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This study examines the impact of a continuing medical education (CME) intervention on smoking cessation among primary-care professionals (PCPs) and explores the relationship between PCP smoking status and patient tobacco-treatment delivery.
Background:
High rates of tobacco use among PCPs have been reported in several European countries. PCPs who smoke are less motivated to provide cessation support to their patients.
Methods:
A before-after study was conducted with 228 PCPs from Greece and Cyprus. The intervention included a one-day CME training, a 2.5-hour seminar three months later, and practice tools. Expert faculty provided informal support to smoking PCPs. Changes in PCP smoking status and 5As (ask, advise, assess, assist, and arrange) tobacco treatment delivery were assessed before and six months after training. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were used to evaluate the association between the training and PCP smoking status and 5As delivery.
Findings:
At baseline, 18% (n = 47) of PCPs were current smokers, and 39% (n = 66) were ex-smokers. At follow-up, 31.9% of current smokers reported quitting (n = 15/47; p < 0.001). Smoking cessation was higher among female PCPs (p = 0.02) and those in Cyprus and Thessaloniki (p < 0.01). PCPs reported increased 5As delivery at follow-up, with the highest rates among ex-smokers (>6 months) and never smokers. PCPs reported significant quitting rates following a comprehensive evidence-based training intervention. The findings suggest that addressing PCPs’ smoking status can improve both health-care provider and patient smoking outcomes.
The Greek model of mental healthcare delivery in rural and remote low-resourced areas is based on Mobile Mental Health Units (MMHUs). MMHUs are low-cost, interdisciplinary, generic community psychiatric services that collaborate closely with the primary healthcare system and local social services. MMHUs may be effective in the treatment of patients with severe and persistent mental illness and cost-effective in the treatment of patients with common mental disorders. The Council of Europe categorised this model as an effective community-based initiative. Major challenges derive from the difficulties MMHUs run by public general hospitals face in recruiting and retaining personnel.
This article deals with Hecataeus of Miletus fr. 310 Jacoby, featuring a curious list of islands located along the Nile, and bearing Greek names such as Ephesus, Chios, Lesbos, Kypros and Samos. Scholars generally assume the list, composed in the late sixth or early fifth century, represents joint Greek emporia established on Egyptian soil, thereby serving as a reliable testimony to the emergence of collective Greek identities during the late Archaic period. The composition of the list, along with the contemporary historical, cultural and archaeological contexts of its place names, is examined with particular emphasis on the collective identities of the islanders. On this basis, it is contended that the list lacks any evidence pertaining to Greek commercial footholds or collective identities in Egypt. Rather, fr. 310 serves as a practical navigational mnemonic, delineating culturally familiar geographical landmarks to assist Greek sailors in traversing a complex foreign river passage. The fragment now emerges as a valuable historical document, illuminating Greek navigational knowledge and practices during the late Archaic period.
This chapter focuses on the urban and rural landscapes of the Balkans in Late Antiquity, covering modern-day Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Greece, Kosovo, Montenegro, North Macedonia, Romania, Serbia and Slovenia . It examines how cities and countryside areas evolved between the third and seventh centuries, with a particular emphasis on the material traces of early Christianity. The chapter draws on archaeological evidence, historical texts and urban planning studies to highlight the transformation of key cities such as Thessaloniki, Nicopolis ad Istrum and Serdica (modern Sofia). This contribution argues that the Balkans served as a cultural and political bridge between Asia and Europe, influencing the spread of Christianity and shaping imperial policies. It also explores how urban centres adapted to economic shifts and military threats, with some cities reinforcing their fortifications while others declined. Thessaloniki, for instance, maintained its urban layout and economic role, even as certain Roman public buildings fell out of use. Religious change also played a crucial role in shaping the Balkan landscape. Christian basilicas replaced pagan temples, while monasteries and bishopric centres became focal points for local governance and cultural life. The chapter further addresses the challenges of dating archaeological sites, emphasising the need for more precise chronological frameworks.
