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PubMed2006

Introduction to the special issue on innovations in problem-based learning.

This special issue on Innovations in Problem-Based Learning is based on a symposium that was organized during the 11th biennial meeting of the European Association for Research on Learning and Instruction (EARLI) in Nicosia (Cyprus). Most papers in this special issue were presented at this symposium. The aim of this special issue in Advances in Health Sciences Education is to provide an overview of the state of the art in PBL research, and to discuss implications of these recent developments for educational practice. This introductory paper presents a short overview of all contributions to the special issue.

Europe↗
PubMed2005

Microsatellite analysis of olive fly populations in the Mediterranean indicates a westward expansion of the species.

Bactrocera oleae is the major insect pest of the olive fruit. Twelve microsatellite loci isolated from the genome of this insect were used in a Mediterranean-wide population analysis. These loci were highly polymorphic with a mean number of alleles per locus of 10.42 and a mean effective number of alleles of 2.76. The analysis was performed on a sample of 671 flies collected from nineteen locations around the European part of the Mediterranean basin. Despite the high level of gene flow across the Mediterranean, results support the notion of a differentiation of three subpopulations: one of the Iberian Peninsula, one of Greece and Italy and one of Cyprus. In addition, the gradual decrease of heterozygosity from the Eastern to the Western part of the Mediterranean indicates a westward expansion of the species.

Alleles↗
PubMed1995

Investigating groundwater pollution from different sources with combined biological and chemical methods.

This paper reviews groundwater pollution caused by the disposal of untreated effluents of a dye factory located 20 km to the west of Nicosia (Cyprus). The task of the work was to investigate the nature of the pollution and differentiate it from other possible pollution sources in the area. It focused on toxicity testing and biofractionation in order to address the most toxic pollutants and, on the evaluation of GC/FID profiles for investigating the connection between groundwater pollution and the effluents. This connection was successful due to a multiple comparison amongst the GC/FID profiles resulting from the polluted groundwater, the water from the reference areas and the dye effluents.

Coloring Agents↗
PubMed1988

The occurrence in the U.K. of Listeria species in raw chickens and soft cheeses.

Retail samples of 100 raw chickens and 222 U.K. and imported soft cheeses were examined for the presence of Listeria species. 60% of raw chickens (fresh and frozen) were contaminated with L. monocytogenes and 28% with other Listeria spp. including L. welshimeri, L. seeligeri and L. innocua. Six serotypes of L. monocytogenes were represented (1/2, 3a, 3b, 3c, 4b, 4d) of which more than one were isolated from some samples. 10% of the soft cheeses examined were found to contain L. monocytogenes at levels from less than 10(2) cfu/g to 10(5) cfu/g. The incidences in cheeses from various countries were Italy (16%), France (14%), Cyprus (10%) and the U.K. (4%). Only 2 serotypes (1/2 and 4b) were isolated, some samples containing both. L. innocua was the only other Listeria sp. found. There was no correlation between either the contamination with E. coli or the processing of the original milk used to make the cheeses (raw or pasteurized) and the presence of L. monocytogenes or other Listeria spp. The contribution of contaminated food to the epidemiology of listeriosis in the U.K. is discussed.

Animals↗
PubMed1987

Results of programmes for antenatal detection of thalassemia in reducing the incidence of the disorder.

The characteristics and the effectiveness of programmes designed to prevent beta-thalassemia major present in high frequency in several areas of the world such as Cyprus, Greece and Sardinia are reviewed. All these programmes are based on heterozygote detection, counselling and foetal diagnosis. The target population for screening have been couples at marriage, conception or early pregnancy. Awareness of the problem and involvement of the population was achieved via mass-media or personal approaches through lectures or discussions. Parent's Association were consulted and have been actively involved. Information leaflets have been made available to prospective couples at several critical areas. Education on thalassemias was introduced into the school curriculum. Counselling was based on a private interview at which the several options available were discussed with the individual carrier or the couple. Prenatal diagnosis was chosen by the large majority of couples counselled. All these programmes resulted in a decline of thalassemia major births by 50-97%. The reasons for residual cases were mostly lack of information and, less frequently, misdiagnoses or refusal of fetal diagnoses.

