Papers by Foteini Anastasiou
Frontiers in Medicine, Mar 23, 2023
An in-person multidisciplinary continuing medical education (CME) program was designed to address... more An in-person multidisciplinary continuing medical education (CME) program was designed to address previously identified knowledge gaps regarding quality indicators of care in kidney cancer. The objective of this study was to develop a CME program and determine if the program was effective for improving participant knowledge. CME programs for clinicians were delivered by local experts (uro-oncologist and medical oncologist) in four Canadian cities. Participants completed knowledge assessment tests pre-CME, immediately post-CME, and 3-month post-CME. Test questions were related to topics covered in the CME program including prognostic factors for advanced disease, surgery for advanced disease, indications for hereditary screening, systemic therapy, and management of small renal masses. Fifty-two participants attended the CME program and completed the pre-and immediate post-CME tests. Participants attended in Ottawa (14; 27%), Toronto (13; 25%), Québec City (18; 35%), and Montréal (7; 13%) and were staff urologists (21; 40%), staff medical oncologists (9; 17%), fellows (5; 10%), residents (16; 31%), and oncology nurses (1; 2%). The mean pre-CME test score was 61% and the mean post-CME test score was 70% (p = 0.003). Twenty-one participants (40%) completed the 3month post-CME test. Of those that completed the post-test, scores remained 10% higher than the pre-test (p value 0.01). Variability in test scores was observed across sites and between French and English test versions. Urologists had the largest
Tobacco Prevention and Cessation, Jul 5, 2022
is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prev... more is an open access, peer-reviewed online journal that encompasses all aspects of tobacco use, prevention and cessation that can promote a tobacco free society. The aim of the journal is to foster, promote and disseminate research involving tobacco use, prevention, policy implementation at a regional, national or international level, disease development-progression related to tobacco use, tobacco use impact from the cellular to the international level and finally the treatment of tobacco attributable disease through smoking cessation.
Cvd Prevention and Control, Sep 1, 2008
ABSTRACT BackgroundSocio-economic status (SES) has been associated with the prevalence and incide... more ABSTRACT BackgroundSocio-economic status (SES) has been associated with the prevalence and incidence of cardiovascular disease (CVD). The aim of this work was to investigate the association between SES and clinical and biochemical factors related to CVD, in a sample of elderly men and women.MethodsDuring 2005–2007, 937 men and women (aged 65–100 years) from Cyprus (n = 300), Mitilini (n = 142), Samothraki (n = 100), Cephalonia (n = 104), Corfu (n = 160) and Crete (n = 131) islands, participated in the survey. CVD risk factors, i.e. hypertension, diabetes, hypercholesterolemia and obesity, as well as behavioural, lifestyle and dietary characteristics were assessed using face-to-face interviews and standard procedures.ResultsMultiple logistic regression analysis revealed that people in the lowest SES group, compared to highest were 2.14-times (95% CI 1.24–3.71) more likely to have four or more of the common CVD risk factors, i.e. smoking, physical inactivity, obesity, hypertension, diabetes and hypercholesterolemia, irrespective of age, sex, dietary habits and depression status. Moreover, an interaction was observed between SES and depression score (p < 0.001), suggesting that people in the lowest SES group and high depression score experience 4.5-times (95% CI 1.38–14.69) higher probabilities of having four or more CVD risk factors.ConclusionsAn inverse relationship between SES and factors related to CVD risk exists among elderly people. Our findings underline the importance of focused preventive strategies, especially, among low SES people, in order to improve the quality of life among elderly individuals.
United European Gastroenterology Journal, 2022
IntroductionThe goal of this project was to create an up‐to‐date joint European clinical practice... more IntroductionThe goal of this project was to create an up‐to‐date joint European clinical practice guideline for the diagnosis and treatment of faecal incontinence (FI), using the best available evidence. These guidelines are intended to help guide all medical professionals treating adult patients with FI (e.g., general practitioners, surgeons, gastroenterologists, other healthcare workers) and any patients who are interested in information regarding the diagnosis and management of FI.MethodsThese guidelines have been created in cooperation with members from the United European Gastroenterology (UEG), European Society of Coloproctology (ESCP), European Society of Neurogastroenterology and Motility (ESNM) and the European Society for Primary Care Gastroenterology (ESPCG). These members made up the guideline development group (GDG). Additionally, a patient advisory board (PAB) was created to reflect and comment on the draft guidelines from a patient perspective. Relevant review questio...