A previously unknown raptor migration hot spot has been identified in southern Greece. During the post-breeding migration of 2024, a total of 11,790 individuals were recorded in 15 days, including 11,606 European Honey Buzzards Pernis apivorus. GPS tracking data from Finnish and Hungarian populations further highlight the site’s significance, suggesting that it could become the third migration hot spot for the species in the Mediterranean, alongside the Straits of Gibraltar and Messina. Plans to develop a wind farm in the area raise concerns due to its crucial role in the beginning of the long sea crossing to Libya.
This chapter deals with the history of money in ancient times. We start with ancient Mesopotamia, where fundamental value (silver and barley) was stored in temples. Clay tablets circulated openly, supporting fundamental value and contractual arrangements. Coinage in ancient Greece and Rome was a step forward in terms of ease of use but involved the risk of debasement – reduction of the content of precious metals. We describe debasement of coins from the late Roman empire to the Middle Ages, then move to China, where the first banknotes were printed in the early part of the second millennium. The use of paper in finance spread to Europe, where it became the key technology supporting the rise of banks in the late Middle Ages and the Renaissance. We describe the rise of central banks in Europe, starting from Sweden and ending with Germany and Italy. We draw several lessons from these experiences. The main one is that a successful money is a private–public partnership, where “public administration” and “private interest” combine and complement each other. The chapter ends with the birth of telecommunication in the nineteenth century and its early applications at the beginning of the twentieth century, which gave rise to radical changes in monetary technology in the subsequent period.
This chapter introduces a Schematic Guide to present some of our arguments about the political manipulation of statistics by governments in power. We apply this Guide to examples of manipulation in four countries: two autocratic (Stalin’s Russia and contemporary China) and two democracies (Greece and Argentina). The Guide highlights three possible stages in the process of statistical manipulation, each stage involving different acts of manipulation. Stage One: a government minister puts pressure on official statisticians to manipulate official statistics; Stage Two: the statisticians comply and produce biased, misleading numbers and/or biased misleading descriptions of the numbers; Stage Three: the government seeks to manipulate the public by using the manipulated statistics to persuade them of the government’s successes. The four examples show that in practice the manipulation does not happen necessarily in a neat sequence. Each of the examples has its own unique features. The persecution of statisticians is a feature of three of the examples, including the two democratic examples. The example of China raises the possibility that statistics can be manipulated by the data that is not collected and published, just as much by the data that is collected and published.
Taking its start from an argument of H. S. Versnel, that Greek expressions of disbelief in the existence of the gods are evidence of the possibility of belief, this article reviews the evidence of such expressions, and of ascriptions of atheism in Greek sources, and suggests that there was a difference of type, not only of degree, between Greek ‘atheism’ and our understanding of the term today. Atheist discourse in Greek sources is characterized by frequent slippages: for example, between the charge of ‘existential atheism’ and the failure to give the gods due acknowledgement; between introducing new gods and disrespecting the old. Ascriptions of atheism to third parties are commonly based on inferences from an individual's actions, lifestyle or presumed disposition – which in turn are rooted in a network of theological assumptions. The phenomenon of ‘Greek atheism’ is, fundamentally, a scholarly mirage.
The preliminary reference procedure is a crucial tool for EU law enforcement. Yet, its usage varies greatly across the Member States. This paper deals with a notable case in which EU justice has not been mobilized: Greece. Until 2023, Greek judges had not made any preliminary references in the migration and asylum fields, despite significant migrant flows. This study investigates why Greece, with its critical migration challenges, became a zero-reference case.
Drawing on empirical and doctrinal research, this paper tests two main hypotheses. The first hypothesis, derived from the “judicial empowerment thesis,” suggests that Greek judges may have been hesitant to refer cases due to political or institutional factors. The second hypothesis, based on scholarship highlighting the role of lawyers and civil society in promoting EU litigation, predicts that the absence of references reflects a lack of activist lawyers, skills, or resources.
The findings challenge common assumptions, revealing that Greek judges are not inherently reluctant to refer cases. Instead, obstacles to access to justice and civil society’s attitudes help understand the absence of references. Going beyond judges, this paper explores how perceptions among migrant supporters, their legal consciousness, and traditional modes of action contribute to the lack of pressure for preliminary references.
This research contributes to understanding the complexities surrounding judicial dialogue and enforcement of EU law. It offers insights into how the interplay of institutional, legal, and social factors shapes legal mobilization and strategic litigation.
Here we present the first high-resolution continuous palaeoecological study from Greece covering the Mesolithic–Neolithic transition at Limni Zazari, a small lake in western Macedonia. We study how interactions between vegetation and climate might have affected the introduction of agriculture to Europe ca. 8500 years ago. We found that mixed deciduous oak woodlands established around the lake once moisture availability began to increase at ~10,300 cal yr BP. Between 8600 and 8000 cal yr BP, climate change, causing drier conditions, led to the decline of the woodlands and the expansion of steppe and grassland vegetation. Concurrently, in agreement with the archaeological record, pollen indicative of arable and pastoral farming indicate the onset of Neolithic farming. After 8000 cal yr BP the forest composition changed, with a major expansion of pine forests and increases in disturbance-adapted trees like Ostrya and Fagus. This change might be linked to changes in moisture availability, but it is likely that land use also facilitated these shifts. We conclude that the introduction of Neolithic farming was advantaged by climate-induced vegetation changes. While the vegetation structure around Zazari was very sensitive to changes in moisture, early anthropogenic disturbances led to changes in the vegetation composition that are still important today.
The warfare of the Greek city states was limited by their means, lacking military academies, professional officers and standing forces. Small communities fought local wars with levies of citizens, often highly motivated, but precious to the polity, which could not be kept in the field for long. Fruits of victory were modest, and defeat could put the survival of the whole state at risk. Fortification as a passive defensive policy was essential. In offensive warfare, states and coalitions mostly pursued a strategy of opportunism, in which the desirable was subordinated to the attainable. Commanders typically tried to avoid decisive engagements due to the risks involved; they focused their attacks on exposed targets like farmland, small towns, isolated garrisons and unprepared enemy troops. They relied heavily on local dissenters and deserters to guide and facilitate operations. When wealthier states like Corinth, Athens and Syracuse found themselves able to invest in warfare, we clearly see their dissatisfaction with this strategic straitjacket. The rapid development of fleets, extensive fortification networks, standing corps of specialist troops and siege technology allowed these states to dominate their less fortunate neighbours. This gives the lie to old notions that the Greeks preferred their wars to be limited in scope. A state that had much more than the others could disrupt the entire system, as Macedon would eventually show.
Philip of Macedon and his son Alexander the Great, despite coming to power in similar circumstances, approached their rule in very different ways. In particular, it suggests that along with a contrast of style, in Keegan’s terms Alexander being a ‘heroic’ leader, his father an ‘unheroic’, one their approach and, as a consequence, the aims and practice of their strategies were quite different. While it could be argued that Philip’s was simply one of survival exacerbated by ever more ‘mission creep’ towards the south of Greece, here it is suggested that instead Philip had from very early on a firm proactive vision of ruling all Greece and used an integrated strategy of diplomacy, financial subversion, and military force to achieve that end and on its success established a firm method of retaining his rule. In contrast, Alexander, while tactically brilliant, unlike his father was a reactive rather than a proactive strategist and his campaigns are best seen as a series of micro-strategies responding to specific circumstances as opposed to an overarching vision. This approach explains the lack of a firm political strand to his strategy and the subsequent collapse of his empire on his death.
Numerous transport stirrup jars have been found at the site of Pefkakia. Most were manufactured in Crete with some from the Greek mainland. There were also at least two Canaanite jars from the Carmel coast. These finds and the first results of petrographic analysis attest to the site's role as a major Aegean harbour.
