Workplace health promotion: results of a combined multidisciplinary intervention over a long period - preliminary results.

OBJECTIVE: Obesity is a multifactorial disease that is one of the major public health problems. It is the result of the interaction between behavioral, social and endocrine-metabolic components. Already in the 80s, it was highlighted by the World Health Organization (WHO) that the workplace is an ideal setting for introducing health promotion programs. The aim of the present study was to implement a health promotion program among healthcare workers (HCWs) operating in an Emergency Hospital in Southern Italy, combining diet, sports activity and motivational support over a 24-month period. PATIENTS AND METHODS: Participants were HCWs operating in an Emergency Hospital in Southern Italy. The inclusion criteria were as follows: overweight or obesity, i.e., body mass index (BMI) >25 kg/m2, or waist circumference >102 cm (males), >88 cm (females); dyslipidemia without pharmacological treatment, i.e., total cholesterol >220 mg/dL, or high-density lipoprotein (HDL) cholesterol <35 mg/dL, or low-density lipoprotein cholesterol (LDL) >130 mg/dL, or triglycerides >200 mg/dL; fasting glucose levels >120 mg/dl and/or reduced tolerance to glucose or diabetes mellitus, without pharmacological treatment was determined through HbA1c. RESULTS: The analysis was conducted on 36 participants. Follow-up was performed after twelve (T12) and twenty-four months (T24). The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) values decreased during the time period. The average BMI of both male and female HCWs was significantly reduced from T0 to T12 and from T0 to T24. The triglyceride levels gradually decreased, but not significantly, from T0 to T24. The average blood glucose values decreased from T0 to T12 and from T12 to T24. The number of subjects who started to perform physical activity increased significantly between T0 and T12 and between T0 and T24. CONCLUSIONS: The findings have led to a significant change in HCWs' lifestyles and body perceptions, as well as their ability to work.

Vaccination of healthcare workers against influenza: does a day off make a difference?

This article presents the results of actions undertaken to increase influenza vaccine uptake by healthcare workers (HCWs) in Greece during the 2016-2017 influenza season. Influenza vaccination among HCWs increased from 10.9% in acute care hospitals and 24.3% in primary healthcare centres in 2015-2016 to 18% in acute care hospitals and 34.6% in primary healthcare centers in 2016-2017. Vaccination on site at the healthcare facility and use of reward systems were significantly associated with increased vaccination rates. Offering vaccinated HCWs one day off work was associated with the greatest increase in influenza vaccine uptake.

Incidence Patterns and Occupational Risk Factors of Human Brucellosis in Greece, 2004-2015.

BACKGROUND: Brucellosis is the most common bacterial zoonosis worldwide. Greece has the highest reported incidence among EU countries. However, occupational risk factors have not been well described. OBJECTIVE: To determine the incidence patterns and exposure risk factors of brucellosis in Greece. METHODS: We used national-level surveillance and occupational denominator data to estimate the incidence patterns and exposure risk factors of brucellosis in Greece, with particular emphasis on occupation. RESULTS: Between November 2003 and December 2015 a total of 2159 human brucellosis cases was reported. The mean incidence rate was 1.62 per 100 000 population per year. A large majority of cases (77.1%) reported consumption of unpasteurized milk or contact with livestock animals. Most cases occured in farmers and livestock breeders (1079 [87.7%] of 1231 cases reporting their occupation), corresponding to an annual incidence of 7.1 per 100 000. However, there were other occupations with a similar or higher risk: butchers and abattoir workers (12.7 per 100 000), laboratory personnel (3.1 per 100 000), while the highest risk was for veterinarians (53.2 per 100 000). CONCLUSION: Brucellosis incidence in specific occupational groups was much higher than in the general population. These results underline the importance of collecting information on occupation, both during the diagnostic process and in the surveillance system. Besides efforts to control brucellosis in animals, organized prevention efforts are needed within an occupational health framework, especially for the most vulnerable workers.

First report of Dientamoeba fragilis infection explaining acute non-specific abdominal pain.