Female↗
PubMedDate not supplied

ELISA for detection of IgM and IgG antibodies to sandfly fever Sicilian virus.

An enzyme-linked immunosorbent assay (ELISA) was developed to detect specific human immunoglobulin G and M antibodies to sandfly fever Sicilian (SFS) virus. Acute and early convalescent serum pairs with greater than or equal to 7 days between the 2 specimens were available from 20 patients and all showed significant optical density (OD) increase and significant titre rise (greater than or equal to 4-fold) by IgG ELISA. However, negative or borderline-positive sera were found as late as 11 days after onset of symptoms when tested by IgG ELISA. Specific IgM antibodies were detected during the first week of symptoms, and maximum OD values were obtained during the first 4 weeks after onset of disease. The IgM OD values declined over the following 3-9 months. All sera collected later than 14 months post-onset were negative by IgM ELISA. The combination of early antibody response and the need to test only one serum specimen gives IgM ELISA an advantage over IgG ELISA in patients diagnosis. The IgG ELISA was also evaluated as a seroepidemiological tool and compared to a plaque reduction neutralization test (PRNT) using sera from a normal Cypriot population. Of 183 sera tested, 34 (19%) were positive in plaque reduction neutralization tests (PRNT) and 113 (62%) by IgG ELISA. A number of PRNT-negative sera were strongly positive by IgG ELISA and also by indirect immunofluorescence test, which may suggest the presence of a virus related to SFS in Cyprus which has not yet been isolated.

Acute Disease↗
PubMed2004

Molecular comparisons of the Culex pipiens (L.) complex esterase gene amplicons.

The amplification of carboxylesterase genes is a mechanism of organophosphate resistance in Culex mosquitoes. Amplified carboxylesterase genes from an insecticide resistant Culex pipiens strain collected in Cyprus were analysed and compared to other Culex amplified carboxylesterase alleles. A 12 kb section of genomic DNA containing two gene loci coding for carboxylesterase alleles A5 and B5 was cloned and sequenced. A comparison between this amplicon and one from a strain with co-amplified carboxylesterase alleles A2 and B2 revealed a number of differences. The intergenic spacer was 3.7 kb in length in the A5-B5 amplicon (2.7 kb in A2-B2) and contained putative Juan and transposable elements upstream of B5. A fragment of a gene with high homology to aldehyde oxidase was also present immediately downstream of A5. The comparison revealed no differences that would explain the successful spread of the A2-B2 amplicon worldwide whilst the A5-B5 amplicon is restricted to the Mediterranean.

Aldehyde Oxidase↗
PubMed2005

Present situation of echinococcosis in the Middle East and Arabic North Africa.

Echinococcosis is one of the major zoonotic parasitic diseases in the Middle East and Arabic North Africa from Morocco to Egypt. Both cystic and alveolar echinococcosis has been reported from these areas. However, cystic echinococcosis is more prevalent and has been reported from all countries in the Middle East and Arabic North Africa. Alveolar echinococcosis is less prevalent and has been reported only from Iran, Turkey, Iraq and Tunisia. Present situation of echinococcosis in dogs and other definitive hosts, animal intermediate hosts and humans in the Middle East and Arabic North Africa has been reviewed. Echinococcus granulosus is highly prevalent in Iran, Turkey, Iraq, Morocco, Tunisia, and Libya. In the Levant countries, the cystic echinococcosis is also highly endemic. In Oman, it is endemic with low prevalence and a very low level in Cyprus. Various surveys have indicated that hydatid cysts are commonly found in sheep, cattle, goats and camels throughout the Middle East and Arabic North Africa. Sheep are the most infected animals of these regions. Most of studies on human have been focused on surgical reports although several population studies have been performed using serological and imaging techniques. Human cystic echinococcosis (CE) is prevalent in the Middle East and Arabic North Africa. It is hyper endemic in Iran, Turkey, Iraq, Jordan, Morocco, Libya, Tunisia, and Algeria, and endemic in Egypt. Studies on the strain specificities of E. granulosus in the Middle East revealed sheep strain (G1) present in sheep, goats, cattle, camels and humans, and the camel strain (G6) in camels, sheep, cattle as well as humans. Dog/sheep strain seems to be more prevalent in the foregoing regions in documented reports from Iran and Jordan. However, a strain of E. granulosus, which resembles the horse strain (G4) strain, has been reported from Jordan. Strain specifications of E. granulosus in Arabic North Africa showed that sheep/dog strain (G1) have been reported from Tunisia and Libya both from humans and animals. However, in Egypt the human cases reported are of camel/dog strain.

