Stress, Anxiety and Depression Prevalence among Greek University Students during COVID-19 Pandemic: A Two-Year Survey.

Background: The negative effect of COVID-19 pandemic on college students' mental health is well-demonstrated. The aim of this study is to assess the impact of the pandemic on the students of Aristotle University of Thessaloniki (Northern Greece), in terms of stress, anxiety, and depression, and to analyze the probable correlation of various social and phycological factors. Methods: The survey was conducted in the form of a questionnaire, which was first distributed in November 2020 and then re-launched in November 2021. The evaluation was carried out through the DASS21 screening tool. Associations regarding participants' characteristics and the three variables (stress, anxiety, and depression) were investigated with Pearson's chi-squared (Χ2) test. Results: The first-year results (November 2020) revealed severe prevalence of stress, anxiety, and depression (37.4%, 27.2% and 47% respectively). The second-year results (November 2021) revealed a significant augmentation in all three variables, mainly for the extreme severe scales (47.3%, 41.1% and 55% respectively). Participants who were receiving psychiatric treatment exhibited higher levels of stress, anxiety, and depression, especially during the second year of the pandemic (p-Value < 0.00001). Female students' mental health was at higher risk, as elevated prevalence of negative symptoms was observed (p-Value < 0.00001). Conclusions: The community of Aristotle University of Thessaloniki has been greatly affected during the last 2 years. The inherent risks of the confinement measures on students' well-being and mental health are undeniable. Recurrent annual psychological evaluation in universities and colleges is strongly advised.

Psychological Distress in Primary Healthcare Workers during the COVID-19 Pandemic in Greece.

OBJECTIVE: The present study aims to evaluate the symptoms of psychological distress during the COVID-19 pandemic, in Greek primary healthcare workers, correlating them with their individual characteristics. MATERIALS AND METHODS: The research is based on a self-report questionnaire distributed to primary HCWs of Thessaloniki's public health care units. A sample of 143 respondents was gathered. The questionnaire consists of 21 items: 6 demographic questions, 9 on personal distress, 5 on work-related distress and 1 on one dominant feeling of the participants. These items were based on existing validated measures, such as the "Depression Anxiety Stress Scale-21", the "Kessler Psychological Distress Scale-10", "General Health Questionnaire- 28" and "Hospital Anxiety and Depression Scale". The associations between participants' gender, education, specialty and parenthood were determined with Pearson's chi-squared (χ2) test. RESULTS: Overall, 70.4% of HCWs were generally affected by the pandemic. The personal distress factors revealed that the majority (67%) experienced distress due to routine changes. The effects on health behavior (sleep, eating behavior and substance use) were not high. Psychological/psychiatric needs were relatively low, while negative emotions and need of social support were high. 31.4% displayed intense emotional instability. All work-related distress factors were rated high. Worry about contracting COVID-19 in the workplace scored the highest (82.6%). Almost half of the participants felt exposed to COVID-19 infection (47.0%). Anxiety (47.2%) and burn-out (78.4%) symptoms were also revealed. Female participants appeared to be more anxious (P<0.01) and upset (P=0.013). CONCLUSION: The exposure to a constant risk could potentially lead to an increase in HCWs' psychological distress. Designing the right tools and organizing the right plans are of paramount importance to prevent the deterioration of their wellness and quality of life.

Management of acute submacular hemorrhage using intravitreal injection of tissue plasminogen activator and gas: A case series.

The objective of this case series is the evaluation of the efficacy and visual outcomes after displacement of subretinal hemorrhage using intravitreal injection of recombinant tissue plasminogen activator, expansile gas, and in some cases an anti-vascular endothelial growth factor agent. A case series of 28 eyes of 28 patients (16 men and 12 women with age range 67-95 years) suffering from subretinal hemorrhage (duration range 1-15 days) caused by age-related macular degeneration or retinal macroaneurysm is presented. All the patients were treated with intravitreal injection of recombinant tissue plasminogen activator and gas and some of them received an anti-vascular endothelial growth factor agent between January 2013 and December 2016. The outcomes assessed were visual acuity (preoperatively 1 week, and 1 month postoperatively) with respect to duration and dimension of hemorrhage, displacement of hemorrhage, and possible complications of the procedure. Successful displacement of hemorrhage was achieved in 25 patients (89.3%), 18 of 28 patients had significant improvement in visual acuity 1 week after the treatment, and 22 of 28 patients had significant improvement in visual acuity 1 month after the treatment. The mean improvement of all patients with anatomical displacement of the hemorrhage in visual acuity was 0.7 ± 0.5 (LogMAR) in 1 month. Two patients developed vitreous hemorrhage after the procedure and one retinal detachment. Visual outcome a month after therapy displayed week correlation with duration, diameter, and thickness of hemorrhage. The results lead to the conclusion that intravitreal treatment of recombinant tissue plasminogen activator and expansible gas with or without injection of anti-vascular endothelial growth factor agent is effective in improving visual acuity and displacing submacular hemorrhage secondary to age-related macular degeneration and retinal macroaneurysm. The best functional outcomes can be expected in patients regardless of the size and duration of the hemorrhage.

Determination of total and lung-deposited particle surface area concentrations, in central Athens, Greece.

Numerous health studies have linked the exposure to particulate matter with adverse health effects, while there is an increasing scientific interest in the particle metrics of surface area (SA) and lung-deposited SA (LDSA) concentration. In the present study, two integrated SA estimation methods, both based on widely used instrumentation, were applied at an urban traffic environment in Athens for a 6-month period. The first estimation method used the size distribution by number to estimate SA (average SA1 669.3 ± 229.0 µm2 cm-3), while the second method used a simple inversion scheme that incorporates number and mass concentrations (average SA2 1627.9 ± 562.8 µm2 cm-3). In pairwise comparisons, SA2 levels were found two times greater than the corresponding SA1, but exhibited a strong correlation (r = 0.73). SA1 and SA2 concentrations correlated well with the traffic-related pollutants NOx (r = 0.64 and 0.78) and equivalent black carbon (r = 0.53 and 0.51). The diurnal variation of SA1 concentrations by size range indicated traffic as a major controlling factor. Estimated LDSA (53.9 µm2 cm-3 on average) concentrations were also clearly affected by anthropogenic emissions with more pronounced associations in the 0.01-0.4 µm range (r = 0.66 with NOx and r = 0.65 with equivalent black carbon). Validating estimated LDSA through simultaneous measurements with a reference instrument revealed that the estimation method underestimates LDSA by a factor between 2 and 3, exhibiting, however, a high correlation (r = 0.79). Overall, the performance of estimation methods appear satisfactory and indicate that a trustworthy assessment of the temporal variability of SA and LDSA concentration metrics can be provided in real time, on the basis of relatively lower-cost instrumentation, especially in view of recent advances in particle sensing technologies.

Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults.

Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition.