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1.
Artigo em Inglês | MEDLINE | ID: mdl-36612661

RESUMO

Colorectal cancer (CRC) is one of the leading causes of death and morbidity worldwide. To date, the relationship between regional deprivation and CRC incidence or mortality has not been studied in the population of Cyprus. The objective of this study was to analyse the geographical variation of CRC incidence and mortality and its possible association with socioeconomic inequalities in Cyprus for the time period of 2000-2015. This is a small-area ecological study in Cyprus, with census tracts as units of spatial analysis. The incidence date, sex, age, postcode, primary site, death date in case of death, or last contact date of all alive CRC cases from 2000-2015 were obtained from the Cyprus Ministry of Health's Health Monitoring Unit. Indirect standardisation was used to calculate the sex and age Standardise Incidence Ratios (SIRs) and Standardised Mortality Ratios (SMRs) of CRC while the smoothed values of SIRs, SMRs, and Mortality to Incidence ratio (M/I ratio) were estimated using the univariate Bayesian Poisson log-linear spatial model. To evaluate the association of CRC incidence and mortality rate with socioeconomic deprivation, we included the national socioeconomic deprivation index as a covariate variable entering in the model either as a continuous variable or as a categorical variable representing quartiles of areas with increasing levels of socioeconomic deprivation. The results showed that there are geographical areas having 15% higher SIR and SMR, with most of those areas located on the east coast of the island. We found higher M/I ratio values in the rural, remote, and less dense areas of the island, while lower rates were observed in the metropolitan areas. We also discovered an inverted U-shape pattern in CRC incidence and mortality with higher rates in the areas classified in the second quartile (Q2-areas) of the socioeconomic deprivation index and lower rates in rural, remote, and less dense areas (Q4-areas). These findings provide useful information at local and national levels and inform decisions about resource allocation to geographically targeted prevention and control plans to increase CRC screening and management.


Assuntos
Neoplasias Colorretais , Humanos , Fatores Socioeconômicos , Chipre/epidemiologia , Teorema de Bayes , Neoplasias Colorretais/epidemiologia , População Rural
2.
Health Res Policy Syst ; 19(1): 43, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33781266

RESUMO

BACKGROUND: Diabetes is a global epidemic affecting every country. Small countries, however, face distinctive challenges related to their health system governance and their ability to implement effective health systems' reforms. The aim of this research was to perform a comparative assessment of existing diabetes management practices at the population level and explore governmental-related policy for Cyprus, Iceland, Luxembourg, Malta and Montenegro. This is the first time that such an evidence-based review study has been performed in the field of diabetes. The overall purpose was to set the agenda for health policy and inform strategic actions for small countries that can benefit from dealing with the diabetes epidemic at a country level. METHODS: We collected data and synthesized the evidence on dealing with diabetes for each of the five small European countries according to the (1) epidemiology of diabetes and other related metabolic abnormalities, (2) burden of diabetes status and (3) diabetes registers and national plans. We collected data by contacting Ministry representatives and other bodies in each state, and by searching through publicly available information from the respective Ministry of Health website on strategies and policies. RESULTS: Diabetes rates were highest in Cyprus and Malta. National diabetes registers are present in Cyprus and Montenegro, while national diabetes plans and diabetes-specific strategies have been established in Cyprus, Malta and Montenegro. These three countries also offer a free holistic healthcare service to their diabetes population. CONCLUSIONS: Multistakeholder, national diabetes plans and public health strategies are important means to provide direction on diabetes management and health service provision at the population level. However, political support is not always present, as seen for Iceland. The absence of evidence-based strategies, lack of funding for conducting regular health examination surveys, omission of monitoring practices and capacity scarcity are among the greatest challenges faced by small countries to effectively measure health outcomes. Nevertheless, we identified means of how these can be overcome. For example, the creation of public interdisciplinary repositories enables easily accessible data that can be used for health policy and strategic planning. Health policy-makers, funders and practitioners can consider the use of regular health examination surveys and other tools to effectively manage diabetes at the population level.


