Nicos Middleton

Nicos Middleton
Cyprus University of Technology · Department of Nursing

PhD, Dept Social Medicine, University of Bristol

About

251
Publications
32,476
Reads
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3,239
Citations
Introduction
Nicos Middleton currently works at the Department of Nursing, Cyprus University of Technology. Nicos does research in Epidemiology and Public Health. Their current project is 'BrEaST start in life' and 'Baby Buddy Forward'.
Additional affiliations
November 2014 - present
Cyprus University of Technology
Position
  • Professor
March 2009 - October 2014
Cyprus University of Technology
Position
  • Professor
January 2006 - June 2008
Harvard School of Public Health
Position
  • PostDoc Position
Education
November 2000 - March 2005
University of Bristol, School of Social & Community Medicine
Field of study
  • Epidemiology
September 1997 - September 1998
LSE & London School of Hygiene and Tropical Medicine
Field of study
  • Health Care Decision analysis (joint degree)
September 1994 - July 1997
University College London
Field of study
  • Statistics & Operational Research

Publications

Publications (251)
Article
During the last decades, vitamin D deficiency has re-emerged worldwide affecting not only population's bone health, but also several other conditions including asthma and allergies. Increasing number of published epidemiological studies in the last seven years have examined the role of vitamin D deficiency in childhood with several outcomes includi...
Article
Full-text available
Background: Several studies have examined the relationship of asthma with serum dyslipidemia and reported positive, negative or no association. Most studies were limited by their cross-sectional design and the wide age range of the participants. In a cohort of children in Cyprus, we explored the association of asthma with serum high-density-lipopr...
Article
Numerous studies have reported adverse effects of traffic pollution on respiratory health. Exposure to power plants emissions has not been as comprehensively studied. The prevalence of asthma and respiratory symptoms was investigated among 15-17 year-olds in communities in the vicinity of power plants in Cyprus in relation to the rest of the island...
Article
Full-text available
Several studies have reported associations between respiratory outcomes in children and a range of self-reported, administrative or geographical indicators of traffic pollution. First-time investigation into the frequency of asthmatic symptoms among 7-8 year-old Cypriot children in 1999-2000 showed increased prevalence in the capital Nicosia compar...
Article
Full-text available
Background Studies on the association of birth by caesarean section (C/S) and allergies have produced conflicting findings. Furthermore, evidence on whether this association may differ in those at risk of atopy is limited. This study aims to investigate the association of mode of delivery with asthma and atopic sensitization and the extent to which...
Article
Full-text available
Introduction: The purpose of this study was to explore the learning needs and the digital health literacy of pregnant women in Greece regarding perinatal health and care issues. Methods: This was a qualitative study involving thirteen Greek pregnant women, in two focus groups of primiparous and multiparous. The interview topic guide was develope...
Article
Funding Acknowledgements Type of funding sources: None. Background The Professional Quality of Life (ProQοL) scale is one of the most widely measures of compassion satisfaction and fatigue used, despite there is not much of published evidence to support its validity. The ProQoL scale assesses multiple domains of work experiences; compassion satisf...
Article
Full-text available
Background Gallbladder cancer has a poor prognosis and imaging can have variable diagnostic accuracy. We assessed the ability of preoperative 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) imaging to predict a postoperative histological diagnosis of gallbladder cancer. Method A retrospective analysis was un...
Article
Introduction Studies on the clinical and socio-demographic characteristics of those involuntarily admitted to psychiatric settings could help professionals and researchers to develop effective, targeted interventions, alternative to compulsory psychiatric care. Aim The association between socio-demographic and clinical characteristics in adults und...
Article
Aim: To investigate the perceived empowerment and turnover intention of middle nurse managers before and after the implementation of a major reform of the healthcare system in Cyprus, which also includes the transition of public hospitals towards administrative and financial autonomy. Background: The empowerment of Nurse Managers is important si...
Article
Full-text available
Background The “Place Standard Tool” (PST) offers a practical framework for structuring conversations about physical and social dimensions of Place which impact on health and well-being. The aim of this study was to survey citizens’ perceptions of Place across diverse settings in Cyprus. While the PST has been extensively used in the context of com...
Conference Paper
Full-text available
Background: Carers of people with dementia (PwD) undertake the role of supporting their relatives in everyday life and caring tasks, sometimes without adequate knowledge of the progression of the disease, practical advice and support mechanisms or services. This study aims to describe the Health Literacy (HL) and eHealth Literacy (eHL) profiles of...
Article
Full-text available
Background Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the...
Article
Objectives: To prospectively quantify at the community level changes in asthma symptom control and other morbidity indices, among asthmatic schoolchildren in response to coronavirus disease 2019 (COVID-19) lockdown measures. Methods: In Spring 2019 and Spring 2020, we prospectively assessed monthly changes in pediatric asthma control test (c-ACT...
Article
Full-text available