Africa, Northern↗
PubMed2005

Towards evidence-based guidelines for radiotherapy infrastructure and staffing needs in Europe: the ESTRO QUARTS project.

BACKGROUND AND PURPOSE: Adequate and equitable access to radiotherapy (RT) must be a reasonable health care goal for the EU. However, there are large variations among the EU countries and even regional variations within countries in the provision of RT. In this report, we combine the best available evidence on the indications for RT with national epidemiological data to arrive at estimates for the appropriate level of RT infrastructure in the 25 EU countries. PATIENTS AND METHODS: Data from three systematic overviews of the best available evidence for the indication for RT in 23 main cancer types are combined with epidemiological data from the EUCAN and GLOBOCAN databases on the crude incidence of each of these cancers in the 25 EU countries. Together with published benchmarks for accelerator throughput this allows estimation of the number of linear accelerators per million people required to facilitate appropriate RT utilization rates in each country. Where possible, the estimates are compared with the detailed data available from Sweden. RESULTS: The crude incidence of the main cancer types shows large variation among the 25 EU countries. This reflects in part differences in exposure to aetiological risk factors and partly differences among the countries in population age structure. Correspondingly, the estimate of the required number of linear accelerators per million people showed considerable variation: ranging from 4.0 in Cyprus to 8.1 in Hungary. The average for the 25 countries was 5.9 per million people. These estimates were compared with available national guidelines and actual data on RT infrastructure and large shortfalls were found in many countries. Implications for health economics and capacity planning are briefly discussed. CONCLUSIONS: The QUARTS project has developed a model that establishes a direct and transparent link between epidemiological data and indications for RT based on the best available evidence. Comparison of the model estimates with current levels of RT infrastructure has revealed major inequalities in provision of RT in the 25 EU countries. Continuation of this study is recommended as a way of improving RT provision on rational grounds throughout the European community and as a model for health care planning in the EU.

Adult↗
PubMed2006

Establishing the health and economic impact of influenza vaccination within the European Union 25 countries.

