Rostrum of Asclepius Vol 24, No. 2 (2025): April - June 2025

The number of children and adolescents diagnosed with type 1 diabetes mellitus is increasing annually. Managing the child's illness requires special care every day, which does not stop when the child is at school. It is a challenge for the health and education systems and especially for the school nurses who care for students with T1DM to properly manage the disease so that diabetes does not hinder the child's academic progress. The purpose of this study is to highlight the good practices of enhancing the care and safety of students with type 1 diabetes in the school environment by evaluating the level of knowledge of school nurses regarding the management of type 1 diabetes. The feeling of high safety and high satisfaction, felt by the parents from the care of the child with T1DM at school, is positively related to the skill level of the school nurse. Modern advances in T1DM management (closed-loop system, insulin pumps) are increasingly used by school-aged children because their use improves the care and quality of children’s lives. However, school nurses feel inadequate (perceived self-efficacy) in caring satisfactorily for students with T1DM at school. It seems that they face a lack of knowledge in the correct management of insulin, glucagon, in the management of insulin pumps and nutritional equivalents and the real knowledge of school nurses regarding T1DM is worse than the perceived knowledge. The level of knowledge of school nurses regarding T1DM is insufficient. It is necessary to introduce policies of continuous, mandatory training of school nurses in T1DM. Collaboration with diabetes providers for ongoing T1DM education may also improve T1DM management in school.

Keywords: school nursing, Type 1 diabetes mellitus,   education, knowledge

ABSTRACT

The concept of rehabilitation begins to be accepted in psychiatry after the introduction of psychopharmacology and then interventions are proposed or followed that strengthen it. Rehabilitation is defined as the ability of patients to live a satisfactory life even with limitations caused by their disease.

 In modern psychiatry, rehabilitation interventions in schizophrenia include individually or in combination: psychoeducation of patients and families, psychological interventions, art therapies and organized physical exercise. The services are organized and provided in a structured and interdisciplinary framework of community structures and services.

 In the present article, studies (primary, systematic reviews and meta-analyzes) that have been published in the electronic databases Pubmed and Google Scholar and in scientific Greek or English language journals, during the period 2010-2020 were sought.

 The findings of the research with particular emphasis on meta- analyzes and evidence from studies show that patient and family psychoeducation and Cognitive Behavioral Therapy (CBT) are rehabilitatively superior to other interventions.A particularly important reinforcing point for the effectiveness of interventions is ensuring the continuity of care and psychosocial rehabilitation of the patient and his family.

  In conclusion, it appears that the results of rehabilitation in schizophrenia are improved by the combination of pharmacotherapy and individualized psychosocial interventions, which must be provided in organized and interconnected community mental health structures and have consistency and duration over time.

Keywords: Rehabilitation, schizophrenia, psychoeducation, psychosocial intervention

In modern society the non-communicable diseases, including stroke, constitute the main cause of death and one of the leading causes of residual disability in the population. The number of strokes is on the rise, necessitating effective management. A literature review of articles was conducted on electronic databases such as PubMed and Google Scholar, as well as in books and electronic websites using keywords. According to these sources, the assessment of the population burden from strokes is carried out through health indicators, tools that contribute to the objective comparison to different countries, with the aim of highlighting the need for improvements at national level. At the European level and after comparing Greece to four other countries, namely Germany, Sweden, Romania and Bulgaria, it is observed that there are differences among the countries of Eastern and Western Europe. Overall in Europe a further increase in the number of strokes is expected in the coming years. The development of stroke management practices is therefore considered significant, both in prevention and at pre-hospital, hospital and post-hospital levels. Greece, facing the additional problem of citizen’s inequality in accessing specialized health services due to its geographical morphology, should develop such practices. With the passing of the law for Units of Increased Care in November 2023 a first step is taken in this direction. However, this specific law does not include actions in the field of stroke prevention, pre-hospital treatment and post-hospital rehabilitation, areas that require improvement in the future.

Keywords: health indicators, stroke, stroke units, best management practices

Obesity, that is the excessive fat accumulation in the human body, is not accidentally characterized as the disease of the 21st century. According to the World Health Organisation (WHO), its rates have tripled worldwide since 1975, with the main causes referring to behavioral factors related to unhealthy diet, lack of physical exercise and a generally unhealthy lifestyle. Its development is favored by a pre-existing genetic backround, as well as by factors related to intrauterine life. Its consequences in health are multileveled and they concern physical, mental and social robustness and health. Obesity in Greece, specifically childhood obesity, is increasing with its rate reaching 37,5% in 2019, ranking it first in Europe. Its growth trend during the last decades, with the recent pandemic as a strengthening factor, makes mandatory the need to confront it . Measures’ inclusion against childhood obesity in the National Prevention Program “Spyros Doxiadis”, proves the great importance the state gives to the disease’s prevention and treatment during childhood. Primary Health Care (PHC) is charged with the duty of developing acts and actions in this direction, something that is after all provided by the law 4486/2017 (“Primary Health Care reformation”). This paper deals with PHC’s role documentation in dealing with childhood obesity in general and with a case study for a five step relevant decision making process for Thessaloniki’s Health Center, in particular. Within this context, the appropriate stakeholders’ role is being studied. For the depiction of the actions’ programming that result from the relevant decisions, is used a Gantt chart.