University students represent a highly active group in terms of their social activity in the community and in the propagation of information on social media. We aimed to map the knowledge, attitudes, and perceptions of University students in Cyprus about severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and Coronavirus disease 2019 (COVI...
Preprint
Full-text available
Background The “Place Standard Tool” (PST) offers a practical framework for structuring conversations about physical and social dimensions of Place which can impact on health and well-being. While extensively used in the context of community engagement, its properties as a measurement tool haven’t been explored. Methods Under the auspices of the C...
Article
Introduction Disease management programs for HF are characterized by heterogeneity and different levels of complexity, thus the results regarding of their effectiveness are controversial. The trajectory of HF makes supportive care (SC) mandatory. The main feature of this framework is continuing communication addressing patient's support needs. Aim...
Article
Background The Professional Quality of Life (ProQoL) scale is one of the most widely measures of compassion satisfaction and fatigue used, despite there is not much of published evidence to support its validity. The ProQoL scale assesses multiple domains of work experiences; compassion satisfaction, burnout and secondary traumatic stress. Our aim w...
Article
Full-text available
Background Antipsychotic polypharmacy and prescription of high-dose antipsychotics are often used for the treatment of psychotic symptoms, especially in compulsory psychiatric care although there is lack of evidence to support this practice and related risks for patients. Aims We aimed to investigate prescription patterns in patients with psychosi...
Article
Background Several generic or feature-specific neighborhood audit tools have been developed. While inter/intra-observer reliability if commonly assessed, validity is not always considered. Methods A two-phase mixed-methods process was used to develop the Cyprus Neighborhood Observational Tool for urban environments (CyNOTes). Phase I: draft based...
Article
Background The extent and magnitude of socio-geographical inequalities in health in Cyprus is not clear as neither “place” nor “health inequalities” feature on the public health agenda. Methods In the context of a wider Neighbourhood Environment and Health programme, the magnitude of inequality in health-related quality of life (HRQoL) among Limas...
Article
Background While the transition to parenthood is critical for mother-child health, traditional antenatal education has been questioned. Digital resources provide opportunities for reducing social disparities and enhancing health literacy, particularly important in a medicalized and decentralized birth environment with high caesarean and low breastf...
Article
Background From a notion concentrated on the ability to understand health information, health literacy (HL) has become a broad concept, considered a critical determinant of community health. The HLS-EU-measures perceived HL based on a theoretical model of the concept. Methods This study explored the metric properties of the tool in a new European...
Article
Background DEpICT is an ongoing exploratory, observational, cross-sectional study in community-dwelling individuals in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV). Methods Participants are >40 years and living i...
Article
Background Census data, GIS, surveys and audits are used to profile “place”, each with shortcomings. There are several “neighbourhood environment” tools, including the “Place Standard” a policy and advocacy tool developed in Scotland. “Place” is not a strong feature in the public health agenda in Cyprus. Methods In an internet survey, participants...
Article
Τhe severity and variation of depressive symptoms (DS), among psychotic individuals under involuntary hospitalization is unclear. We investigated the socio-demographic and clinical characteristics of psychotic adults with DS involuntarily hospitalized for compulsory treatment in Cyprus. We also evaluated the psychometric properties (internal consis...
Article
Full-text available
Introduction: While breastfeeding self-efficacy (BSES) is an important modifiable determinant of breastfeeding, a structured assessment is not standard practice in Cyprus. We assessed the Greek version of the Breastfeeding Self-Efficacy Scale (BSES-SF), including its predictive validity in terms of Breastfeeding (BF) and Exclusive Breastfeeding (E...
Article
Background: The south-eastern Mediterranean experiences frequent desert dust storm events (DDS) that have been shown to be associated with adverse health effects. Aims: This study assessed the perceptions and practices towards DDS of local authorities and stakeholders from 3 countries in the region, Cyprus, Greece and Israel. Methods: Between...
Article
Health literacy (HL) and eHealth literacy (eHL) can facilitate carers of people with dementia (PwD) to search, find, assess and apply information related to dementia-specific issues from different resources. There is a lack of research with regard to HL and eHL among carers of PwD. The aim of this study is to identify the levels of HL and eHL among...
Article
Full-text available
Objective: To synthesize current evidence on nurses' attitudes and/or knowledge on the entire spectrum of patient rights. Method: A systematic search of the literature was performed in Web of Science, PubMed, Scopus and CINAHL. Studies were selected according to pre-defined inclusion/exclusion criteria. The Cochrane and PRISMA guidelines, includin...
Article
Full-text available
Background Social inequalities in health threaten social cohesion and their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods A cross-sectional survey using primary data...
Article
Full-text available
Socio-demographic and clinical characteristics of adults under compulsory psychiatric treatment, have not been reported adequately in Southern European countries. We investigated the socio-demographic and clinical characteristics of adults with psychotic symptomatology who were involuntarily treated in the acute Mental Health Services in Cyprus. A...
Article