BACKGROUND: In 2003, the World Health Assembly (WHA) issued a resolution for prevention and control of influenza pandemics and annual epidemics, which urges the European Union 25 (EU-25) Member States to (1) establish and implement strategies to increase vaccination coverage of all people at high risk, including the elderly and people with underlying disease, with the goal of attaining vaccination coverage of the elderly population of at least 50% by 2006 and 75% by 2010; (2) to assess the disease burden and economic impact of annual influenza epidemics as a basis for framing and implementing influenza prevention policies. This resolution was reinforced by the European Union (EU), where Member States agreed to make additional efforts to improve uptake on their territory in accordance with their own recommendations and to achieve the World Health Organisation (WHO) target of 75% in high risk groups before 2010. It was also noted that the changing demographic profile of the EU population would result in an increasing number of elderly people falling within the current target groups. OBJECTIVES: To establish the number of people who may be eligible for influenza vaccination in the EU, and estimate the costs and consequences of not vaccinating this population for five EU Member States, France, Germany, Italy, Spain, and the UK. METHODS: A mathematical model has previously been developed, in which vaccine distribution data are combined with demographic and health economics data to model the public health consequences of influenza and possible intervention strategies. We have extended that model using specific EU-25 demographic data on populations at risk of influenza during the inter-pandemic period. For each country, the total population and age breakdown was calculated to estimate the percentage of the population that falls under the WHA recommendations. Other target groups for influenza vaccination were identified by analysing estimating the proportion of the population with respiratory or cardiovascular related diseases, diabetes, AIDS or transplantation, as well as health care professionals. Target population size and possible vaccination coverage rates across the EU-25 Member States, along with the potential cost and health consequence impact is estimated. RESULTS: For the EU-25, it was estimated that up to 49.1% of the population (or 223.4 million people) should be vaccinated against influenza. This ranged from 41.6% in Cyprus to 56.4% in the UK. There were, on average, 174 vaccine doses distributed per 1000 population within the EU-25, which leads to an average vaccination rate of the target population of 35.4% based on current supply constraints. As a consequence, up to 144.4 million people who could be considered "at risk" may not currently be vaccinated. Implementing a 100% vaccination rate programme for all risk groups across the EU-25 would lead to an estimated reduction of number of influenza cases of 7.22 million, 1.96 million reduced PCP visits for influenza treatment, 796,743 less hospital admissions and 68,537 fewer influenza related deaths for all EU-25 countries. The implementation of a 100% vaccination rate programme for all risk groups in France, Germany, Italy, Spain and UK would require an additional 1.52 billion Euro. This would result in estimated savings of 39.45 million Euro of reduced primary care visits and further savings of 1.59 billion Euro in reduced hospitalisations respectively in these countries. CONCLUSIONS: There is a gap between current vaccination coverage and the EU recommendations. The public health consequences of low vaccination coverage include increased morbidity, hospitalisations and mortality associated with influenza-related complications. This model is a powerful tool to: (1) support EU public health officials in implementing recommendations; (2) to visualize the need for increased vaccination rates for better influenza control; (3) the consequences of low vaccine coverage.

Adolescent↗
PubMed2005

The experience of new European Union Member States concerning the control of bovine tuberculosis.

On 1 May 2004, 10 new States joined the European Union, including Cyprus (CY), the Czech Republic (CR), Estonia (ES), Hungary (HU), Latvia (LA), Lithuania (LI), Malta (MA), Poland (PO), Slovakia (SK), and Slovenia (SN). Using OIE and published data, this paper summarises the status of bovine and human tuberculosis in animals in these countries between 1996 and 2003. National control programmes against bovine tuberculosis in cattle have been successful: the current herd incidence of this disease in cattle is currently lower than 0.2%, so all countries meet the OIE requirements for freedom from the disease. Furthermore, two countries have already been officially declared bovine tuberculosis-free EU States: the CR on 31 March 2004 (European Commission Decision No. 2004/320/EC) and SK on 4 March 2005 (Commission Decision No. 2005/179/EC). The last outbreak of bovine tuberculosis was diagnosed in cattle in CY (1928), ES (1986), LA (1989), SK (1993), CR (1995), and MA (2001). However, several issues of concern remain including the potential existence of a wildlife reservoir, the presence of Mycobacterium bovis, M. caprae, and other members of the M. tuberculosis complex (particularly M. tuberculosis or M. microti) in imported domestic or wild animals, and the potential for delayed detection of bovine tuberculosis in those States where annual tuberculin testing is no longer performed on cattle older than 24 months.

Animal Husbandry↗
PubMed2005

The shaping of mitochondrial DNA phylogeographic patterns of the brown hare (Lepus europaeus) under the combined influence of Late Pleistocene climatic fluctuations and anthropogenic translocations.

