Job Satisfaction of Nurses Versus Other Mental Health Professionals Working in Psychosocial Rehabilitation Services.

INTRODUCTION: The objectives of Psychiatric Reform were, on the one hand, psychiatric hospitals' shutting down and, on the other hand, the creation of Psychosocial Rehabilitation facilities, in order to provide appropriate care to individuals suffering from mental health problems in community. Therefore, mental health professionals' job satisfaction constitutes one of the fundamental factors leading either to success or failure of each reforming effort. PURPOSE: The aim of this study was to investigate the level of professional satisfaction of nurses working in Psychosocial Rehabilitation facilities compared to other mental health professionals. METHODOLOGY: Three hundred and sixty-seven mental health professionals, working in the field of psychosocial rehabilitation completed (a) a sociodemographic questionnaire, and (b) Spectοr's Job Satisfaction Survey (JSS). RESULTS: Moderate levels of total professional satisfaction were observed. Low satisfaction rates were recorded in "Pay," "Promotion," and "Fringe Benefits" subscale. High satisfaction rates were recorded in "Supervision," "Cooperation between colleagues," and "Nature of work," while moderate satisfaction rates were reported in "Contingent rewards," "Operating procedures," and "Communication" within facilities. It is noteworthy that nurses were statistically significant less satisfied with the "Contingent rewards" (p = 0.028), the "Nature of work" (p = 0.001), and the "Communication" (p = 0.019), while they were statistically significant more satisfied with "Supervision" (p = 0.007) compared to the other specialties of mental health professionals. CONCLUSIONS: The results can be used by those with administrative and scientific responsibilities in the field of mental health in order to recognize professionals' difficulties and solve their problems in psychosocial rehabilitation facilities. These interventions could improve their levels of job satisfaction, in order to achieve optimal therapeutic results for mentally ill and improve the quality of the services provided.

Body Image, Social Physique Anxiety Levels and Self-Esteem among Adults Participating in Physical Activity Programs.

(1) Background: individuals may benefit from being involved in physical and athletic activities in order to improve their body appearance and promote their physical and mental health. This study aimed to investigate body image, body mass index (BMI) characteristics, social physique anxiety, self-esteem and possible correlations between the above factors. (2) Methods: 245 adults engaged in training programs in gyms, as well as in track and field, football and basketball athletic activities completed (a) a sociodemographic questionnaire which recorded their BMI values and utilized the (b) Body-Esteem Scale for Adolescents and Adults, (c) the Social Physique Anxiety Scale and (d) the Rosenberg Self-Esteem Scale. (3) Results: Females and individuals with higher BMI reported statistically significant lower body-esteem and greater social physique anxiety levels compared to males and individuals with lower BMI, respectively (p < 0.05). A total of 25.3% of our participants were labeled as "overweight", while 20.4% had been overweight in the past. Significant differences were reported between body-esteem and social physique anxiety levels (p < 0.001); age (p = 0.001); BMI value (p < 0.001) and never having a problem with body weight (p = 0.008). Additionally, individuals with lower body-esteem and greater social physique anxiety levels presented lower global self-esteem (p < 0.001). (4) Conclusions: individuals' engagement in physical activity promotes physical as well as mental well-being, contributing to an improved quality of life, which may be the most important issue for health care professionals.

Long-term Evaluation of Proximal Aortic Neck Dilatation After Endovascular Abdominal Aortic Aneurysm Repair With a Variety of Contemporary Endografts.

PURPOSE: To measure the long-term proximal aortic neck dilatation (AND) after elective endovascular aortic aneurysm repair (EVAR) with a variety of contemporary, third-generation, endograft devices. MATERIALS AND METHODS: This is a noninterventional prospective cohort study of 157 patients that underwent standard EVAR with self-expanding abdominal endografts. Patients' recruitment lasted from 2013 to 2017, and postoperative follow-up was up to 5 years. A computed tomography angiography (CTA) was performed at the first month and then at 1, 2, and 5 years. Proximal aortic neck's (PAN) basic morphological characteristics (diameter, length, angulation) were measured based on the analysis of CTA in a standardized fashion. Neck-related adverse events, such as migration, endoleak or rupture, and reinterventions were recorded. RESULTS: Significant straightening of the PAN was evident even in the first-month CTA with concurrent neck shortening that became significant at 5 years. Both the suprarenal aorta and the PAN significantly dilated overtime, with PAN dilating more progressively. Mean neck dilatation at the juxtarenal level was 0.8±0.4 mm at 1 year, 1.8±0.8 mm at 2 years, and 3.9±1.7 mm at 5 years, with a mean neck dilatation rate of 0.07 mm/month overall. The incidence of AND ≥2.5 mm was 37.2% at 2 years and 58.1% at 5 years after EVAR and was considered important (≥5 mm) in 11.5% of patients at 2 years and 30.6% of patients at 5 years. A multivariate analysis performed showed that the endograft oversizing, the preoperative neck diameter, and the preoperative abdominal aortic aneurysm sac diameter served as independent predictors of AND at 5 years. At the 5-year follow-up, 8 late type Ia endoleaks (6.5%) and 7 caudal migrations (5.6%) were identified, while no late ruptures were reported. In total, 11 late endovascular reinterventions (8.9%) were performed. Overall, proximal neck-related adverse outcomes (5/7 migrations and 5/8 endoleaks) and reinterventions (7/11) were significantly associated with the presence of important late AND. CONCLUSION: Proximal AND after EVAR is common. It can influence the long-term durability of proximal endograft fixation and is significantly associated with adverse outcomes, often leading to reinterventions. A systemic and extended surveillance protocol is needed for maintenance of good long-term results. CLINICAL IMPACT: This is a thorough and systematic analysis of the long-term geometric remodeling of the proximal aortic neck after EVAR, that highlights the importance of a strict, and extended surveillance protocol for maintenance of good long-term results of EVAR.

