Rostrum of Asclepius Vol 23, No. 4 (2024): October - December 2024

Introduction: The increase in life expectancy, the increase of elderly people and the technological progress especially in the field of medicine, make people with disabilities (PWD) an increasingly large population group. According to data collected by Eurostat, almost 25% of the citizens of the Union (24.7%) aged 16 and over are people with partial or severe gradual need. According to W.H.O people with disabilities exceed one billion or 15% of the world's population. Although legislative frameworks have been established for the treatment of people with disabilities, they often become the object of social racism and unequal treatment by the whole. Aim: The aim of this paper was to review the literature on how people with disabilities are treated by the community. Methodology: The methodology followed included a search for review and research studies of the last five years (2019 to 2023) in Pubmed and Cohrane Library databases in Greek and English language . Results: Only half of people with disabilities work, while this ratio for non-disabled people is 3 in 4. The 28.4% of disabled people are at risk of poverty or social exclusion compared to 17.8% of non-disabled people. Only 29.4% of people with disabilities have a higher education degree compared to 43.8% of people without disabilities. The 52% of people with disabilities feel discriminated against. Conclusions: It was found that the degree and nature of disability, self-esteem and character of people with physical disabilities affect social acceptance. People with special needs should be the social group with the highest unemployment rate and with the lowest income. Prejudice and racism towards people with disabilities can be eliminated by a radical change in the way of thinking, upgrading of education, cultivation of social consciousness and imposition of sanctions by the competent bodies.

Keywords: Acceptance, people with disabilities, community

ABSTRACT

In the era of post-modernity, which defines an ever-changing global economy, the framework of skills required in the labor market is undergoing constant transformation. Soft skills are increasingly important in this era, where occupational requirements have changed and working conditions have evolved. Employers are now looking not only for high levels of technical expertise, but also for employees' ability to communicate effectively, work in teams and respond to change and challenges.

The purpose of this study was to investigate the impact of soft skills in the global labour market and, in particular, in the nursing profession. A review of international literature and content analysis of relevant studies was used as a method. Research data shows that soft skills are considered as important qualifications when practicing a profession in the global labour market. More specifically, in the work environment of nurses, soft skills of communication, empathy, critical thinking, creative thinking, teamwork, leadership/leadership and professionalism are considered most important.

Keywords: soft skills, global labour market, nurses

ABSTRACT

Introduction: Arterial stiffness (AS) or inelasticity is the term used to describe the reduced viscoelastic properties of the vascular wall. In recent years, special emphasis has been placed on the role of AS in the occurrence of cardiovascular diseases while its assessment is increasingly used in clinical practice.

Purpose: The purpose of this paper is to investigate the literature and highlight some of the most common mechanisms that contribute to increased AS, the risk factors and measurement techniques.

Methodology: A literature review was performed in the online databases PubMed and Google Scholar, without setting a time limit. The inclusion criteria included articles written in Greek and English, either review or research.

Results: AS develops through a complex interplay between static and dynamic changes involving structural and cellular components of the vascular wall. These include the reduced elastin/collagen ratio, the production of worn elastin fibers, the deposition of weaker collagen on the vessel wall, vascular dysfunction, while the Renin Angiotensin Aldosterone system and inflammatory factors also play an important role. Risk factors include all those factors that affect the elastic specifications of the arteries.

The main method used to estimate AS is pulse wave velocity (PWV), while Carotid-femoral PWV has been characterized as a "gold method" as it is an easy, reproducible, economical, and non-invasive method, has the highest predictive value of cardiovascular events without being affected by other factors. The AIx obtained by pulse wave analysis (Pulse Wave Analysis PWA) is an indirect but reliable indicator of arterial stiffness and depends on the speed of the wave, on the heart rate and on the intensity of the reflection from the periphery of the wave.

Conclusions: Elevated AS has implications for cardiovascular health and likely accounts for a large proportion of cardiovascular disease years worldwide. AS can be easily measured in daily clinical practice and can contribute to the prediction of cardiovascular risk while understanding the pathophysiological mechanisms as well as risk factors can contribute to the design of effective treatments.