The phylogeographic structure of the brown hare (Lepus europaeus) was studied by analysing mtDNA control region sequences of 98 individuals from continental and insular Greece, Bulgaria, Cyprus and northern Israel, together with 44 published sequences from Italy and central Europe. We found two distinct clades separated by an average nucleotide divergence of 6.6%, which may correspond to a Balkan and to an Asia Minor refugium. The estimated time of separation of the two clades was dated back to 105,000- 490,000 years ago. These two clades coexist in the area of northeastern Greece and Bulgaria, most likely as a result of a post-glacial northward expansion. Within the southern Balkan refugium, network analyses showed geographical structuring, which supports the hypothesis of several isolated Late Pleistocene populations. The central European and Italian populations appear to have originated from a non-detected northern Balkan population that was genetically closely related to some northern Greek populations, as a result of postglacial expansion, translocations or a combination of both. Moreover, several cases of ancient and recent translocations by humans were detected, especially for some island populations, while the eastern Aegean islands off the Asia Minor coast were most likely colonized naturally through Late Pleistocene land bridge connection. The genetic analysis presented here provides a framework for designing proper conservation and management guidelines for this species.

Animals↗
PubMed2002

ITS 2 sequences heterogeneity in Phlebotomus sergenti and Phlebotomus similis (Diptera, Psychodidae): possible consequences in their ability to transmit Leishmania tropica.

An intraspecific study on Phlebotomus sergenti, the main and only proven vector of Leishmania tropica among the members of the subgenus Paraphlebotomus was performed. The internal transcribed spacer 2 (ITS2) sequences of 12 populations from 10 countries (Cyprus, Egypt, Italy, Lebanon, Morocco, Pakistan, Portugal, Spain, Syria, and Turkey) were compared. Samples also included three species closely related to P. sergenti: Phlebotomus similis (three populations from Greece and Malta), Phlebotomus jacusieli and Phlebotomus kazeruni. Our results confirm the validity of the taxa morphologically characterised, and imply the revision of their distribution areas, which are explained through biogeographical events. At the Miocene time, a migration route, north of the Paratethys sea would have been followed by P. similis to colonise the north of the Caucasus, Crimea, Balkans including Greece and its islands, and western Turkey. Phlebotomus sergenti would have followed an Asiatic dispersion as well as a western migration route south of the Tethys sea to colonise North Africa and western Europe. This hypothesis seems to be well supported by high degree of variation observed in the present study, which is not related to colonisation or to intra-populational variation. Two groups can be individualised, one oriental and one western in connection with ecology, host preferences and distribution of L. tropica. We hypothesise that they could be correlated with differences in vectorial capacities.

Africa, Northern↗
PubMed1989

Molecular genetics of amyloid neuropathy in Europe.

The Portuguese type of familial amyloid polyneuropathy (FAP type I), a disabling autosomal dominant disorder with onset in early adult life, is caused by a point mutation in the transthyretin (TTR; previously known as prealbumin) gene. DNA analysis in thirteen European families (one British, two French, one Italian, one Greek, and eight Cypriot) showed that members of all those from Cyprus and Greece, and one from France, carried the FAP type I mutation. Patients from seven of these ten kindreds were not known to have a genetic disease before this study, which demonstrated the mutation in 16 of 43 clinically unaffected relatives. 2 of these were aged over 50 years. TTR gene analysis has useful applications in genetic counselling, including prenatal diagnosis, in identifying the cause of seemingly sporadic cases of amyloid neuropathy, and in epidemiological studies of FAP.

Adult↗
PubMed2001

Distribution of the CCR5 gene 32-basepair deletion in West Europe. A hypothesis about the possible dispersion of the mutation by the Vikings in historical times.

The chemokine receptor CCR5 constitutes the major coreceptor for the macrophage-tropic strains of HIV-1. A mutant allele of the CCR5 gene named Delta32 was shown to provide to homozygotes a strong resistance against infection by HIV. The frequency of the Delta32 allele was collected in 7328 noninfected unrelated individuals from 31 different European populations, and in Cyprus, Turkey, Daghestan, and North-Africa. The Delta32 allele was found in all populations studied, with a mean frequency of about 8.0%. A north to south gradient correlating latitude with Delta32 allelic frequencies was found (r = 0.795, p < 10(-9)), with highest allele frequencies in Nordic countries. We hypothesized that the Delta32 allele was disseminated in Europe by the Vikings during the eighth to the tenth centuries, because the most elevated values of this variant are actually found in their actual populations, and because they raided during the corresponding period in most European countries.