Incidence and risk factors of postimplantation syndrome after elective endovascular aortic aneurysm repair.

BACKGROUND: Postimplantation syndrome (PIS) represents an acute phase systemic inflammatory response following endovascular aortic aneurysm repair (EVAR). Our objective was to investigate the risk factors associated with the manifestation and severity of PIS with various available stent-grafts. METHODS: We performed a retrospective analysis of prospectively collected data covering the period 2016-2020. The study included 191 patients. Body temperature was recorded regularly and blood sample was obtained daily. The imaging protocol included computed tomography aortoiliac angiography before surgery and one month after. The volumes of pre-existing and new-onset mural thrombus were calculated in a semi-automated fashion. Five abdominal aortic stent-graft devices were used: Endurant™ ΙΙ, Anaconda™, Treo®, E-tegra® and AFX® 2. Subgroup analysis was performed between woven polyester and ePTFE lined devices. RESULTS: The incidence of PIS was 21.5%. No significant differences were observed regarding demographics, risk factors, aneurysm anatomy or operative data. The amount of pre-existing and new-onset mural thrombus were not related with PIS (P=0.117 and P=0.096). PIS incidence in the polyester subgroup was 24.2%, significantly higher compared to 8.3% in the ePTFE subgroup. In-subgroup analysis revealed that the use of Anaconda™ was associated with the higher frequency (61.1%, P=0.021). Multivariate logistic regression showed that polyester was the single factor significantly associated with PIS (hazard ratio=2.6, P=0.043), as opposed to the new onset thrombus (hazard ratio=1.29, P=0.101). CONCLUSIONS: PIS is not uncommon and should be taken into consideration in patients presenting with fever after EVAR. The endograft's liner material seems to play the primordial role, with woven polyester to be attributed with significantly higher incidence.

Simultaneous transcervical angioplasty and stenting of innominate and right internal carotid arteries.

Severe stenosis of both the internal carotid and the innominate arteries is a rare condition. Hybrid procedures combining carotid endarterectomy and retrograde endovascular innominate angioplasty have been introduced to reduce the complications of open surgery. The recently reported good results of carotid angioplasty and stenting have encouraged us to perform simultaneous transcervical angioplasties and stenting of both arteries in a symptomatic 64-year-old woman. The procedure was successful and without complications and there have been no symptoms or restenosis in the 18-month follow-up period. Carrying out additional procedures of this will be necessary to reach wider conclusions.

The results of a simplified technique for safe carotid stenting in the elderly.

PURPOSE: The purpose of this study was to report the preliminary experience of a modified transcervical carotid angioplasty and stenting (CAS) technique with filter protection and flow reversal only during filter placement in patients unsuitable for transfemoral CAS and at high risk for carotid endarterectomy (CEA). PATIENTS AND METHODS: Twenty-five of 132 patients, aged 75 to 86 years old, with severe carotid stenosis had been selected. Eighteen patients had transient ischemic attacks (TIAs) in the last month and seven patients were asymptomatic. Patients with limited life expectancy were not included. The common carotid artery (CCA) was mobilized and cannulated. The flow in the internal carotid artery (ICA) was reversed by occluding the proximal CCA and connecting the introducing sheath to a blood transfusion bag positioned close to the floor, instead of returning it directly to the venous system. This produced retrograde flow in the ICA in all patients as a result of greater pressure gradient. The carotid filter was inserted to the distal ICA under retrograde flow and then antegrade flow was resumed and CAS was performed. All patients were autotransfused except for four patients who had severe renal insufficiency to avoid readministration of contrast media. RESULTS: All procedures were successful except in one patient converted to open endarterectomy because of CCA dissection (technical success rate 97.5%) and one patient who had a TIA involving the right hand 10 hours after CAS and recovered completely after 3 hours (event rate 2.5%). Reversed flow was visualized with intraoperative angiography in the ICA in all patients. Twenty-two patients were discharged the next morning and three (12%) on the following day because of hypotension. The duration of reversed flow was 1 to 4 minutes (mean, 1.5 minutes), the amount of blood collected was 100 to 400 mL (mean, 250 mL), and none of these patients had any hemodynamic disturbance during the procedure. Creatinine levels showed no increase postoperatively in either patient. The patients were followed-up clinically and with color Duplex scan for 3 to 24 months, so far, and they are free of symptoms or significant restenosis. CONCLUSION: The results of this preliminary study indicate that the transcervical approach with flow reversal during the insertion of the protecting filter allows CAS with minimal interruption of cerebral circulation and is simple and safe in patients unsuitable for CEA and transfemoral CAS for anatomic reasons. Further research with randomization and with pre-procedure and post-procedure diffusion-weighted magnetic resonance imaging (DW-MRI) is required in order to expand the indications of this method.