Death In Greece Research Articles

On the impact of mass screening for SARS-CoV-2 through self-testing in Greece.

Screening programs that pre-emptively and routinely test population groups for disease at a massive scale were first implemented during the COVID-19 pandemic in a handful of countries. One of these countries was Greece, which implemented a mass self-testing program during 2021. In contrast to most other non-pharmaceutical interventions (NPIs), mass self-testing programs are particularly attractive for their relatively small financial and social burden, and it is therefore important to understand their effectiveness to inform policy makers and public health officials responding to future pandemics. This study aimed to estimate the number of deaths and hospitalizations averted by the program implemented in Greece and evaluate the impact of several operational decisions. Granular data from the mass self-testing program deployed by the Greek government between April and December 2021 were obtained. The data were used to fit a novel compartmental model that was developed to describe the dynamics of the COVID-19 pandemic in Greece in the presence of self-testing. The fitted model provided estimates on the effectiveness of the program in averting deaths and hospitalizations. Sensitivity analyses were used to evaluate the impact of operational decisions, including the scale of the program, targeting of sub-populations, and sensitivity (i.e., true positive rate) of tests. Conservative estimates show that the program reduced the reproduction number by 4%, hospitalizations by 25%, and deaths by 20%, translating into approximately 20,000 averted hospitalizations and 2,000 averted deaths in Greece between April and December 2021. Mass self-testing programs are efficient NPIs with minimal social and financial burden; therefore, they are invaluable tools to be considered in pandemic preparedness and response.

Maternal mortality in Greece: The evolution from traditional mammis to overmedicalized obstetric care during the 20th century

AbstractGreece has been absent from the literature on maternal mortality in historical Europe, as very little evidence is yet available regarding maternal mortality patterns before the 1950s. The discontinuity in the collection and publication of demographic data in Greece, as well as the nonavailability of continuous national published statistics are the most important reasons for the lack of studies on maternal mortality. Therefore, this study aims to address this gap by utilising annual published statistics at the aggregate level, focusing primarily on the first half of the 20th century, while also making a significant contribution to the postwar period. The results of the study indicate a high incidence of maternal deaths in Greece, particularly in the northern—mostly rural and later annexed—regions of the country until the late 1930s. An important reason may be the lack of obstetric care in these areas. Although major urban centres were primarily served by qualified midwives by the mid‐1920s, rural Greece had access only to untrained midwives due to the insufficient number of trained midwives that could cater the needs of the entire country. Other contributing factors may include the high prevalence of infectious diseases, such as tuberculosis and malaria in certain areas of the country, poor nutritional status throughout the country before the 1950s, low literacy rates, low living standards, and lack of public health infrastructures. Greece's case study is intriguing as it has transitioned from an almost absolute lack of obstetric care, with the exception of the mostly untrained rural midwives known asmammisbefore the 1950s, to becoming one of the most highly medicalised countries in Europe by the end of the 20th century, succeeding very low levels of maternal mortality.

Temporal Trends in Stillbirth in Greece: A Longitudinal Population-Based Study.

Stillbirths are a major public health issue and a key population health indicator. The aim of this study was to comprehensively investigate and present time trends in stillbirth in Greece. Data on all live births and stillbirths were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021 and the annual stillbirth rate (SBR) was calculated, defined as the number of stillbirths per 1,000 live births and stillbirths (total births). Trends in the SBR were assessed using joinpoint regression analysis with calculation of the annual percent change (APC) with a 95% confidence interval (95% CI) and level of statistical significance p<0.05. The SBR in Greece, after an initial increasing trend (1957-1965: APC=2.6, 95% CI: 0.5 to 4.7, p=0.016), and an all-time high of 15.8 per 1,000 births in 1966, recorded a four decades period of continuous improvement (1965-2003: APC=3.0, 95% CI: -3.2 to -2.8, p<0.001) and reached a historic low in 2008 (3.3 per 1,000 births) (a decrease by 79%). However, the SBR stagnated at an elevated level during the decade 2006-2016 and showed a steeply upward trend during the most recent period 2016-2021 (APC=7.4, 95% CI: 3.0 to 12.1, p=0.001). In 2021, the SBR was 5.3 per 1,000 births, 60% up from 2008. It was estimated that the SBR improvement for the 1967-2021 period resulted in 50,914 stillbirths averted (7.9 per 1,000 births), but the recent increase in the SBR has led to 1,200 additional fetal deaths (1.0 per 1,000 births) during 2009-2021. After an impressive decline for almost four decades the SBR gradually deteriorated during the economic crisis and finally showed an alarming rising trend after 2015, resulting in an increasing burden of fetal deaths in Greece. Further public health interventions are needed to address preventable risk factors and ensure access to optimized antenatal monitoring.

