, Gori D, Annesi-Maesano I, Slama R, Duijts L, de Jongste JC, Aurrekoetxea JJ, Basterrechea M, Morales E, Ballester F, Murcia M, Thijs C, Mommers M, Kuehni CE, Gaillard EA, Tischer C, Heinrich J, Pizzi C, Zugna D, Gehring U, Wijga A, Chatzi L, Vassilaki M, Bergström A, Eller E, Lau S, Keil T, Nieuwenhuijsen M, Kogevinas M. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children. Eur Respir J 2016; 48:115-24. [PMID: 26965294 DOI: 10.1183/13993003.01016-2015] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 01/27/2016] [Indexed: 11/05/2022]
Abstract
Maternal smoking during pregnancy increases childhood asthma risk, but health effects in children of nonsmoking mothers passively exposed to tobacco smoke during pregnancy are unclear. We examined the association of maternal passive smoking during pregnancy and wheeze in children aged ≤2 years.Individual data of 27 993 mother-child pairs from 15 European birth cohorts were combined in pooled analyses taking into consideration potential confounders.Children with maternal exposure to passive smoking during pregnancy and no other smoking exposure were more likely to develop wheeze up to the age of 2 years (OR 1.11, 95% CI 1.03-1.20) compared with unexposed children. Risk of wheeze was further increased by children's postnatal passive smoke exposure in addition to their mothers' passive exposure during pregnancy (OR 1.29, 95% CI 1.19-1.40) and highest in children with both sources of passive exposure and mothers who smoked actively during pregnancy (OR 1.73, 95% CI 1.59-1.88). Risk of wheeze associated with tobacco smoke exposure was higher in children with an allergic versus nonallergic family history.Maternal passive smoking exposure during pregnancy is an independent risk factor for wheeze in children up to the age of 2 years. Pregnant females should avoid active and passive exposure to tobacco smoke for the benefit of their children's health.
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Kyriakoulis K, Patelarou A, Laliotis A, Wan AC, Matalliotakis M, Tsiou C, Patelarou E. Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2016; 13:34. [PMID: 27649902 PMCID: PMC5066070 DOI: 10.3352/jeehp.2016.13.34] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/21/2016] [Indexed: 05/06/2023]
Abstract
PURPOSE The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. METHODS The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). RESULTS Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. CONCLUSION Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students' EBP competence.
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Evlampidou I, Bagkeris M, Vardavas C, Koutra K, Patelarou E, Koutis A, Chatzi L, Kogevinas M. Prenatal Second-Hand Smoke Exposure Measured with Urine Cotinine May Reduce Gross Motor Development at 18 Months of Age. J Pediatr 2015; 167:246-52.e2. [PMID: 25863662 DOI: 10.1016/j.jpeds.2015.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 02/02/2015] [Accepted: 03/03/2015] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To evaluate the association of second-hand smoke exposure of pregnant mothers using urine cotinine with the neurodevelopment of their children at 18 months of age in the mother-child cohort in Crete (Rhea Study). STUDY DESIGN Selected participants were Greek mothers with singleton pregnancies, had never smoked, and had available urine cotinine measurements in pregnancy, and their children for whom a neurodevelopmental assessment was completed. We performed face-to-face interviews twice during pregnancy and postnatally, and assessed children's neurodevelopment at 18 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition. We used linear regression and generalized additive models. RESULTS Of 599 mothers, 175 (29%) met the inclusion criteria. Maternal urine cotinine levels were low (mean: 10.3 ng/mL, SD: 11.7 ng/mL). Reported passive smoking from different sources was strongly associated with urine cotinine levels. A negative association was observed between cotinine levels in pregnancy and child's gross motor function (beta = -3.22 per 10 ng/mL, 95% CI -5.09 to -1.34) after adjusting for factors potentially associated with neurodevelopment; results were similar in both sexes. A negative association was also observed for cognitive and receptive communication scales but the effect was small and not statistically significant. CONCLUSIONS Maternal exposure during pregnancy to second-hand smoke measured through urine cotinine was associated with a decrease in gross motor function among 18-month-old children, even at low levels of exposure.
