The COVID-19 pandemic has the potential to adversely affect the mental health of healthcare workers (HCWs). The public healthcare system in Greece was already facing serious challenges at the outset of the outbreak following years of austerity and an escalating refugee crisis. This multi-center, cross-sectional study aims to assess the levels and associated risk factors of anxiety, depression, traumatic stress and burnout of frontline staff in Greece. A total of 464 self-selected HCWs in six reference hospitals completed a questionnaire comprising sociodemographic and work-related information and validated psychometric scales. The proportion of HCWs with symptoms of moderate/severe depression, anxiety and traumatic stress were 30%, 25% and 33%, respectively. Burnout levels were particularly high with 65% of respondents scoring moderate/severe in emotional exhaustion, 92% severe in depersonalization and 51% low/moderate in personal accomplishment. Predictive factors of adverse psychological outcomes included fear, perceived stress, risk of infection, lack of protective equipment and low social support. The psychological burden associated with COVID-19 in healthcare professionals in Greece is considerable, with more than half experiencing at least mild mental health difficulties. Findings signal the need for immediate organizational and individually tailored interventions to enhance resilience and support wellbeing under pandemic conditions.

COVID-19 is an emerging disease of global public health concern. As the pandemic overwhelmed emergency departments (EDs), a restructuring of emergency care delivery became necessary in many hospitals. Furthermore, with more than 2000 papers being published each week, keeping up with ever-changing information has proven to be difficult for emergency physicians. The aim of the present review is to provide emergency physician with a summary of the current literature regarding the management of COVID-19 patients in the emergency department.

Patients with cardiovascular diseases face difficulty to adhere to non-pharmaceutical treatment recommendations and consequently face an increased recurrence rate, re-hospitalizations and poor quality of life. Our review of the literature over the past decade aims to be a useful tool to the enlightening of health care providers and health educators about the interventions that enhance treatment adherence to lifestyle modification. PubMed, PsycLIT, Cochrane Library, Scopus, CINAhl, PSYinfo, Web of Science, and Central databases were searched to identify articles published within the decade 2011-2021 and 42 studies met the criteria for inclusion. Our study revealed many different approaches to inconsistency in life style prescriptions focusing mainly on psychological and social factors. Interventions like increasing of knowledge, joining cardiac rehabilitation programs, development of a therapeutic alliance, behavioral techniques that reinforce self-efficacy and motivation, use of technology as reminder and creating a support network are not only effective but also low-cost programs that will play a decisive role in treatment effectiveness. Improving treatment adherence to lifestyle recommendations requires a multidimensial approach by an interdisciplinary team of health professionals. Investing in interventions that improve attitudes, beliefs, readiness and self-care, can prove to be very rewarding for patients, health and economics. The present literature review will assist health professionals and educators create experiential educational and behavioral programs that promote the adoption of healthy behavior and help maintain adherence over time. Future research is required for identifying the most effective interventions based on different lifestyles practices and cultural factors.

During the first 2 years of the coronavirus disease 2019 pandemic, health systems worldwide were put under extreme pressure, and healthcare professionals had to manage unprecedented health crises as well as provide healthcare services to an increased number of patients. Therefore, public health policies with respect to smoking and education of the general population regarding the harmful effects of active and second-hand smoking may not have received adequate attention during this period. More specifically, certain subpopulations suffering from chronic diseases may not have received adequate information about the effects of smoking on the course and outcome of their disease; high-level, evidence-based pharmaceutical therapies; and the potential for follow-up. However, adequate education and awareness regarding short- and long-term health benefits from smoking cessation for the general population as well as special subgroups remains of utmost importance. Healthcare professionals should understand that it is only through high-quality evidence and results from independent studies that they will be able to provide their expertise and scientific knowledge concerning newer tobacco products and their effects on human health.

Background: Incorrect use of inhaler devices is associated with unfavorable outcomes Aim: To evaluate device use errors in asthma and COPD patients treated in outpatient clinics of 3 tertiary hospitals and one private practice office in Greece Methods: Demographics and medical history were recorded. Patients demonstrated the use of their prescribed device and use was evaluated according to predefined steps Results: 607 patients (50.2%male, mean age 60.2years) performed 663 demonstrations (56 patients were using 2 different types of devices). 49.8% were treated for asthma and 50.2% for COPD. 79.5% were using DPIs. Errors were documented in 41.2%, were associated with the type of device, p<0.001 and were less common in asthmatics compared to COPD patients 63.3% vs 54.5% respectively, p=0.013. Errors were more common among patients using pMDIs compared to those using DPIs (48.5% vs 39.1%, respectively p=0.020) and was associated with more exacerbations in the previous year (1.48±1.3 vs 0.82±1.00, for incorrect and correct use respectively, p<0.001). The commonest error in both pMDIs and DPIs was associated with the breathing in maneuver, 52% and 48.3% respectively. 15.5% of patients were never trained. Trained patients performed less errors compared to not trained patients, 14.6% vs 66.9% respectively, p<0.001. Correct use was more common among those trained by a doctor compared to other health care professionals 75.2% vs 26.5% respectively, p<0.001 Conclusion: Device use errors are common and associated with unfavorable outcomes. Trained patients were more likely to use the device correctly. Patients should be encouraged to demonstrate the use of their devices during medical visits in everyday clinical practice