Assessing the impact of kidney cancer-related premature mortality and productivity loss in Greece and Portugal

ABSTRACT Objective In 2018, 371,750 people were diagnosed with kidney cancer globally, constituting 2.2% of all cancer diagnoses. Since 2010, the number of kidney cancer deaths in Europe have decreased in people under 65. However, this is not the case in Greece and Portugal. This study estimated the mortality and lost productivity due to premature mortality from kidney cancer in Greece and Portugal. Methods Years of life lost (YLL) and present value of future lost productivity (PVFLP) due to kidney cancer mortality (ICD-10 code: C64 – Malignant neoplasm of kidney, except renal pelvis) were calculated using the human capital approach. Age-specific mortality, mean earnings, and labor force participation rates were used in these calculations. Results In 2019, there were 564 and 454 kidney cancer deaths in Greece and Portugal, respectively, resulting in 5,871 (3,636 in males and 2,234 in females) and 5,397 (3,100 in males and 2,297 in females) YLL, respectively. YPLL and annual PVFLP were estimated to be 1,326 and €14.8 M in Greece and 1,278 and €11.8 M in Portugal, respectively. Conclusion YLL and PVFLP due to kidney cancer mortality are substantial in Greece and Portugal. These results provide new evidence to assist decision-makers in allocating resources to reduce cancer burden.

Russia’s Radical Byron: Reexamining the “Decembrist Pushkin”

Abstract Lord Byron’s reputation in Russia’s literary imagination might surprise those who remember him not only as a multifaceted poet or political commentator, but also as a sexual libertine. Following his death in Greece, the tempestuous Byron came to stand for both freedom and romanticism in Russia, especially for the poets who would become associated with the Decembrist Uprising, a failed attempt by liberal nobles to reform the absolutist state by military coup in 1825. Perhaps even more importantly, Byron also became identified with the primary candidate for the role of Russia’s national poet: Alexander Pushkin. Though much as been written about Pushkin’s “Byronic apprenticeship,” this article focuses on how Pushkin’s responses to the English poet led him to depart from—and even conflict with—a specifically political version of Byronism promoted by his contemporaries. In particular, it analyzes Russian poetic response to Byron’s death, including works by Pushkin, Ivan Kozlov, Wilhelm Küchelbecker, Kondraty Ryleev, and Dmitry Venevitnov. It also considers Pushkin’s “To the Sea” (1824), analyzing an extended polemic with Prince Pyotr Viazemsky about Byron’s political legacy that this poem initiates.

Association of SARS-CoV-2 Vaccinations with SARS-CoV-2 Infections, ICU Admissions and Deaths in Greece.

The available coronavirus disease 2019 (COVID-19) vaccines have shown their effectiveness in clinical trials. We aimed to assess the real-world effects of SARS-CoV-2 vaccinations in Greece. We combined national data on vaccinations, SARS-CoV-2 cases, COVID-19-related ICU admissions and COVID-19-related deaths. We observed 3,367,673 vaccinations (30.68% of the Greek population), 278,821 SARS-CoV-2 infections and 7401 COVID-19-related deaths. The vaccination rate significantly increased from week 2 to week 6 by 85.70%, and from week 7 to 25 by 15.65%. The weekly mean of SARS-CoV-2 cases, COVID-19 ICU patients and COVID-19 deaths markedly declined as vaccination coverage accumulated. The rate of SARS-CoV-2 cases increased significantly from week 2 to week 13 by 16.15%, while from weeks 14–25 the rate decreased significantly by 13.50%. The rate of COVID-19-related ICU admissions decreased significantly by 7.41% from week 2 to week 4, increased significantly by 17.22% from weeks 5–11, then decreased significantly from weeks 17–20, by 11.99%, and from weeks 21–25, by 16.77%. The rate of COVID-19-related deaths increased significantly from week 2 to week 15 by 12.08% and decreased significantly by 16.58% from weeks 16–25. The data from this nationwide observational study underline the beneficial impact of the national vaccination campaign in Greece, which may offer control of the SARS-CoV-2 pandemic.