Rural and Remote Health, 2021
This work is licensed under a Creative Commons Attribution 4.0 International Licence
Health-related quality of life of irritable bowel syndrome patients in different cultural settings
Background: Early diagnosis of anaemia represents an important task within primary care settings.... more Background: Early diagnosis of anaemia represents an important task within primary care settings. This study reports on the frequency of new cases of anaemia among patients attending rural primary care settings in Crete (Greece) and to offer an estimate of iron deficiency anaemia (IDA) frequency in this study group. Methods: All patients attending the rural primary health care units of twelve general practitioners (GPs) on the island of Crete for ten consecutive working days were eligible to participate in this study. Hemoglobin (Hb) levels were measured by portable analyzers. Laboratory tests to confirm new cases of anaemia were performed at the University General Hospital of Heraklion. Results: One hundred and thirteen out of 541 recruited patients had a low value of Hb according to the initial measurement obtained by the use of the portable analyzer. Forty five (45.5%) of the 99 subjects who underwent laboratory testing had confirmed anaemia. The mean value of the Hb levels in th...
Rural and Remote Health, 2005
Experimental gerontology, Jan 12, 2018
To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults... more To evaluate modifiable, lifestyle risk factors of cardiovascular disease (CVD) among older adults, across ageing, in the Mediterranean area. During 2005-2017, 3131 individuals from 26 Mediterranean islands of 5 countries, ≥65 years of age, were voluntarily enrolled. Anthropometrical, clinical and socio-demographic characteristics, dietary habits, lifestyle parameters were measured through standard procedures. Analyses were performed by year and across consecutive age groups of the participants. A decrease in the prevalence of current smoking (p < 0.001), engagement in physical activities (p = 0.001) and participation in social events (p = 0.001) for every year increase in age was found. Moderate alcohol drinking increased through ageing (p = 0.008), whereas adherence to Mediterranean diet remained stable, but adequate (p = 0.90). Trend analysis also revealed that a quadratic (U-shape) function better characterized the association between ageing and total cardiometabolic risk fact...
Cardiovascular diagnosis and therapy, 2017
Adherence to a Mediterranean dietary pattern is a well-established protective factor against card... more Adherence to a Mediterranean dietary pattern is a well-established protective factor against cardiovascular disease (CVD). However, diet quality is only one aspect of the overall healthy lifestyle adopted by Mediterranean populations. The latter has never been evaluated as a multi-factorial composite lifestyle. Thus, the aim of the present study was to provide a broader picture of the Mediterranean lifestyle and its effects on CVD risk, among elderly individuals. During 2005-2015, 2,749 older (aged 65-100 years) from 21 Mediterranean islands (MEDIS) and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled onto the study. Dietary habits, physical activity status, socio-demographic characteristics, lifestyle parameters (sleep, smoking habits, social life and educational status) and clinical profile aspects were derived through standard procedures. The overall prevalence of the traditional CVD risk factors were 62.3% for hypertension, 22.3% for diabetes mellitus (ty...
Annals of epidemiology, Mar 1, 2017
The aim of the present work was to evaluate the relation between car use and the level of success... more The aim of the present work was to evaluate the relation between car use and the level of successful aging of a random sample of older adults living in the Mediterranean basin. During 2005-2011, 2749 older (aged 65-100 years) from 22 islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the Mediterranean islands cross-sectional study. Sociodemographics, medical conditions, and dietary and lifestyle habits were derived throughout standard procedures. Car use was recorded with a standard binary question. A successful aging index ranging from 0-10 was used. Older adults who used a car on regular basis had significantly higher levels of successful aging, as well as less prevalence of obesity and hypertension while were more physically active (P < .001). After adjusting for several confounders car use was still positively related with elderly islander's successful aging level (beta coefficient [95% confidence interval]: 0.65 [0.54-0.77]). In concl...