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Portillo MC, Regaira E, Pumar-Méndez MJ, Mujika A, Vassilev I, Rogers A, Wensing M, Foss C, Ruud Knutsen I, Todorova E, Roukova P, Kennedy A, Serrano M, Lionis C, Angelaki A, Patelarou E, Koetsenruijter J. Voluntary Organizations and Community Groups as New Partners in Diabetes Self-management and Education: A Critical Interpretative Synthesis. DIABETES EDUCATOR 2015; 41:550-68. [PMID: 26160829 DOI: 10.1177/0145721715594026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study is to critically review the literature on the role and work of voluntary organizations and community groups and volunteers in diabetes self-management programs. It seeks to explain how these organizations are located and could be integrated further within a broader system of support. METHODS A critical interpretative synthesis of the literature was undertaken as part of the conceptual development of a European research project. Evidence (2000-November 2014) was searched in databases, with the use of key terms, and limited to the languages of the participating countries. This was supplemented by an additional hand search and snowballing technique. A total of 21 articles were included in the review. RESULTS Evidence regarding the involvement of voluntary organizations in diabetes self-management programs mainly related to: the nature and remit of their work, responsibilities, and attributes; key strategies of programs accounting for success; motivations/barriers for engaging in volunteering participation; relationships between volunteers and users; and connections/tensions with formal services. CONCLUSIONS This review has uncovered a range of facets of voluntary organizations and community groups relevant for supporting diabetes self-management such as the context within which they act and the nature of relationships developed with community and health services. The principles of "assistance, support, sharing, and link" seem essential for this voluntary initiative in self-management to establish effective reciprocal collaboration with health professionals.
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Casas M, Cordier S, Martínez D, Barros H, Bonde JP, Burdorf A, Costet N, dos Santos AC, Danileviciute A, Eggesbø M, Fernandez M, Fevotte J, García AM, Gražuleviciene R, Hallner E, Hanke W, Kogevinas M, Kull I, Stemann Larsen P, Melaki V, Monfort C, Nordby KC, Nybo Andersen AM, Patelarou E, Polanska K, Richiardi L, Santa Marina L, Snijder C, Tardón A, van Eijsden M, Vrijkotte TGM, Zugna D, Nieuwenhuijsen M, Vrijheid M. Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts. Scand J Work Environ Health 2015; 41:384-396. [DOI: 10.5271/sjweh.3500] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Patelarou E, Tzanakis N, Kelly FJ. Exposure to indoor pollutants and Wheeze and asthma development during early childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3993-4017. [PMID: 25872014 PMCID: PMC4410229 DOI: 10.3390/ijerph120403993] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/25/2015] [Accepted: 04/03/2015] [Indexed: 11/16/2022]
Abstract
Background: This review aimed to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution with early childhood respiratory disease. Methods: We carried out a systematic literature search of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed exposure to indoor pollutants and asthma and wheeze from infancy up to the age of 5. Results: The search, between January 2004 and February 2014 yielded 1840 studies for consideration. Following application of eligibility criteria to titles and abstracts 22 independent studies were deemed relevant for further review. Two additional studies were next identified through examination of the references’ lists of these studies. Of these 24 selected studies, 16 adopted a prospective cohort design and 8 were case-control studies. Fourteen studies assessed exposure to bio-aerosols, 8 studies assessed exposure to specific air chemicals and two studies assessed exposure to bio-aerosols and air chemicals. Furthermore, 11 studies examined the association of exposure with asthma and 16 with wheeze. Findings indicate that existing studies have reported contradictory effects of indoor pollutants levels and occurrence of asthma/wheeze. Conclusion: Additional research to establish causality and evaluate interventions to prevent disease onset is needed.
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Brokalaki H, Patelarou E, Giakoumidakis K, Kollia Z, Fotos NV, Vivilaki V, Brokalaki E, Chatzistamatiou E, Kallikazaros IE. Translation and validation of the Greek "Minnesota Living with Heart Failure" questionnaire. Hellenic J Cardiol 2015; 56:10-19. [PMID: 25701967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is an important measurement instrument for assessing the health-related quality of life (HRQOL) among heart failure patients. The purpose of this study was to translate and validate the MLHFQ in the Greek language. METHODS Three hundred forty-four consecutive adult patients from three General Hospitals, two in Athens and one in another part of the country, who were diagnosed with chronic heart failure, and 347 healthy controls were enrolled in the study from March 2009 to March 2010. The questionnaire instrument was translated from English, back-translated, and reviewed by a committee of experts. The psychometric measurements that were performed included reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and Principal Components Method. In a further step, confirmatory analysis (CFA)--known as structural equation modeling--of the principal components was conducted. RESULTS The internal consistency of the Greek MLHFQ version was found to be 0.97, using Cronbach's alpha coefficient. An exploratory factor analysis identified two domains that accounted for 72.5% of the variance of MLHFQ items; the area under the ROC curve was calculated at 0.942 and the logistic estimate for the threshold score of 24.50 provided the model with 95.1% sensitivity and 99.8% specificity. Additionally, the CFA demonstrated that the two-factor model offered a very good fit to our data. CONCLUSIONS Our data indicate that the Greek MLHFQ is a reliable and valid tool for assessing HRQOL among patients with heart failure. Health professionals can use it in their clinical practice to improve their evaluation of these patients.
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