POSC129 Economic Burden of Metastatic Breast Cancer in Greece

Breast cancer (BC) is the most commonly diagnosed cancer in women and the second leading cause of cancer death in Greece. The economic burden of BC is substantial and has been steadily increasing. The aim of this study was to provide the first estimate on the direct costs associated with the management of metastatic BC (mBC) in Greece.

Targeted prevention of road traffic deaths in Greece: a multifactorial 5-year census-based study.

Between 2012 and 2016, Greece suffered yearly more than 800 deaths from road traffic incidents (RTIs), holding one of the worst performances in the European Union for RTI-related deaths per population. Our primary aim is to identify risk factors associated with mortality to set a targeted policy framework on road safety. This is a retrospective analysis of data collected prospectively from Traffic Police. A correlation of 29 factors with adult drivers' mortality was made, applying multivariate logistic regression models. At a second stage, a scoping literature review identified the best possible targeted prevention measures. A total of 93,019 drivers with a mean age of 42.2 ± 0.1years were recorded, of which 2772 (3%) died. Age above 65 (aOR 3.1, p < 0.001), non-use of seatbelt (aOR 8.2, p < 0.001) or helmet (aOR 2.85, p < 0.001) and alcohol consumption (aOR 3.3 for cars, 4 for motorbikes, p < 0.001) were the driver-related parameters with the strongest correlation with a fatal outcome. Drivers' behavior with specific high-risk maneuvers increased odds of death 2-4 times, depending on vehicle type. One-lane, rural road network was the environmental factor with the most significant impact. Based on the results of the analyses, our scoping review identified and suggested 23 specific measures for the Greek government and policymakers to examine. Human-related factors were the parameters with the strongest impact on mortality after an RTI in Greece. These findings demonstrate an educational gap that must be primarily addressed with the introduction of missing road safety education in schools and an intensified and innovative population awareness campaign.

National Survey of Morbidity and Risk Factors (EMENO): Protocol for a Health Examination Survey Representative of the Adult Greek Population.

BackgroundMain causes of death in Greece are cardiovascular diseases (CVDs), malignant neoplasms, respiratory diseases, and road traffic crashes. To assess the population health status, monitor health systems, and adjust policies, national population-based health surveys are recommended. The previous health surveys that were conducted in Greece were restricted to specific regions or high-risk groups.ObjectiveThis paper presents the design and methods of the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors). The primary objectives are to describe morbidity (focusing on CVD, respiratory diseases, and diabetes), related risk factors, as well as health care and preventive measures utility patterns in a random sample of adults living in Greece.MethodsThe sample was selected by applying multistage stratified random sampling on 2011 Census. Trained interviewers and physicians made home visits. Standardized questionnaires were administered; physical examination, anthropometric and blood pressure measurements, and spirometry were performed. Blood samples were collected for lipid profile, glucose, glycated hemoglobin, and transaminases measurements. The survey was conducted from May 2013 until June 2016.ResultsIn total, 6006 individuals were recruited (response rate 72%). Of these, 4827 participated in at least one physical examination, 4446 had blood tests, and 3622 spirometry, whereas 3580 provided consent for using stored samples for future research (3528 including DNA studies). Statistical analysis has started, and first results are expected to be submitted for publication by the end of 2018.ConclusionsEMENO comprises a unique health data resource and a bio-resource in a Mediterranean population. Its results will provide valid estimates of morbidity and risk factors’ prevalence (overall and in specific subdomains) and health care and preventive measures usage in Greece, necessary for an evidence-based strategy planning of health policies and preventive activities.International Registered Report Identifier (IRRID)DERR1-10.2196/10997

The Role of Pharmacists in Cardiovascular Disease Prevention: Qualitative Studies from the United Kingdom and Greece.

