Who is going to rescue the rescuers? Post-traumatic stress disorder among rescue workers operating in Greece during the European refugee crisis.

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.

Ophthalmological disorders in rural areas of Crete: a geospatial analysis.

INTRODUCTION: Estimation of the prevalence of vision impairment in a population can be performed using epidemiological research. The purpose of this study was to measure, using spatial statistics, the prevalence of ophthalmologic disease identified at visits of the Mobile Ophthalmologic Unit (MOU) of the Vardinogiannion Eye Institute of Crete (VEIC) to villages in Crete. The study also aimed to estimate increased 'risk' of ophthalmological disease according to demographic and location factors and, thus, use the present findings as a basis for planning future services. METHODS: Estimation of risks for cataract, glaucoma, and refractive errors were assessed by multiple logistic regression models in order to measure the effect of demographic (age, sex) and location (province, distance from nearest ophthalmologist) parameters. Spatial analysis was applied in order to produce a density and probability density map of ophthalmologic disorders using kriging interpolation methods. RESULTS: Newly diagnosed cataracts and refractive errors were found more frequently in locations greater than 70 km from the nearest ophthalmologist (respectively, OR = 6.0 [95% CI = 1.637-9.482]; OR = 27.4 [20.038-39.028] p-value = 0.004). Those aged >60 years had higher risk for all eye abnormalities: cataracts (OR = 0.7; 95% CI = 0.238-0.938), glaucoma (OR = 1.6; 95% CI = 1.227-2.037), and refractive errors (OR = 0.5; 95% CI = 0.183-0.829). CONCLUSION: The present study supports the use of local policies and preventive measures in rural areas of Crete in order to improve rural health standards. Some insights concerning the effectiveness of future visits of MOUs are provided, guided by spatial analysis.

Evidence-Based Conceptual Collection of Methods for Spatial Epidemiology and Analysis to Enhance Cancer Surveillance and Public Health.

(1) Background: Although spatial statistics are often used by cancer epidemiologists, there is not yet an established collection of methods to serve their needs. We aimed to develop an evidence-based cancer-oriented conceptual collection of methods for spatial analysis; (2) Methods: A triangulation of approaches was used; literature review, consensus meetings (expert panel), and testing the selected methods on "training" databases. The literature review was conducted in three databases. This approach guided the development of a collection of methods that was subsequently commented on by the expert panel and tested on "training data" of cancer cases obtained from the Cancer Registry of Crete based on three epidemiological scenarios: (a) low prevalence cancers, (b) high prevalence cancers, (c) cancer and risk factors; (3) Results: The final spatial epidemiology conceptual collection of methods covered: data preparation/testing randomness, data protection, mapping/visualizing, geographic correlation studies, clustering/surveillance, integration of cancer data with socio-economic, clinical and environmental factors. Some of the tests/techniques included in the conceptual collection of methods were: buffer and proximity analysis, exploratory spatial analysis and others. All suggested that statistical models were found to fit well (R2 = 0.72-0.96) in "training data"; Conclusions: The proposed conceptual collection of methods provides public health professionals with a useful methodological framework along with recommendations for assessing diverse research questions of global health.

PTSD, burnout and well-being among rescue workers: Seeking to understand the impact of the European refugee crisis on rescuers.

Individuals who perform rescue and recovery duties, as part of their daily work activities, confront diverse stressors that can affect their mental state and overall well-being. The study aimed to assess the prevalence and the factors associated with self-assessed PTSD, perceived well-being and burnout among rescue workers operating at Lesvos during the European refugees crisis. 217 rescuers participated in the study, while the PTSD Checklist-Civilian Version (PCL-C), the Maslach Burnout Inventory (MBI) and the Well-being Index (WHO-5) were utilized. The prevalence of self-assessed PTSD and perceived burnout syndrome was 17.1% and 57% respectively, while 72.8% of the rescuers reported low levels of perceived well-being. Self-assessed PTSD was positively correlated with perceived burnout and inversely correlated with perceived well-being. Perceived burnout was also inversely correlated with perceived well-being. A number of significant predictors were identified for self-assessed PTSD, perceived burnout and well-being, including: family status, age, duration of shifts, collection of dead adults or dead children bodies. The impact of the refugee crisis is visible on the rescue workers that offer rescue and first aid services. There is an urgent need for implementing effective interventions focusing on the identified determinants in order to enhance the occupational psychological burden of rescuers.