Assuntos
Diabetes Mellitus , Política de Saúde , Chipre/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos
3.
J Interpers Violence ; 36(15-16): NP8333-NP8346, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-30982416

RESUMO

Although many studies generally agree that unemployment may affect domestic violence, little is known about these effects in small nations. The relationship between unemployment and domestic violence in large and small nations may be different. This is because small nations have more expensive public sectors and limited employment opportunities in comparison with larger nations. We examined how longitudinal rates of national help-seeking domestic violence contacts (DVCs) from the only nongovernmental domestic violence support agency in Cyprus (a small nation) fluctuated in relation to national unemployment data between 1996 and 2016. This period included an economic crisis which commenced in 2011 and showed signs of recovery in 2015. We analyzed whether the fluctuations in unemployment registrations could predict changes in DVCs. Our analysis included 5,103,120 unemployment registrations and 21,774 DVCs. Findings supported our hypothesis and revealed unemployment predicted and correlated with DVCs. There were significant changes to DVCs when Cyprus plunged into economic crisis, meaning that when unemployment increased, DVCs also increased. Cyprus does not deviate from larger societies in help-seeking behavior in the form of people contacting a national helpline when exposed to economic crises. This study provides evidence of the link between economic hardship and increased help-seeking behaviors in small nations. Societies at risk of an economic crisis need to consider the potential impact on domestic violence rates and on demand for support services.


Assuntos
Violência Doméstica , Recessão Econômica , Chipre/epidemiologia , Humanos , Pobreza , Desemprego
4.
Lancet Haematol ; 7(6): e469-e478, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32470438

RESUMO

BACKGROUND: Transfusion-dependent haemoglobinopathies require lifelong iron chelation therapy with one of the three iron chelators (deferiprone, deferasirox, or deferoxamine). Deferasirox and deferiprone are the only two oral chelators used in adult patients with transfusion-dependent haemoglobinopathies. To our knowledge, there are no randomised clinical trials comparing deferiprone, a less expensive iron chelator, with deferasirox in paediatric patients. We aimed to show the non-inferiority of deferiprone versus deferasirox. METHODS: DEEP-2 was a phase 3, multicentre, randomised trial in paediatric patients (aged 1 month to 18 years) with transfusion-dependent haemoglobinopathies. The study was done in 21 research hospitals and universities in Italy, Egypt, Greece, Albania, Cyprus, Tunisia, and the UK. Participants were receiving at least 150 mL/kg per year of red blood cells for the past 2 years at the time of enrolment, and were receiving deferoxamine (<100 mg/kg per day) or deferasirox (<40 mg/kg per day; deferasirox is not registered for use in children aged <2 years so only deferoxamine was being used in these patients). Any previous chelation treatment was permitted with a 7-day washout period. Patients were randomly assigned 1:1 to receive orally administered daily deferiprone (75-100 mg/kg per day) or daily deferasirox (20-40 mg/kg per day) administered as dispersible tablets, both with dose adjustment for 12 months, stratified by age (<10 years and ≥10 years) and balanced by country. The primary efficacy endpoint was based on predefined success criteria for changes in serum ferritin concentration (all patients) and cardiac MRI T2-star (T2*; patients aged >10 years) to show non-inferiority of deferiprone versus deferasirox in the per-protocol population, defined as all randomly assigned patients who received the study drugs and had available data for both variables at baseline and after 1 year of treatment, without major protocol violations. Non-inferiority was based on the two-sided 95% CI of the difference in the proportion of patients with treatment success between the two groups and was shown if the lower limit of the two-sided 95% CI was greater than -12·5%. Safety was assessed in all patients who received at least one dose of study drug. This study is registered with EudraCT, 2012-000353-31, and ClinicalTrials.gov, NCT01825512. FINDINGS: 435 patients were enrolled between March 17, 2014, and June 16, 2016, 393 of whom were randomly assigned to a treatment group (194 to the deferiprone group; 199 to the deferasirox group). 352 (90%) of 390 patients had ß-thalassaemia major, 27 (7%) had sickle cell disease, five (1%) had thalassodrepanocytosis, and six (2%) had other haemoglobinopathies. Median follow-up was 379 days (IQR 294-392) for deferiprone and 381 days (350-392) for deferasirox. Non-inferiority of deferiprone versus deferasirox was established (treatment success in 69 [55·2%] of 125 patients assigned deferiprone with primary composite efficacy endpoint data available at baseline and 1 year vs 80 [54·8%] of 146 assigned deferasirox, difference 0·4%; 95% CI -11·9 to 12·6). No significant difference between the groups was shown in the occurrence of serious and drug-related adverse events. Three (2%) cases of reversible agranulocytosis occurred in the 193 patients in the safety analysis in the deferiprone group and two (1%) cases of reversible renal and urinary disorders (one case of each) occurred in the 197 patients in the deferasirox group. Compliance was similar between treatment groups: 183 (95%) of 193 patients in the deferiprone group versus 192 (97%) of 197 patients in the deferisirox group. INTERPRETATION: In paediatric patients with transfusion-dependent haemoglobinopathies, deferiprone was effective and safe in inducing control of iron overload during 12 months of treatment. Considering the need for availability of more chelation treatments in paediatric populations, deferiprone offers a valuable treatment option for this age group. FUNDING: EU Seventh Framework Programme.