Keywords: arterial stiffness, pulse wave velocity, pulse wave analysis, pathophysiology, mechanisms,   risk factors, arterial stiffness measurement

Abstract Crush syndrome constitutes a rare but severe multifactorial process presented in approximately 2-5% of crush injuries patients. It was firstly described by Bywater in 1941, after the London bombardment. The aim of this study is to review the recent literature and present the current evidence and concepts with regard to both the pathophysiology and the treatment management of the syndrome. Frequently erupted after prolonged (>2–3 hours) flattening, crush syndrome comes out after building collapses, earthquakes, explosions, however it can also be the result of high energy occupational or road accidents. Hemorrhage within the muscles due to prolonged compression of the skeletal muscles leads to local ischemia with subsequent appearance of compartment syndrome and necrosis of the muscle groups. The mechanism of ischemia-reperfusion consequences to the eruption of several life-threatening systemic processes after release of the affected limb processes, including acute renal failure (rhabdomyolysis-myoglobinuria, hypovolemic shock), lactic acidosis, hypovolemic shock, metabolic acidosis, heart arrhythmias as well as hypokalemia and disseminated intravascular coagulation. Early and immediate therapeutic intervention consists of hemodynamic stabilization, rapid hydration, correction of electrolyte disturbances and acidosis, and maintenance of adequate diuresis. There are several cases where hemodialysis is imperative. Immediate therapeutic intervention is a key point in the management of crush syndrome to avoid life-threatening complications. The clinical signs can provide important diagnostic information however, high clinical suspicion and immediate response of the medical and nursing staff is required for both the diagnosis and for the treatment of the syndrome.

Keywords: Keywords: crush syndrome, acute renal failure, reperfusion injury, hypovolemia, compartment syndrome

Total hip arthroplasty (TΗA) is a common surgery performed to relieve pain and improve function in people with advanced hip arthritis. Patients’ preoperative preparation and postoperative rehabilitation capabilities should be optimized prior to surgery. Preoperative preparation helps patients to deal with and/or avoid any health complications, before ΤΗΑ. Training in new movement patterns, in-pool exercise, as well as resistance training do reduce preoperative pain. Through preoperative physical therapy, patients' goals and expectations are redefined and, at the same time, as they get aware of their postoperative prognosis, manage to reduce their anxiety. In addition, preoperative physiotherapy achieves a reduction in the length of hospital stay, minimizing this way the possibility of early postoperative complications. Preoperative physiotherapy appears to be a realistic and safe form of rehabilitation, which improves patients’ both pain and function, prior to THA. In fact, through this procedure, the length of hospital stay is reduced, limiting down the possibility of undesirable complications.

Keywords: total hip arthroplasty, Preoperative preparation, physiotherapy

Introduction: Alternative proteins have been shown to have great nutritional value as they consist a great amount of essential macronutrients which benefit the human diet and contribute to building muscle groups, strengthening the immune system as well as many essential functions for life. Health professionals play an important role in achieving patient adherence to dietary recommendations and in providing a consultative approach to health issues. Aim: The purpose of the present study was to assess the knowledge and attitudes of health professionals regarding the nutritional value of alternative protein consumption and to weight this questionnaire. Material and Method: The study was conducted at the University General Hospital "Attikon" from March 2022 to March 2023. 100 questionnaires were completed by health professionals working in Attikon hospital. The population of the study concerns health professionals working in "Attikon" as nursing, medical and paramedical staff. The statistical program SPSS 26.0 was used for the analysis. Exploratory factor analysis (Rotation Method: Varimax) was used to investigate the structure of the knowledge and attitude questionnaires. Results: The factor "Knowledge about the consumption of alternative proteins" contained 15 questions, with loadings ranging from 0.75 to 0.95, explained 69.2% of the variability and had acceptable reliability (Cronbach's a=0.98). The factor "Knowledge of the environmental footprint of alternative proteins" contained 3 questions, with loadings ranging from 0.45 to 0.95, explained 12.1% of the variability and had acceptable reliability (Cronbach's a=0.67). Discussion Greeks are people that would hardly change their eating habits. Global economic use, intense immigration, global demographic and cultural developments have left their mark on people's eating behavior. Conclusions: The questionnaire under consideration does not require much time to complete and can be applied reliably and validly in Greece. It is a reliable and valid tool for assessing the knowledge of health professionals regarding the consumption of alternative proteins.