Keywords: Primary Health Care, prevention, childhood obesity, stakeholders, decision making, Gantt

Introduction: Emergency Departments (EDs) are critical hubs in the healthcare system that function with limited resources. This increases the length of stay in emergency departments while decreasing patient satisfaction. Purpose: The purpose of this study was to evaluate health care consumers' perceptions of the presence of an electronic application that would give information on waiting times in emergency departments, available medical specialisations by hospital, and emergency case guidance. Material and Method: The study's sample was made up of people who used health services in the Attica region, regardless of their age or gender. Following a review of the literature and relevant studies, a customised questionnaire was developed for the purpose of collecting research data. The statistical programme SPSS 26.0 was used to conduct the analysis. Results: The sample consists of 121 subjects with a mean age of 41 years (SD=12.7 years). 83.5% of the participants believed that such an application would improve the efficiency of TEPs. The waiting time in the TEPs until the final examination by the respective medical specialty is independently related to the satisfaction score of the participants. More specifically, longer waiting time for examination was associated with significantly less satisfaction. The age of health service users is related to the necessity of having an electronic application. In particular, the older the participants were, the less likely they were to think that there were other benefits besides reducing waiting time from such an application. Conclusions: The adoption of new technology in the EDs offers considerable benefits, including reduced wait times and better service to users of health services, while also serving as a milestone for their modernization.

Keywords: EDs, electronic application, waiting time

The refugee-immigrant crisis in recent years has concerned the world community as well as Greece which, in addition to managing the flows, was asked to create health programs to deal with the health problems of asylum seekers and to protect public health Purpose: The purpose of this project was initially to investigate the challenges and problems faced by health professionals, in Reception and Identification Centers and in accommodation structures, during the exercise of their duties. Through this investigation, the results were compared with similar investigations. Material and Method: The research was conducted with a sample of 72 people through the completion of an anonymous questionnaire which included demographic data of the respondents and the accommodation structures and questions about the health level of asylum seekers in the past and during their stay in the Greek facilities, the characteristics of daily medical visits, the needs of health professionals to serve the asylum seekers and finally the most important challenges they face in the exercise of their duties. Results: Chronic diseases are the greater percentage of daily visits, while low rates of daily visits related to communicable diseases, mental health issues, pediatric and gynecological/obstetrical issues were found. In addition, it was found that asylum seekers have low vaccination coverage and their knowledge about health issues is limited. It was also established that the problems they face in the exercise of their duties mainly concern the lack of specialized personnel and medical equipment, the cooperation with other health structures mainly of secondary and mental care, communication and cross-cultural mediation. Conclusions: The refugee phenomenon creates an unstable and constantly changing environment. The health challenges are many and the creation of a holistic health program for asylum seekers is considered essential. The challenges faced by health professionals can act as barriers to access of PoCs to health services and lead to unmet health needs putting both the individual health of PoCs and public health at a disadvantage.

Keywords: asylum seekers, refugee phenomenon, health program, health needs of Asylum seekers

Introduction: To contain the spread of the SARS-COVID-19 pandemic, a worldwide lockdown was implemented, which led to a decrease in the employment activities of teenagers, and many resorted to electronic games. Sedentary lifestyle leads to an increase in the risk of developing obesity and, consequently, an increase in the risk of developing co-morbidities, such as diabetes mellitus. Purpose: The purpose of this systematic review was to investigate sedentary behavior related to electronic games and internet use and its relationship to body weight gain in adolescents during the pandemic. Material-methods: The relevant international literature was searched, from 2020 to 2023, in the electronic databases: Medline, PubMed, Scopus, Cochrane Library. The keywords used were: Sedentary behavior, AND online gaming, OR internet gaming, OR computer gaming, OR gaming behavior, OR digital gaming, OR video gaming, online OR role-playing game, AND obese, OR overweight, OR weight gain, OR obesity, OR BMI, OR Body Mass Index, AND COVID-19, OR COVID 19 pandemic, OR coronavirus, AND adolescents. Results: During the pandemic, there was a significant increase in the time spent on screens by teenagers as well as a significant increase in their body weight. The majority of studies cite increased screen time as a key causative factor in adolescent weight gain, which has been observed in some cases to be a risk factor for the development of type 2 diabetes. Conclusions: During the lockdown, a large percentage of teenagers resorted to electronic games. This had significant consequences, as it contributed to an increase in their body weight, increasing the prevalence of obesity in this population. Nevertheless, new research is required from the scientific community in the wake of the Pandemic, to clarify the possible return of teenagers to their pre-Pandemic habits.

Keywords: obesity, electronic games, screens, pandemic, COVID-19

Introduction: In recent decades, the surrounding social reality as well as the economy have undergone dramatic changes due to technology, the complexity of business structures and globalization. The related developments that frame the 'post-modern' society and economy require and presuppose that education systems equip workers with new forms of personal and interpersonal/social skills. This kind of skills will enable them to avail themselves of emerging new forms of socialization and actively contribute to growth in the context of an economic system where the main asset is communication and knowledge as opportunities for career advancement. The same requirements apply to the nursing profession. Purpose: The purpose of this study is to assess the degree of development of personal and interpersonal-social skills among the Member States of the European Union and in particular in the nursing profession. Methodology: The method used was a review of international literature and content analysis of relevant studies. Results: Scientific studies indicate an inflation in their development patterns, and a variety of education and training programmes in these skills are being set up and funded as part of the policies of the European Union countries. A high degree of prioritization can be found in the political agendas of the majority of the various countries. Research evidence shows that soft skills are essential for success in the nursing profession. Conclusions: The soft skills of communication, empathy, critical thinking, teamwork, leadership and professionalism are considered most important in the working environment of nurses.

Keywords: personal and interpersonal-social skills, nursing profession, European Union