Assuntos
Deferasirox/uso terapêutico , Deferiprona/uso terapêutico , Transfusão de Eritrócitos/métodos , Hemoglobinopatias/tratamento farmacológico , Quelantes de Ferro/uso terapêutico , Sobrecarga de Ferro/tratamento farmacológico , Administração Oral , Adolescente , Agranulocitose/induzido quimicamente , Agranulocitose/epidemiologia , Albânia/epidemiologia , Anemia Falciforme/terapia , Técnicas de Imagem Cardíaca/métodos , Criança , Pré-Escolar , Chipre/epidemiologia , Deferasirox/administração & dosagem , Deferasirox/economia , Deferiprona/administração & dosagem , Deferiprona/economia , Egito/epidemiologia , Transfusão de Eritrócitos/estatística & dados numéricos , Feminino , Ferritinas/sangue , Ferritinas/efeitos dos fármacos , Grécia/epidemiologia , Hemoglobinopatias/terapia , Humanos , Lactente , Quelantes de Ferro/administração & dosagem , Quelantes de Ferro/economia , Sobrecarga de Ferro/sangue , Itália/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Cooperação do Paciente , Resultado do Tratamento , Tunísia/epidemiologia , Reino Unido/epidemiologia , Doenças Urológicas/induzido quimicamente , Doenças Urológicas/epidemiologia , Talassemia beta/terapia
5.
J Occup Environ Med ; 61(8): e348-e353, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31348420

RESUMO

OBJECTIVE: Investigate psychological distress and its link to stress management interventions in the financial industry (FI) in comparison to the human services (HS) sector. METHOD: Observational study across participating organizations in FI (66) and HS (81). Web-based version of depression anxiety stress scales (21 questions) and eight questions related to stress prevention interventions adopted by employers. RESULTS: Indicated that FI workers are twice as likely as HS employees to present with stress and depression. Differences emerged on the availability of support at the workplace: FI workers reporting total lack of psychological support, although other forms of wellbeing promotion were more frequent. Close to 60% of individuals in the HS group reported no support (48% in the FI). CONCLUSION: Workers in the FI industry have increased levels of workplace stress that could be possibly attributed to absence of prevention interventions at the workplace.


Assuntos
Indústrias , Doenças Profissionais/epidemiologia , Doenças Profissionais/terapia , Serviços de Saúde do Trabalhador , Angústia Psicológica , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/terapia , Efeitos Psicossociais da Doença , Chipre/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Feminino , Administração Financeira , Bombeiros/psicologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Doenças Profissionais/psicologia , Estresse Ocupacional/prevenção & controle , Estresse Ocupacional/psicologia , Recursos Humanos em Hospital/psicologia , Projetos Piloto , Prevalência , Fatores de Risco
6.
BMC Public Health ; 19(1): 627, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118020

RESUMO

BACKGROUND: Area-level measures of socioeconomic deprivation are important for understanding and describing health inequalities. The aim of this study was the development and validation of a small-area index of socioeconomic deprivation for Cypriot communities and the investigation of its association with the spatial distribution of all-cause premature adult mortality. METHODS: Six area-level socioeconomic indicators were used from the 2011 national population census (low educational attainment, unemployment, not owner occupied household, single-person household, divorced or widowed and single-parent households). After normalization and standardization of the geographically smoothed indicators, Principal Component Analysis (PCA) was used to construct indicator weights. The association between deprivation indices and the spatial distribution of all-cause premature adult mortality was estimated in Poisson log-linear spatial models. RESULTS: PCA resulted in two principal components explaining the 65.7% of the total variance. The first principal component included four indicators (low educational attainment, single-person households, divorced or widowed and single-parent households, the latter however with a negative loading) and it thought more likely to capture rural-related aspects of deprivation. The second principal component included the other two indicators (unemployment and not owner occupied households) and it is more likely to capture urban-related aspects of material deprivation. Restricting the analysis in the metropolitan areas of the island resulted in a different set of indicators for the urban-specific deprivation index. All developed indices were linearly associated with all-cause premature adult mortality. The all-cause premature adult mortality increased by 17% per 1 standard deviation (SD) increase in rural-related socioeconomic deprivation (95% CrI: 8-27%) and 8% per 1 SD increase in urban-related aspects of material deprivation (95% CrI: 3-15%) in the nationwide analysis and 9% per 1 SD increase in urban-specific socioeconomic deprivation (95% CrI: 4-15%) across metropolitan areas. CONCLUSIONS: The results of this study demonstrate that a set of small-area indices of socioeconomic deprivation across Cypriot communities have good construct and predictive validity. However, the study indicates that different aspects of socioeconomic deprivation may be important in rural and urban areas in Cyprus. The developed socioeconomic deprivation indices could offer a valid new tool for Cypriot public health research and policy in terms of identifying areas in greatest need, guiding resource allocation and developing area-targeted public health programmes and policies.