Objective:In the United Kingdom (UK), cardiovascular disease (CVD) is the second main cause of death (27.4%) and the leading cause of death in Greece, accounting for 48% incidences. Pharmacists, the most accessible health-care professionals, can have a key role in all stages of CVD prevention. This study aimed to explore the current and future role of pharmacists in CVD prevention, focusing on two European countries, the United Kingdom and Greece.Methods:Semi-structured interviews were conducted with 40 community pharmacists; 20 in the UK and 20 in Greece. All interviews were audio-recorded, transcribed, and analyzed thematically.Findings:Five main themes were identified: current pharmacists' role, future pharmacists' role, communication, resources and tools, and knowledge. Whereas pharmacists in the UK use a patient-centered approach, Greek pharmacists use a paternalistic approach. Nevertheless, the majority found it difficult to initiate a consultation. Both the UK and Greek pharmacists primarily focus on secondary CVD prevention, while dispensing prescribed medications, which is their main current role. Greek pharmacists recognized a potential role in primary prevention and early screening of CVD through the initiation of CVD prevention services with a weight management program being proposed. Barriers identified for a role in CVD prevention included: high workload in Greece and reimbursement issues and interprofessional relations in the UK.Conclusion:Pharmacists in both countries perceive having a potential role in CVD prevention based on their accessibility and customer relations. The challenges include a closer working relationship with other clinicians, communication/consultation skills training, and developing a sustainable funding model for the service.

Comparing flood mortality in Portugal and Greece (Western and Eastern Mediterranean)

For the first time flood mortality is analysed and compared between a Western (Portugal) and an Eastern Mediterranean country (Greece). Flood fatalities are examined and compared in terms of frequency, temporal evolution, spatial distribution, deadliest flood types, gender of the victims, circumstances surrounding fatalities, and individual and societal risk.A common flood fatalities database was formed for the period 1960–2010 by merging the DISASTER database for Portugal and the Greek databaseIndividual flood cases generated more deaths in Greece than in Portugal (excluding an outlier flash flood event in the latter). Despite some fluctuations evidence of a gradual decrease in fatality numbers were recorded for both countries. Since the 1980's the number of flood cases with multiple fatalities has been gradually declining, due to changes in qualitative characteristics of mortality. Flood fatalities predominantly occur during autumn in Greece and during winter in Portugal.In both Greece and Portugal flash floods were responsible for more than 80% of the total mortality. The main metropolitan areas of each country were found to be hotspots of flood mortality; a trend connected, with the higher population density along the coastal areas combined with the expansion of urban fabric towards flood-prone areas.Gender distribution of fatalities indicates that males are more vulnerable in both countries. The circumstances surrounding fatalities showed that fatalities occurring inside buildings have been gradually reducing in time, while vehicle-related deaths have been rising, showing that individuals hold an active role when they voluntarily enter in floodwaters during a flood.

A validated GC/MS method for the investigation of quetiapine-related deaths in Greece

A validated GC/MS method for the investigation of quetiapine-related deaths in Greece

Resource utilization and costs for treatment of stroke patients in an acute stroke unit in Greece

BackgroundStroke comprises the leading cause of death in Greece, and more than 40% of the overall lifetime cost for stroke care, represents the acute phase hospitalization. The aim of the present study was to assess the resource utilization and estimate the costs for treatment of stroke patients in an Acute Stroke Unit (ASU). MethodsPatients with first-ever stroke treated in the ASU of an academic hospital in Athens during 2003–2009 were included in the analysis. The National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were employed to assess the neurological impairment on admission and the handicap at discharge, respectively. The cost categories measured were: diagnostic investigations, medications, medical and nursing staff, and overhead costs. A generalized linear model was used to predict the mean cost per patient, based on the clinical characteristics of the patients on admission, and during their hospitalization. ResultsIn total, 784 patients were included in the analysis, with mean age of 72.2 (11.2) and mean length of hospital stay of 12.3 (9.5) days. The mean cost per patient was estimated at €2,864 (2,198), and the mean cost per day at €244 (54). The relevant cost for the mildly handicapped patients was €1,573 (625), while for the severely handicapped patients it was €4,136 (2,538). Delayed discharge was associated with a mean cost of €362 (634) per patient, while the cost for the acute phase management of the patients was €2,445 (2,471). The neurological impairment on admission (NIHSS score) and the delayed discharge, were strong predictors of the mean cost per patient. ConclusionsThe costs for treatment of stroke patients in an ASU comprise a significant burden in Greece. Further research should be performed to explore the long-term costs for the treatment of the disease at a nation-wide level.