Dientamoeba fragilis is now considered a potentially emerging gastrointestinal pathogen in both developing and developed countries. We first report an autochthonous case of D. fragilis infection in Greece. A 49-year-old female with acute non-specific abdominal pain required emergency surgical admission for active observation and repeated assessment. To the best of our knowledge, this is the first reported case of acute unexplained abdominal pain finally attributed to D. fragilis infection using microscopic and molecular methods.

Correlative ROI Calculation of MCAs: Another Promising Primary Sign of Acute Infarction?

The purpose of this project was to calculate the ROI of the middle cerebral artery (MCA) in patients with acute stroke to establish if this measurement could be used as another primary sign of infarction even if other established primary signs of infarction are absent. CT brain scans of 465 patients, who presented in the emergency room in the first six hours after the onset of symptoms, were studied retrospectively. Two polygonal ROIs were drawn on the M1 segments of both middle cerebral arteries and three parameters were calculated automatically: HU density, volume and surface of the corresponding artery segment. The age and gender of each patient were also recorded, as well as the CT findings (including the hyperdense appearance of MCA and the insular ribbon sign) and the neurological findings. The range of calculated ROIs was between 9 HU and 134 HU. A statistically significant difference was reported in ROI measurement between the right and left MCA in patients with left (or right) hemiparesis respectively. A significant difference was also reported between the ROIs of the right and left MCA in patients with acute ischemic stroke in the region of the brain supplied by the left (or right) MCA respectively. ROI measurement of MCA is easy to apply and interpret during the CT scan and might serve as an additional primary sign of infarction.

Respiratory health of municipal solid waste workers.

BACKGROUND: There is an increasing evidence that the incidence of work-related pulmonary problems is greater in waste collectors than in the general workforce. AIMS: To evaluate the respiratory health of municipal solid waste workers (MSWWs). METHODS: One hundred and eighty-four municipal employees of Keratsini (104 MSWWs and 80 controls) participated in a cross-sectional study. All participants were asked to fill in a slightly modified version of the Medical Research Council questionnaire. Lung function was evaluated by spirometry. RESULTS: Spirometry revealed reduced mean forced vital capacity (FVC) and forced expiratory volume in 1 s (as a percentage of predicted values) in MSWWs compared with controls. After adjustment for smoking status, only the decline in FVC was statistically significant (P < 0.05). Prevalence of all respiratory symptoms was higher in MSWWs than in controls. After adjustment for confounding factors, the difference reached statistical significance (P < 0.05) for morning cough, cough on exertion and sore throat. CONCLUSIONS: The results of this cross-sectional study indicate a higher prevalence of respiratory symptoms and a greater decrease in lung function in MSWWs. A number of limitations such as the relatively small size of population and the 'healthy worker' effect should be taken into account.

Prevalence of hepatitis A virus infection among municipal solid-waste workers.

A study was conducted among 151 municipal workers (72 solid-waste workers, and 79 workers not exposed to waste). Total antibodies against Hepatitis A virus (HAV) were measured, and socio-demographic information was collected using a self-administered questionnaire. Univariate analysis has shown that occupational exposure to waste, age, duration of employment and educational status were significantly associated with the prevalence of anti-HAV(+). Municipal Solid Waste Workers had a higher prevalence of anti-HAV(+) in comparison with municipal workers not exposed to waste. Duration of employment was significantly associated anti-HAV(+). Multivariate analysis revealed an independent association of anti-HAV(+) with occupational exposure to waste and ageing. Our results suggest a potential causal role of occupational exposure to waste, in the development of HAV infection.

Automated identification of cancerous smears using various competitive intelligent techniques.

In this study the performance of various intelligent methodologies is compared in the task of pap-smear diagnosis. The selected intelligent methodologies are briefly described and explained, and then, the acquired results are presented and discussed for their comprehensibility and usefulness to medical staff, either for fault diagnosis tasks, or for the construction of automated computer-assisted classification of smears. The intelligent methodologies used for the construction of pap-smear classifiers, are different clustering approaches, feature selection, neuro-fuzzy systems, inductive machine learning, genetic programming, and second order neural networks. Acquired results reveal the power of most intelligent techniques to obtain high quality solutions in this difficult problem of medical diagnosis. Some of the methods obtain almost perfect diagnostic accuracy in test data, but the outcome lacks comprehensibility. On the other hand, results scoring high in terms of comprehensibility are acquired from some methods, but with the drawback of achieving lower diagnostic accuracy. The experimental data used in this study were collected at a previous stage, for the purpose of combining intelligent diagnostic methodologies with other existing computer imaging technologies towards the construction of an automated smear cell classification device.