Assuntos
Disparidades nos Níveis de Saúde , Indicadores Básicos de Saúde , Mortalidade Prematura/tendências , Fatores Socioeconômicos , Adulto , Censos , Chipre/epidemiologia , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Reprodutibilidade dos Testes , População Rural/estatística & dados numéricos , Pais Solteiros , Análise de Pequenas Áreas , Desemprego , Viuvez
8.
Reprod Health ; 15(1): 157, 2018 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-30231873

RESUMO

BACKGROUND: Prematurity and low birth weight are significant predictors of perinatal morbidity and mortality and are influenced by the overall health and socioeconomic status of the pregnant mother. Although Cyprus is characterized by the highest prematurity rate in Europe (13.1% in 2014), the relationship between maternal health and socioeconomic characteristics with prematurity and low birth weight has never been investigated. We aimed to investigate the association of maternal demographic, clinical and socioeconomic characteristics with premature delivery and low neonatal birth weight in Cyprus. METHODS: In a case-control design, questionnaire data were collected from 348 women who gave birth prematurely (cases) and 349 women who gave birth at term (controls). Information was obtained on gestation duration and birth weight as well as maternal demographic, socioeconomic and clinical profiles, including parameters such as smoking, body mass index, alcohol consumption, presence of gestational diabetes and mental health factors. RESULTS: Premature delivery was associated with greater maternal age (OR: 1.12, 95% CI: 1.06-1.18), absence of gestational diabetes (OR: 0.53, 95% CI: 0.30-0.97), long working hours (OR: 3.77, 95% CI: 2.08-6.84) and emotional stress (OR: 8.5, 95% CI: 3.03-23.89). Within the cases group, emotional stress was also associated with lower birth-weight (ß: -323.68 (95% CI: -570.36, - 77.00). CONCLUSIONS: The findings of this study demonstrate the positive association of maternal psychological factors, working conditions as well as maternal age with prematurity and low birth weight in Cyprus. Additional, prospective, studies are needed in the country to further investigate these associations and inform public health intervention measures.


Assuntos
Recém-Nascido de Baixo Peso , Nascimento Prematuro , Fatores Socioeconômicos , Peso ao Nascer , Estudos de Casos e Controles , Criança , Chipre/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Prospectivos , Fatores de Risco
9.
BMC Public Health ; 17(1): 262, 2017 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-28302094

RESUMO

BACKGROUND: Asthma is one of the main non-infectious diseases of the respiratory system with substantial economic burden worldwide. The objective of this study was to estimate the economic burden of adult asthma in Cyprus during 2015. METHODS: A retrospective probabilistic prevalence-based cost of illness model was developed to calculate the economic burden of asthma including direct and indirect costs. The bottom-up approach (person-based data) was used for the calculation of direct costs while for the calculation of indirect costs the approach of human capital was employed. In addition, bootstrapped sensitivity analysis with 1000 bootstrap simulations was performed in order to calculate a 95% Confidence Interval (CI). RESULTS: Mean patient cost of asthma in Cyprus in 2015 was estimated at €579.64 (95% CI: €376.90-€813.68). Direct costs accounted for 82.08% of the overall expenses, €475.75 per patient (95% CI: €296.94-€697.69). Indirect costs of €103.89 (95% CI: €49.59-€181.46) accounted for 17.92% of the overall expenses. CONCLUSION: This was the first study in Cyprus, which used bootstrapped prevalence-based cost of illness model to estimate the cost of asthma. This study confirms that asthma is an expensive disease for the society. In addition, it provides important information and analysis of the economic consequences of asthma to policy makers in order to strengthen surveillance of the disease as well as draft the national health policy accordingly.