Tracking animals to their death

Migration may be a high-risk period. In a study involving three species of raptor migrating from Europe to Sub-Saharan Africa, Klaassen et al. (2014) satellite-tracked 51 out of 69 birds to their deaths and showed that rate of mortality during migration was 6x that during stationary phases when birds were on their winter and summer grounds. Travel across the Sahara was particularly risky. Satellite tracking has also been used to infer mortality in other taxa (e.g. sea turtles) and may allow high-risk hotspots to be identified for wide-ranging species.

Regional mortality differentials in Greece by selected causes of death: 2006–2008

Deaths due to neoplasms and diseases of the circulatory and the respiratory system represent 80% of all deaths in Greece. In the context of dearth of statistical analysis of spatial patterns of cause-specific mortality in Greece, this paper aims at studying the distribution and structure of appropriate mortality measures for the above mentioned causes of death at prefecture level. To achieve this, official statistics on deaths (2006–2008) and population (2007) are employed and Standardized Mortality Ratios (SMRs) by gender and cause of death are estimated using as ‘standard’ mortality schedule the national age-sex and cause-specific death rates. Estimation of Moran's I statistic revealed the existence of significant positive spatial autocorrelation for neoplasms and circulatory diseases. Empirical Bayes procedures were employed to adjust SMR values which, although show less dispersion, were close to the original estimates. The thematic maps depict regions with relatively high (SMRs > 100) or low (SMRs < 100) mortality and their significance levels, indicating that spatial patterns exhibit many similarities between sexes for each cause of death. SMRs for neoplasms and circulatory diseases show a roughly similar tendency; lower mortality compared to the country's average in southern and western Greece and the islands, and higher mortality in northern Greece, especially in the Region of East Macedonia and Thrace. Patterns due to respiratory diseases, on the other hand, differ somewhat but the corresponding relative risks are not as significant. Thorough observation and analysis of the conditions prevailing in northern Greece is needed to identify factors exacerbating ill health.

Carbon Monoxide–Related Deaths in Greece

Carbon monoxide (CO) is the cause of more than one half of the fatal poisonings throughout the world. The aim of this study was to assess the characteristics of nonfire CO-related deaths in Greece, as they were recorded at the Department of Forensic Medicine and Toxicology, School of Medicine, University of Athens. This retrospective study concerned the toxicological records of all fatal cases of CO poisoning received by the Department of Forensic Medicine and Toxicology during the period 1987 to 2009. The records were reviewed and compiled according to the official coroner's verdict as to the manner of poisoning (accident or suicide), as well as according to the sex and the nationality of the victims. The registered victims were 176 (131 males, 45 females). Of CO deaths, 97.2% were accidental, and 2.8% were suicides, through automobile exhaust. Among the decedents, 32 victims were immigrants (30 males, 2 females). The average annual death rate for males was nearly 3½ times higher than that for females. This increase suggests a need for preventive strategies targeting not only high-risk population, such as homeless or immigrants, but also the general population. Preventive messages in many languages through the media about potential sources of CO exposure are recommended. Precautions should also be taken during periods of low temperatures.

Maternal mortality in Greece, 1996–2006

Objective To present retrospective data for maternal deaths in Greece from 1996 to 2006. Methods Demographic information and information on the causes of death was provided by the Hellenic Statistical Authority. Maternal deaths were assessed by cause of death, maternal age, and place of residence. The maternal mortality ratio (MMR) was estimated and expressed as the number of deaths per 100 000 live births. Results From 1996 to 2006, 29 deaths were attributed to pregnancy and childbirth, yielding a total MMR of 2.63. The leading cause of direct deaths was hemorrhage and that of indirect deaths was cardiac disease. There was a borderline significant decline in the MMR during the study period. The MMR was significantly higher at the extremes of the reproductive age range. Conclusion Maternal mortality in Greece is low; however, no formal data have been published since 1996. Knowledge of the causes of maternal death can lead to the prevention of maternal deaths and safer motherhood.