Africa, Northern↗
PubMed2000

Hepatitis B epidemiology in Asia, the Middle East and Africa.

Asia and Africa have previously been classified as areas of high endemicity for hepatitis B virus (HBV), but in some countries highly effective vaccination programmes have shifted this pattern towards intermediate or low endemicity. Thus, China is now the only country in Asia where HBV endemicity is high. Countries with intermediate endemicity include India, Korea, the Philippines, Taiwan and Thailand, and those with low endemicity include Japan, Pakistan, Bangladesh, Singapore, Sri Lanka and Malaysia. Most countries in Africa have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity. Zambia has borderline intermediate/high endemicity. In the Middle East, Bahrain, Iran, Israel and Kuwait are areas of low endemicity, Cyprus, Iraq and the United Arab Emirates have intermediate endemicity, and Egypt, Jordan, Oman, Palestine, Yemen and Saudi Arabia have high endemicity. All of these Middle East countries reach a large proportion of their population with hepatitis B vaccination, which is reducing the infection rate, particularly in Saudi Arabia. The vaccination programme in Taiwan has also greatly reduced the HBV infection rate. Future vaccination programmes must take into account the mode of transmission of HBV, the healthcare infrastructure to deliver vaccination, and the socioeconomic and political factors in each individual country, to determine the most cost-effective way of infection control.

Africa↗
PubMed2003

Gamma radiation measurements and dose rates in commercially-used natural tiling rocks (granites).

The gamma radiation in samples of a variety of natural tiling rocks (granites) imported in Cyprus for use in the building industry was measured, employing high-resolution gamma-ray spectroscopy. The rock samples were pulverised, sealed in 1-l plastic Marinelli beakers, and measured in the laboratory with an accumulating time between 10 and 14 h each. From the measured gamma-ray spectra, activity concentrations were determined for (232)Th (range from 1 to 906 Bq kg(-1)), (238)U (from 1 to 588 Bq kg(-1)) and (40)K (from 50 to 1606 Bq kg(-1)). The total absorbed dose rates in air calculated from the concentrations of the three radionuclides ranged from 7 to 1209 nGy h(-1) for full utilization of the materials, from 4 to 605 nGy h(-1) for half utilization and from 2 to 302 nGy h(-1) for one quarter utilization. The total effective dose rates per person indoors were determined to be between 0.02 and 2.97 mSv y(-1) for half utilization of the materials. Applying dose criteria recently recommended by the EU for superficial materials, 25 of the samples meet the exemption dose limit of 0.3 mSv y(-1), two of them meet the upper dose limit of 1 mSv y(-1) and only one clearly exceeds this limit.

Construction Materials↗
PubMed2001

Leaching of metals from soil contaminated by mining activities.

Stabilization/solidification (s/s) is one of the most effective methods of dealing with heavy metal contaminated sites. The ability of lime and cement stabilization to immobilize Pb, Cu and Fe contained in a contaminated soil originating from an old mining and smelting area located along the Mediterranean Sea shore in northern Cyprus was investigated. The stabilization was evaluated by applying leaching tests. A series of tests were conducted to optimize the additive soil ratio for the best immobilization process. Additive/soil=1/15 (m/m) ratio was found to be the optimum for both lime and cement. Application of the US EPA toxicity characteristic leaching procedure (TCLP) on the soil samples treated with lime at additive/soil=1/15 (m/m) mixing ratios showed that Cu and Fe solubility was reduced at 94 and 90%, respectively. The results of cement treatment using the same ratio, reduced the solubility 48 and 71% for Cu and Fe, respectively. The Pb solubility was found to be below the regulatory limit of 5mg/l so no additive treatment was needed. The optimum additive/soil amount (1/15) was selected for more detailed column studies, that were carried out in the acidic pH range. According to the results of column leaching tests, it was found that, the degree of heavy metal leaching is highly dependent on pH.

Calcium Compounds↗