Assuntos
Asma/economia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Adulto , Asma/epidemiologia , Chipre/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos
10.
Psychol Health Med ; 21(7): 787-99, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26782700

RESUMO

The impact of psychiatric illnesses upon asthma patients' functioning is not well understood. This study examined the impact of psychiatric comorbidity upon illness management in asthma patients using empirically-derived psychiatric comorbidity groups. Participants were a clinic sample of Greek-speaking asthma patients (N = 212) assessed using the Patient Health Questionnaire (PHQ) Somatoform, Depression, Panic Disorder (PD), Other Anxiety Disorder, Eating Disorder (ED) and Alcohol sub-scales. The associations between sub-scales were examined using multiway frequency analysis. The following groups were derived: Somatoform disorder and/or Any Depressive disorder (n = 63), Somatoform disorder and/or Other Anxiety disorder (n = 51), Somatoform disorder and/or Any ED (n = 60), and Any Anxiety group including PD and/or Other Anxiety disorder (n = 24). Across all groups, psychiatric illness was associated with significantly worse asthma control (p < .01). Participants in Any Anxiety group, OR = 4.61, 95% CI [1.90, 11.15], Somatoform and/or Any Depressive disorder, OR = 2.06, 95% CI [1.04, 4.09] and Somatoform and/or Other Anxiety disorder, OR = 2.75, 95% CI [1.35, 5.60] were at higher risk for asthma-related Emergency Room (ER) visits compared to controls. However only Somatoform and/or Any Depressive disorder, OR = 3.67, 95% CI [1.60, 8.72], Somatoform and/or Other Anxiety disorder, OR = 5.50, 95% CI [2.34, 12.74], and Somatoform and/or Any ED, OR = 4.98, 95% CI [2.14, 11.60] group membership were risk factors for asthma-related hospitalizations. Results suggest that while comorbid psychiatric disorders generally negatively impact asthma illness management, different psychiatric comorbidities appear to have disparate effects upon illness management outcomes.


Assuntos
Asma/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Asma/psicologia , Comorbidade , Chipre/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Prevalência , Fatores de Risco , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/psicologia
11.
Nephron ; 131(1): 5-10, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26418867

RESUMO

BACKGROUND/AIMS: Factor V Leiden heterozygosity occurs in 3-8% of the general European and US populations. Activated protein C resistance (APC-R)--a non-molecular laboratory test--can efficiently demonstrate the presence of this mutation and can be performed on most coagulation analyzers. On the other hand, fistula or graft thrombosis is a common and costly complication in hemodialysis patients. Our aim was to establish the value of APC-R determination in hemodialysis patients by assessing the risk of access thrombosis in patients with increased APC-R. METHODS: A total of 133 patients (81 men, mean age 64.5 ± 14.9 years and 52 women, mean age 63.6 ± 15 years) were selected. Participants were divided into 2 groups: those with access thrombosis (54 patients, 40.6%) and those with no access thrombosis (79 patients, 59.4%), and they were tested for the most common congenital or acquired thrombophilia risk factors. RESULTS: Overall, 12 patients (9%) had an increased APC-R and 10 of them had at least 1 episode of access thrombosis (83.3%). Univariate analysis to estimate crude odds ratio (OR) showed an OR of 8.8 (95% CI 1.8-41.8) times higher risk for access thrombosis in these patients. No significant differences were found after adjusting for age, hypertension, diabetes mellitus, coronary artery disease, cerebrovascular disease, peripheral arterial disease and malignancy. Sex was also a factor influencing thrombosis, presenting a higher OR for women (OR 2.2, 95% CI 1.1-4.4). CONCLUSION: This study revealed a significant association between access thrombosis and increased APC-R in hemodialysis patients. This indicates that the determination of APC-R should be considered--especially, in populations with a high prevalence of Factor V Leiden--as proper anticoagulant therapy in these patients may reduce the risk of access thrombosis.