Keywords: health professionals, Alternative proteins, knowledge, attitudes

Introduction: The reason why people engage in the noble act of blood donation shows their level of awareness towards the society as a whole. What is not known is that a balanced diet and an adequate hydration before donating blood can make the procedure more pleasant and significantly reduce any adverse reactions such as sweating, dizziness, loss of consciousness. Aim: The purpose of this research study is to investigate the knowledge and attitude of blood donors on nutrition before and after the blood donation process. Material and Methods: The present study was carried out by the staff of the Blood Donation of the University General Hospital "ATTIKON" and the cross-sectional study method with convenience sampling and the use of a questionnaire was chosen. The study population consisted of 290 blood donors. Results: The study involved 290 people, 184 men (63.4%) and 106 women (36.6%) who came to the blood donation site to donate blood. The 31.0% of the sample were blood donors in the last 1-3 years and 21.7% were first-time blood donors. In the first place the reason why the participants gave blood was volunteering (44.5%) and the second was the need for blood from a patient in their family (42.8%). A drop was observed in blood pressure values and in some cases there was a significant correlation with whether they had eaten before the blood donation procedure. Discussion: Overall, knowledge about blood donation (before and after) was insufficient. Research results show that the fear of unwanted side effects from donating blood such as dizziness, fainting, etc. are inhibiting factors for someone to come forward for voluntary blood donation and if they do, it is after a call for blood for someone close to them. Conclusions: With the questionnaire used as a research tool, the knowledge and the nutritional behavior of the blood donors when they were going to come for blood donation and its results were examined.

Keywords: dietary habits, nutrition, blood donors, blood donation

Introduction: Health literacy is defined as the extent to which individuals could acquire, process, and understand basic health information and services which make health decisions. Studies have shown that limited health literacy can reach up to 50% of CKD patients and is particularly important in CKD patients due to the complexity of the disease, which requires patient involvement in disease management. Purpose: The purpose of this study is to identify potential goals and strategic interventions to improve health literacy in patients with CKD. Material and method: This is a systematic review writing based on scientific principles and rules. Bibliographic data were searched from the Greek and English literature on extrarenal dialysis and health literacy. Data sources such as PubMed, and Google Scholar were searched using combinations of the following search terms: health literacy, CKD, hemodialysis, peritoneal dialysis, and kidney transplant. Results: Patients with CKD take different approaches to health information. Limiting or avoiding health information may be a strategy used by some individuals to cope with illness and does not necessarily mean that health information is inaccessible or difficult to understand. Co-morbidity and fragmented healthcare can make the healthcare system difficult to navigate. A trusting relationship with healthcare providers promotes several aspects of literacy. Recent literature suggests that literacy levels may be associated with clinical outcomes (higher rates of cardiovascular disease, increased frequency of ED visits, more hospitalizations, increased risk of death). Conclusions: Health literacy is an important factor in the kidney disease journey. Tools are available to help health professionals address health literacy in clinical practice. Critical collective efforts are needed to reduce the health impact of low literacy. Furthermore, more studies are needed to understand the impact of literacy on CKD patients

Keywords: chronic kidney disease, health literacy, dialysis, peritoneal dialysis, kidney transplantation, νοσηλευτής

Background: Mental health nurses face particularly difficult situations in the workplace, such as isolation, physical and verbal attacks and suicide attempts due to the nature of their patients' psychiatric disorders. Aim: The aim of the systematic review was to investigate the QoPL of nurses in the field of mental health and the factors related to it. Material-Method: Systematic literature review carried out from February – April 2023 in international bibliographic databases (Medline, PubMed, Scopus). The inclusion criteria set were that the studies be primary studies, the sample of studies concern nurses in the field of mental health, be published in the English language, be published after 2015 and that there is free access to the articles. After the search, 392 articles were identified and after evaluation only 12 met the criteria for inclusion in the systematic review. Results: Mental health nurses may often experience higher stress and burnout than people in other professions. Nurses working in psychiatric clinics have a low level of compassion satisfaction, a low level of burnout, and a moderate level of post-traumatic stress. Correlations were observed between compassion satisfaction and job burnout, compassion satisfaction and resilience, and burnout and compassion fatigue. Therefore, it is important to implement actions to improve resilience, prevent burnout, and reduce compassion fatigue in mental health nurses. Conclusions: This systematic review showed that mental health nurses experience higher burnout and secondary traumatic stress and lower compassion satisfaction compared to other categories of nurses. QoPL is an important aspect of job satisfaction, and it is necessary to further investigate the QoPL of nurses working in mental health settings, so as to ensure the job satisfaction of nurses in the field of mental health.

Keywords: quality of work life, mental health nurses, compassion fatigue, compassion satisfaction, posttraumatic stress, burnout