Turkiye Klinikleri Journal of Family Medicine Special Topics, 2010
Gastroenterology Insights, 2012
Primary care physicians face challenges in diagnosing and managing gastroesophageal reflux diseas... more Primary care physicians face challenges in diagnosing and managing gastroesophageal reflux disease (GERD). The Reflux Disease Questionnaire (RDQ) meets the standards of validity, reliability, and practicability. This paper reports on the validation of the Greek translation of the RDQ. RDQ is a condition specific instrument. For the validation of the questionnaire, the internal consistency of its items was established using the alpha coefficient of Chronbach. The reproducibility (testretest reliability) was measured by kappa correlation coefficient and the criterion of validity was calculated against the diagnosis of another questionnaire already translated and validated into Greek (IDGP) using kappa correlation coefficient. A factor analysis was also performed. Greek RDQ showed a high overall internal consistency (alpha value: 0.91) for individual comparison. All 8 items regarding heartburn and regurgitation, GERD, had good reproducibility (Cohen's κ 0.60-0.79), while the remaining 4 items about dyspepsia had a moderate reproducibility (Cohen's κ=' 0.40-0.59) The kappa coefficient for criterion validity for GERD was rather poor (0.20, 95% CI: 0.04, 0.36) and the overall agreement between the results of the RDQ questionnaire and those based on the IDGP questionnaire was 70.5%. Factor analysis indicated 3 factors with Eigenvalue over 1.0, and responsible for 76.91% of variance. Regurgitation items correlated more strongly with the third component but pain behind sternum and upper stomach pain correlated with the second component. The Greek version of RDQ seems to be a reliable and valid instrument following the pattern of the original questionnaire, and could be used in primary care research in Greece.
Maturitas, 2011
Objectives: To evaluate the prevalence of low energy reporting (LER) and associations between LER... more Objectives: To evaluate the prevalence of low energy reporting (LER) and associations between LER and lifestyle, psychological and clinical parameters, in elderly people living in eastern Mediterranean islands. Methods: 1190 men and women, aged 65-100 years, participated in this cross-sectional study. Sociodemographic, clinical and lifestyle characteristics were recorded for the study participants. Among others, the ratio of energy intake to estimated basal metabolic rate (EI/BMR) was calculated and was used for the assessment of LER. Results: Prevalence of LER was 47.7%. Lower EI/BMR (i.e., higher risk for LER) was associated with older age (p = 0.001), male sex (p < 0.001), higher body mass index (BMI; p = 0.04), lower adherence to the Mediterranean diet (p < 0.001) and non-current smoking (p = 0.007). The sex-specific analysis revealed that, lower EI/BMR values were associated with lower adherence to the Mediterranean diet and being non-current smoker in both men and women (p ≤ 0.05), as well as with older age (p = 0.01), higher BMI (p = 0.02) and hypercholesterolemia (p = 0.02), only in women. Conclusion: In elderly, several clinical and lifestyle factors seem to be related to LER, and they should be taken into account in their nutritional assessment.
International Journal for Quality in Health Care, 2010
Objective. Establishing sufficient primary health-care services in rural areas is of high interes... more Objective. Establishing sufficient primary health-care services in rural areas is of high interest in developing health systems. The objective of the present study was to describe the state of rural health services, in terms of personnel and equipment, in rural primary care settings in Greece. Design. A questionnaire was sent to all Greek rural settings (RS) (practices) twice during 2007. The questionnaire included questions about the number of doctors in the practice, their specialty, presence of a nurse, population served and average distance from the regional Health Center and hospital. It also included questions about the average number of consultations per day, home visits, maintenance of medical records and medical equipment. Setting. Rural primary care settings in Greece. Participants. Doctors serving primary care needs during the second half of 2007. Intervention(s). None. Main Outcome Measure(s). Data concerning staffing, function and available equipment of the RS have been collected. Results. Five hundred eighty-two (40.9%) of the rural practitioners replied. Twenty-nine percent of the participants were general practitioners (GPs). Doctors reported average population of responsibility of 2263 citizens and a regular average of 26 consultations per day. A nurse was present in 174 RS (29.5%). Medical records of any form were kept in only 36% of the RS. GPs were more prone to maintain patients files compared with non-specialized doctors. Essential equipment proved to be limited in the majority of the RS. Conclusions. Rural practices in Greece report shortages of medical staff (GPs), nursing staff and equipment.
Diabetes & Metabolism, 2010
Aim.-The role of animal-protein consumption on the prevalence of diabetes is not yet fully unders... more Aim.-The role of animal-protein consumption on the prevalence of diabetes is not yet fully understood. For this reason, this study investigated the relationship between long-term animal-protein intake and diabetes in elderly individuals with no known cardiovascular disease.
BMC Gastroenterology, 2011
Background: Upper gastrointestinal endoscopy is the most preferable diagnostic examination for pa... more Background: Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods: Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open-ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP) questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results: Nine hundred and ninety two patients were recorded, 159 of them (16%) were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6%) patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8%) (p = 0.036) and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions: Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.
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Papers by Foteini Anastasiou