Assuntos
Resistência à Proteína C Ativada/diagnóstico , Resistência à Proteína C Ativada/epidemiologia , Fator V , Trombose/diagnóstico , Dispositivos de Acesso Vascular/efeitos adversos , Idoso , Redução de Custos , Chipre/epidemiologia , Feminino , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Diálise Renal/efeitos adversos , Diálise Renal/economia , Fatores de Risco , Trombose/economia , Trombose/epidemiologia , Dispositivos de Acesso Vascular/economia
12.
BMC Musculoskelet Disord ; 16: 193, 2015 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-26268588

RESUMO

BACKGROUND: Osteoarthritis is one of the primary causes of long-term functional disability. With an estimated 13.5% prevalence in the general population contributes to a significant financial burden both for patients and healthcare systems. The purpose of this research is to highlight the direct annual cost of the disease to the private healthcare sector of Nicosia. METHODS: A questionnaire based on Greek and international research was completed between 10/1/2012 and 11/30/2012, with a sample of 20 doctors specialists in orthopaedics and rheumatology (50% of practising physicians in the private sector). An assessment of the annual cost of medical procedures and tests, pharmacologic therapies (modalities) and supplies per patient followed, based on current costs. Direct costs were assessed through the micro-costing "bottom-up" approach. We isolated and separately priced the original diagnosis, followed by each stage of the disease. RESULTS: The cost for the six predominant medical tests to establish a diagnosis and exclude mainly RA such as ESR, CPR, and X-ray as well as a physician's office visit was 150€ per patient. The average direct cost per patient during stages 1, 2 and 3 of the disease was 280.54€, 1,834.64€ and 5,641.72€ annually, respectively, with an annual average of 2,573€ per patient. CONCLUSIONS: Even though during the period of the study, the country had not yet established clinical guidelines, the participating physicians followed international practices. Significant rise in the cost in each stage of the disease was found, with additional increases in the following years as a result of the expected increased prevalence of the disease. It is noted here that uninsured patients, as well as those who qualified for free medical care, they seek these services in the private sector, and had to pay out of pocket money for examination and treatment. These patients, thus, contended with a serious financial burden. Therefore, it is important to inform them very extensively regarding evidence-based management of the disease to aid them in coping with this chronic illness.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Ortopedia/economia , Osteoartrite/economia , Médicos/economia , Reumatologia/economia , Idoso , Chipre/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/epidemiologia
13.
Cult Health Sex ; 17(6): 682-99, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25567318

RESUMO

Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Atitude , Vítimas de Crime/estatística & dados numéricos , Criminosos/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Adolescente , Adulto , Agressão , Áustria/epidemiologia , Bélgica/epidemiologia , Chipre/epidemiologia , Economia , Feminino , Grécia/epidemiologia , Humanos , Lituânia/epidemiologia , Masculino , Análise Multinível , Países Baixos/epidemiologia , Polônia/epidemiologia , Política , Portugal/epidemiologia , Prevalência , Fatores de Risco , Sexismo , Eslováquia/epidemiologia , Espanha/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
Asia Pac J Clin Nutr ; 22(4): 620-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24231023

RESUMO

Diabetes and diabetes-induced complications is a rising health concern in Northern Cyprus. Of the adult population in Northern Cyprus, 12.2% has diabetes and 90% of all individuals suffering from cardiovascular disease are people with diabetes. The aim of this study was to evaluate nutritional habits of people with diabetes in Northern Cyprus in order to make the necessary recommendations to improve their eating habits to prevent diabetes-induced complications. We used the Healthy Eating Index (HEI) to evaluate dietary quality of people with diabetes in Northern Cyprus based on their 24-hour food intake. A total of 200 participants with diabetes were selected randomly from the out-patient clinic of Dr. Burhan Nalbantoglu central hospital in Nicosia. Individuals were asked to complete a questionnaire to determine their 24-hour food intake and frequency of intake of various food substances. The mean HEI score for the subjects with diabetes was 58.8. The HEI component scores for saturated fat, vegetables, dairy products and meat consumption were less than 5, whereas average scores for fat, cholesterol, fruits, grains, and sodium consumption were more than 5. The meat component of the HEI had the lowest mean score (3.3). There was statistical significance between male and female subjects regarding the HEI scores for meat and nutrient variety intake. In conclusion, the results of the present study suggest that subjects with diabetes in Northern Cyprus should improve their diet by decreasing their intake of saturated fat and by increasing their intake of vegetables, meat and milk.