Abstract Aim: To investigate the perceived self-efficacy, structural empowerment and power of middle nurse managers before the implementation of a major reform of public hospitals in Cyprus. Background: Nurse managers' self-efficacy is important as it makes a difference in nurses' motivation as well as the way they feel, think, and behave. Empower...
Article
Full-text available
Background Desert dust events in Mediterranean countries, originating mostly from the Sahara and Arabian deserts, have been linked to climate change and are associated with significant increase in mortality and hospital admissions from respiratory causes. The MEDEA clinical intervention study in children with asthma is funded by EU LIFE+ program to...
Article
Background Device‐associated health care‐associated infections (DA‐HAIs) are a major threat to patient safety, particularly in the Intensive Care Unit (ICU). This study aimed to evaluate the effectiveness of a bundle of infection control measures to reduce DA‐HAIs in the ICU of a General Hospital in the Republic of Cyprus, over a 3‐year period. Me...
Preprint
Full-text available
Background: Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs) is currently not available. Knowledge about the...
Article
Full-text available
Workplace bullying/mobbing is an extreme work-related stressor, but also a severe hazard for physical, mental and psychological health in healthcare employees, including nurses. A range of trauma-related symptoms has been linked with bullying victimization. The aim of the study was the investigation of workplace bullying/mobbing-related trauma symp...
Article
Full-text available
Background The selection of quality indicators demonstrating the efficiency and relevance of nursing practice in patient outcomes in the intensive care unit remains a challenge. Aim The aim of this study was to develop a set of potential quality indicators to quantify nursing care provided to critically ill patients through a consensus method. De...
Article
Background Traditional approaches to antenatal education have been questioned as to their effectiveness. The use of the internet for information-seeking is very prevalent, however sources are of varied quality. We explored the information-seeking behaviour of pregnant women in the context of health literacy skills and informed decision-making. Met...
Article
Issue The transition to parenthood presents opportunities to promote mother-child health. Though of varying quality, internet information-seeking is prevalent while attendance in antenatal classes is low. Digital innovation can support access to timely and valid information for all, key component of WHO's Respectful Maternity Care. Description of...
Article
Background DEpICT is an ongoing observational, cross-sectional study in community-dwellers in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV). Methods Participants are >40 years who have been living in the same addr...
Article
Background Census data, GIS, surveys and audits are used to profile “place”, each with shortcomings. There are several “neighbourhood environment” tools, including the “Place Standard” a policy and advocacy tool developed in Scotland. “Place” is not a strong feature in the public health agenda in Cyprus. Methods In an internet survey under the aus...
Preprint
Full-text available
Background: Breastfeeding self-efficacy (BSES) is an important modifiable determinant of BF initiation, duration and exclusivity. The use of valid measurement tools of BSES is important in clinical and community practice. Thus, we aimed to assess the properties of the Breastfeeding Self-Efficacy Scale (BSES-SF) to measure the self-efficacy of mothe...
Article
Supportive care (physical, psychosocial, and spiritual) may be beneficial as a coping resource in the care of patients with heart failure (HF). Nurses may provide individualised supportive care to offer positive emotional support, enhance the patients' knowledge of self-management, and meet the physical and psychosocial needs of patients with HF. T...
Article
Full-text available
Background: Teamwork and job satisfaction are important among the multidisciplinary team who care patients with chronic illnesses such as heart failure (HF) patients. TeamSTEPPS teamwork perceptions questionnaire (T-TPQ) and Minnesota Satisfaction Questionnaire "short form" (MSQ-short) are both self-report questionnaires which examine multiple dim...
Article
Full-text available
Greece has been malaria-free since 1974. In October 2011, following an outbreak of 36 locally acquired malaria (LAM) cases in Evrotas Municipality, a Pro-Active Case Detection (PACD) program for malaria was implemented among migrants from malaria-endemic countries, to support early diagnosis and treatment of cases. We evaluated the PACD program for...
Article
Full-text available
Introduction The standardized mortality ratio (SMR) is commonly used to assess the overall quality of care by comparing the observed hospital mortality with the mortality predicted by statistical models. If the observed deaths are less than the predicted, the overall quality of care can be considered high; in the opposite case, it is low. Aim The...
Article
Full-text available
Background: The QOL-PCD questionnaire is a recently developed Health Related Quality of Life (HRQoL) instrument for Primary Ciliary Dyskinesia. The aim of this study was to translate the adult QOL-PCD questionnaire into Greek language and to conduct psychometric validation to assess its performance. Methods: Forward translations to Greek and bac...
Preprint
Full-text available
Background Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. The reasons behind this phenomenon remain unclear. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and, therefore, their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using...
Preprint
Full-text available
Background: Social inequalities in health threaten social cohesion and their investigation is an important research field. Monitoring the health of the population is necessary to identify health needs, design programs focused in people’s needs and to evaluate the effectiveness of health policies. Methods: A cross-sectional survey using primary data...