Prevalence of hepatitis B virus markers in municipal solid waste workers in Keratsini (Greece).

AIM: To evaluate the prevalence of hepatitis B virus (HBV) markers among municipal solid waste workers (MSWWs) in Keratsini (Greece). METHODS: We assessed in a cross-sectional study the prevalence of biological markers of HBV infection (HbsAg, anti-Hbc, anti-Hbs) and their association with exposure to waste and other socio-demographic factors in 166 municipal employees in Keratsini (Greece). RESULTS: The prevalence of anti-Hbc (+) did differ significantly between exposed and non-exposed employees to waste. Older employees had a significantly higher prevalence of anti-Hbc (+). MSWWs who were anti-Hbc (+) were less educated than non-exposed employees. Logistic regression analysis has shown that the exposure to waste and age were independently associated with the anti-Hbc positivity. CONCLUSION: Occupational exposure to waste is possibly associated with the acquisition of HBV infection. Immunization of MSWWs should be considered to reduce the risk of HBV infection.

Occupational injuries in Greece (1938-1955): history of medicine and descriptive epidemiology.

AIM: To describe the longitudinal trends in the rates of total and fatal occupational accidents in Greece during 1938-1955. MATERIAL AND METHODS: Information on occupational injuries have been provided from the yearly reports of the Organization of Social Insurances (1938-1955) and on population data from the tables of National Statistic Agency. Bio-statistical analysis was performed by the use of SPSS software and Stat-Calc of Epi Info. RESULTS: The evolution of the longitudinal trend of occupational accidents has revealed a biphasic character, with a decreasing trend during 1938-1945 and an increasing trend during 1946-1955. The phenomenon was obvious in both sexes and in all age groups. On the contrary fatal occupational injuries increased across the period 1938-1945 and subsequently decreased. These temporal trends can be interpreted on the light of the important reduction in the level of economic activity during the second world war and the subsequent gradual recovery in the post war period. CONCLUSION: The biphasic characteristics of the occupational accidents longitudinal trend seems to be influenced by historical factors. Important lessons were learnt from the period of war. The decrease of the rate of total occupational accidents does not necessary reflect a satisfactory level of safety at work. The level of the economic activity, the efficiency of the registration and prevention agencies play a role. In addition, the rate of fatal injuries has a critical role in benchmarking national occupational health performance.

Survey on the use of smart and adaptive engineering systems in medicine.

In this paper, the current published knowledge about smart and adaptive engineering systems in medicine is reviewed. The achievements of frontier research in this particular field within medical engineering are described. A multi-disciplinary approach to the applications of adaptive systems is observed from the literature surveyed. The three modalities of diagnosis, imaging and therapy are considered to be an appropriate classification method for the analysis of smart systems being applied to specified medical sub-disciplines. It is expected that future research in biomedicine should identify subject areas where more advanced intelligent systems could be applied than is currently evident. The literature provides evidence of hybridisation of different types of adaptive and smart systems with applications in different areas of medical specifications.

Factors affecting accuracy of producing time intervals.

The present study assessed the accuracy of producing time intervals. 92 subjects were asked to produce three different time intervals (15, 30, and 60 sec.) under six experimental conditions during which they performed concurrent tasks of different cognitive difficulty and requiring different cognitive functions. Real-life working situations guided the design of the experiment. Accuracy of time estimation was significantly affected by the length of the intervals to be produced and the concurrent tasks performed. 15-sec. intervals were more accurately estimated. Accuracy decreased as the cognitive demands of the concurrent tasks increased; subjects systematically overestimated the duration of the intervals. Having an activity requiring time estimation seems to have a positive effect on the accuracy of time estimation. The same was found for certain strategies aiding time estimation which were used spontaneously by certain subjects. No significant difference in the accuracy of estimation between women and men was found.