Assuntos
Diabetes Mellitus/dietoterapia , Diabetes Mellitus/epidemiologia , Dieta , Promoção da Saúde , Estado Nutricional , Adulto , Idoso , Animais , Índice de Massa Corporal , Chipre/epidemiologia , Complicações do Diabetes/dietoterapia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/prevenção & controle , Gorduras na Dieta/administração & dosagem , Comportamento Alimentar , Feminino , Humanos , Masculino , Carne , Pessoa de Meia-Idade , Leite , Inquéritos e Questionários , Verduras
15.
Health Syst Transit ; 14(6): 1-128, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23149260

RESUMO

The health system in Cyprus comprises separate public and private systems of similar size. The public system, which is financed by the state budget, is highly centralized and tightly controlled by the Ministry of Health. Entitlement to receive free health services is based on residency and income level. The private system is almost completely separate from the public system and for the most part is unregulated and largely financed out of pocket. In many ways there is an imbalance between the public and private sectors. The public system suffers from long waiting lists for many services, a situation that has been worsened by the recent economic crisis, while the private sector has an overcapacity of expensive medical technology that is underutilized. To try to address these and other inefficiencies, a new national health insurance scheme funded by taxes and social insurance contributions has been designed to offer universal coverage and introduce competition between the public and private sectors through changes in provider payment methods. However, the scheme has not been implemented due to cost concerns. Despite the low share of economic resources dedicated to health care and access issues for some vulnerable population groups, overall Cypriots enjoy good health comparable to other high-income countries.


Assuntos
Atenção à Saúde/organização & administração , Política de Saúde , Chipre/epidemiologia , Organização do Financiamento , Reforma dos Serviços de Saúde , Gastos em Saúde , Recursos em Saúde , Acessibilidade aos Serviços de Saúde , Nível de Saúde , Humanos , Seguro Saúde/organização & administração , Programas Nacionais de Saúde/organização & administração
16.
BMC Public Health ; 12: 334, 2012 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-22569201

RESUMO

BACKGROUND: A preliminary study was undertaken in a community of Cyprus where low-level arsenic (As) concentrations were recently detected in the groundwater that was chronically used to satisfy potable needs of the community. The main objective of the study was to assess the degree of association between orally-ingested As and self-reported type-2 diabetes mellitus (DM) in 317 adult (≥18 years old) volunteers. METHODS: Cumulative lifetime As exposure (CLAEX) (mg As) was calculated using the median As concentrations in water, individual reported daily water consumption rates, and lifetime exposure duration. Logistic regression models were used to model the probability of self-reported DM and calculate odds ratios (OR) in univariate and multivariate models. RESULTS: Significantly higher (p < 0.02) CLAEX values were reported for the diabetics (median = 999 mg As) versus non-diabetics (median = 573 mg As), suggesting that As exposure could perhaps be related to the prevalence of DM in the study area, which was 6.6%. The OR for DM, comparing participants in the 80th versus the 20th percentiles of low-level As CLAEX index values, was 5.0 (1.03, 24.17), but after adjusting for age, sex, smoking, education, and fish consumption, the As exposure effect on DM was not significant. CONCLUSIONS: Further research is needed to improve As exposure assessment for the entire Cypriot population while assessing the exact relationship between low-level As exposure and DM.


Assuntos
Arsênio/análise , Diabetes Mellitus Tipo 2/epidemiologia , Exposição Ambiental/análise , Água Subterrânea/química , Adolescente , Adulto , Chipre/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Adulto Jovem
17.
Cancer Nurs ; 35(3): 187-94, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22538260

RESUMO

BACKGROUND: Family members of patients with chronic illnesses experience distress as a result of caregiving roles, which can be manifested as burden and depression, but cross-disease studies on how caring is experienced are limited. OBJECTIVE: The present study was designed to examine the burden and psychiatric morbidity in the form of depression experienced by Cypriot families caring for a relative with one of the following: cancer, Alzheimer's disease, or schizophrenia. METHODS: This study was cross-sectional, descriptive, and correlational. A total of 410 caregivers were recruited from the community. The research instruments included the Greek version of the Burden Interview and the Center of Epidemiological Studies-Depression Scale. Descriptive statistics, 1-way analysis of variance, and post hoc Tukey pairwise comparisons were used to examine significant differences between the 3 groups. RESULTS: The results indicate a high level of burden and depression among all caregivers. Significant differences (P < .001, F = 26.11) between the 3 caregiving groups were detected in terms of burden, with the highest reported for Alzheimer's disease caregivers. One-way analysis of variance showed significant differences (P = .008, F = 4.85) between the 3 caregiving groups in terms of depression, with the highest depression levels being for cancer caregivers. CONCLUSIONS: The findings increase our understanding about burden and emotional well-being in family caring for relatives with cancer and other chronic illnesses. IMPLICATIONS FOR PRACTICE: The findings may be useful for health professionals to plan intervention strategies focusing on each domain of burden. The lessons learned from the caregiving role of family caregivers of patients with Alzheimer's disease or schizophrenia can be used to improve the caregiving process of patients with cancer.