Carbon monoxide-related deaths in Greece

Carbon monoxide-related deaths in Greece

Report on the 29th International Byron Conference

The 29th International Byron Conference was held at University of Liverpool between 19th and 24th of August 2003. It opened with a welcome session in main lecture theatre of 1830s building of Liverpool Medical Institute. This is a very fine, wood-panelled and balconied theatre-very like, I imagine, kind of lecture theatre in which Coleridge and Hazlitt would have given their lectures. The conference was officially got under way with addresses by Professor Philip Davis (Head of English at Liverpool), Professor Drummond Bone (Liverpool's Vice- Chancellor) and Mr Ron Gould (Lord Mayor of Liverpool). The conference theme was 'Byron and Good Life', with a minor theme of 'Byron and Sea'. Vincent Newey (Leicester) got discussion of 'Byron and Good Life' off to an excellent start with 'Good Life, Bad Life: Byron, Dickens and Adventure of Georg Simmel'. Uncovering numerous hidden quotations from and references to Byron across Dickens's work, Newey argued that Dickens's critique of English aristocracy was mainly based on his reading of Norman Abbey cantos of Don Juan. Acknowledging a fundamental difference between Byronic celebration of 'the classical body' in Childe Harold IV and rather more Dickensian province of 'the grotesque body', Newey nevertheless uncovered traces of former in account of Steerforth's death in David Copperfield, suggesting that death of Steerforth in some ways depicts nineteenth-century death of Byronism. The first panel of conference was opened by Corinna Russell (Cambridge). Her paper, 'Reading the moral of all human tales: Childe Harold IV and Wreck of Good Life', carefully distinguished between ethical and moral and argued that Byron's understanding of morality was not primarily to do with interior intents but with public realm of actions. Shobhana Bhattacharji (Delhi) spoke on complexities involved in reading Childe Harold's Pilgrimage. She argued that meaning of poem is bound up with its gaps and with silences, and that reader picks up more of permanent paradoxes of poem than they can wholly explain. This, she demonstrated, is part of difficulty of Childe Harold. After a five minute mid-session break (an innovation much appreciated by delegates), Paul M. Curtis (Moncton-and organiser of next year's International Conference, on 'Byron and Sublime', to be held at his university) and Michael O'Neill (Durham) gave their papers. Curtis's 'Prophecy and Prophetic in Byron's Poetry and Drama' was concerned with Byron's relationship with prophetic tradition and prophetic habits of mind. Michael O'Neill's paper, 'A Stalking Oracle: Beppo and Good' made an interesting distinction between 'attention' and 'curiosity', then contrasted 'attention' with what O'Neill argued is pure 'curiosity' of Beppo-a curiosity through which selfconsciousness is lost and world is simply relished. In afternoon we moved to University's Senate Room for another four-paper session. First we heard Tony Howe (Cambridge) speak on 'Byron's The Island and Choice of Good Lives' and David Roessel, winner of Elma Dangerfield Prize for In Byron's Shadow, on 'Seeking a Soldier's Grave: Byron and a Good Death'. Tony Howe bravely declared that ending of The Island is flawed. David Roessel showed how Tennessee Williams made a play out of image of Byron's heroic death in Greece without, it seems, knowing anything about poet at all. After break, Gavin Hopps (Aachen) gave a fine paper on what he called Byron's 'porousness' that distinguished between Childe Harold's Pilgrimage, in which Byron constantly moves outwards, towards and into space and art works, and Don Juan, where Byron does opposite and brings a whole metaphysical world into Norman Abbey and Aurora Raby. Hopps's distinctive terminology-the 'porous', 'penetrable' and 'leaky' were some of his terms-echoed through rest of conference. …

L26 Hypertension as a cause of death in Greece

L26 Hypertension as a cause of death in Greece