Assuntos
Doença de Alzheimer/terapia , Cuidadores/psicologia , Efeitos Psicossociais da Doença , Depressão/epidemiologia , Neoplasias/terapia , Esquizofrenia/terapia , Estresse Psicológico/psicologia , Adulto , Idoso , Estudos Transversais , Chipre/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Metodológica em Enfermagem
18.
BMC Public Health ; 9: 147, 2009 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-19457230

RESUMO

BACKGROUND: Dietary and lifestyle behaviors at young ages have been associated with the development of various chronic diseases. Schools are regarded as an excellent setting for lifestyle modification; there is a lack, however, of published dietary data in Cypriot school children. Thus, the objective of this work was to describe lifestyle characteristics of a representative segment of Cypriot school children and provide implications for school health education. METHODS: The CYKIDS (Cyprus Kids Study) is a national, cross-sectional study conducted among 1140 school children (10.7 +/- 0.98 years). Sampling was stratified and multistage in 24 primary schools of Cyprus. Dietary assessment was based on a 154-item semi-quantitative food-frequency questionnaire and three supplementary questionnaires, assessing dietary patterns and behaviors. Adherence to the Mediterranean diet was evaluated by the KIDMED index (Mediterranean Diet Quality Index for children and adolescents). Physical activity was assessed by a 32-item, semi-quantitative questionnaire. RESULTS: Analysis revealed that 6.7% of the children were classified as high adherers, whereas 37% as low adherers to the Mediterranean diet. About 20% of boys and 25% of girls reported "not having breakfast on most days of the week", while more than 80% of the children reported having meals with the family at least 5 times/week. Some food-related behaviors, such as intake of breakfast, were associated with socio-demographic factors, mostly with gender and the geomorphological characteristics of the living milieu. With respect to physical activity, boys reported higher levels compared to girls, however, one fourth of children did not report any kind of physical activity. CONCLUSION: A large percentage of Cypriot school children have a diet of low quality and inadequate physical activity. Public health policy makers should urgently focus their attention to primary school children and design school health education programs that target the areas that need attention in order to reduce the future burden of metabolic disorders and chronic diseases.


Assuntos
Dieta , Atividade Motora , Adolescente , Antropometria , Índice de Massa Corporal , Criança , Estudos Transversais , Chipre/epidemiologia , Dieta Mediterrânea , Feminino , Humanos , Estilo de Vida , Masculino , Avaliação Nutricional , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pais , Fatores Socioeconômicos , Inquéritos e Questionários
19.
Prev Med ; 48(3): 232-6, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19272301

RESUMO

OBJECTIVE: The goal of the study is to identify predictors of current cigarette smoking in adolescents within the school, home, and broader social environment. METHOD: A two stage cluster sample design was used to select a representative sample of students from all middle and high schools in Cyprus in 2005-2006. Standardized Global Youth Tobacco Survey (GYTS) methodology was employed in administering the questionnaires and processing the results. Analyses were conducted using logistic regression with the outcome variable being current smoking. RESULTS: After adjusting for the effect of other predictors in the model, the strongest predictor of adolescent smoking was smoking peers. Having parents and grandparents that smoke, concerns about weight, access to pocket money, ease of buying cigarettes, owning an item with a cigarette logo on it, the belief that smokers are less attractive, and the false consensus effect all remain statistically significant predictors. CONCLUSION: In designing smoking prevention programs, factors pertaining to the school, social and familial circle of adolescents as well as misconceptions on the link between smoking and physical appearance need to be considered. Such programs can act as empowering tools to complement legal measures which need to be firmly enforced and constantly revised to be effective.


Assuntos
Comportamento do Adolescente/psicologia , Fumar/psicologia , Adolescente , Criança , Análise por Conglomerados , Chipre/epidemiologia , Características da Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Marketing , Grupo Associado , Prevalência , Fatores de Risco , Instituições Acadêmicas , Fumar/epidemiologia , Prevenção do Hábito de Fumar , Meio Social , Fatores Socioeconômicos
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