On the basis of recently discovered sources and original research, this book identifies and analyses three story-patterns associated with human kingship in early Greek and ancient Near Eastern myth. The first of these, the 'Myth of the Servant', was used to explain how an individual of non-royal lineage rose to power from obscure origins. The second myth, on the 'Goddess and the Herdsman', made the fundamental claim that the ruler engaged in a sexual relationship with a powerful female deity. Third, although kings are often central to the ancient literary evidence, the texts themselves were usually authored by others, such as poets, priests, prophets or scholars; like kings, these characters similarly tended to base their authority on their ability to articulate and enact the divine will. The stage was thus set for narratives of conflict between kings and other intermediaries of the gods.
The Venetian Republic reached its zenith in the dramatic takeover of “a quarter and a half a quarter” of the Byzantine Empire in the Fourth Crusade. It acquired a network of port cities – the Stato da Mar – that enabled its control over trade routes between Europe, Asia, and the Middle East. Called the “hinge” of Europe by one historian, Venice spearheaded an economic leap forward on the continent through a mastery of long-distance navigation. This was Italy’s second great urban age, as cities saw resurgences from the dramatic declines into feudalism in late antiquity. Venice was the prototypical world city of the time, competing with Genoa for control of seaborne trade routes. Indeed, the activities in Italian city-states are critical to the scholarly understanding of the European economic revivals in the ninth and eleventh centuries. The city figures centrally in major works by Janet L. Abu-Lughod, Michael McCormick, Henri Pirenne, and Fernand Braudel for fostering seminal forms of intercity relations at crucial times. Its relations with Constantinople, for example, were of equal importance with those of its Italian neighbors.
Part II centers Greece within British cultural heritage discourse, asking how British narratives about Greece shift after the Greek wars for independence produce a modern nation to vie with Britain’s depiction of itself as cultural (and material) heir to classicism. The temporal forms I identify in this part – inheritance and irony – define Britain in relation to Greece, both historically and geopolitically. Across Part II, I consider Lord Elgin’s acquisition of the Parthenon Marbles, their display in the British Museum, the conspiracy to whiten them on the eve of World War II, and the claims of universal cultural heritage that began in the nineteenth century and still feature in their exhibition. These narratives and their trajectory, I argue, demonstrate how classicism develops in and through cultural and eventually racial supremacy.
The Roman conquests in the western Mediterranean saw the arrival of Roman coins, but in the east the local coinages at first remained and were manipulated.
The Mediterranean is ubiquitous in nineteenth-century British literature, but this study is the first to fully recover and explore the region's centrality to Romantic and Victorian constructions of the past, the present, and the shape of time itself. Placing regions central to the making of Western cultural heritage, such as Italy and Greece, into context with one another and with European imperialism, Lindsey N. Chappell traces the contours of what she terms 'heritage discourse' – narrative that constructs or challenges imperial identities by reshaping antiquity – across nineteenth-century British texts. Heritage discourse functions via time, and often in counterintuitive and paradoxical ways. If assertions of political, cultural, and eventually racial supremacy were the end of this discourse, then time was the means through which it could be deployed and resisted. Chappell shows how historical narratives intervened in geopolitics, how antiquarianism sparked scientific innovation, and how classical and biblical heritage shaped British imperialism.
To assess the health technology assessment (HTA) process in Greece from its establishment in 2018 until 2023 in terms of timeliness and productivity.
Methods
Data were collected from the HTA Committee’s database and other publicly available sources. The overall study timeframe was divided into three periods: (i) July 2018–January 2020, (ii) January 2020–July 2021, and (iii) July 2021–February 2023.
Results
During the study period, a total of 1,157 applications for medicinal products (MPs) (including 219 new active substances (NAS) and orphans) were submitted to the HTA Committee. The number of HTA recommendations increased from 60 (first period) to 641 (third period), while the backlog of MPs pending HTA and price negotiations decreased from 89 and 106 (January 2020) to 8 and 44 (February 2023), respectively. The median time intervals for all application types decreased significantly over time. In February 2023, the median time for clinical data assessment of NAS (excluding orphans) almost halved from 207 days in the first period to 114 days; median times for NAS and orphans from regulatory approval to HTA application were 420 and 457 days, and from HTA application to reimbursement 228 and 417 days, respectively.
Conclusions
The performance of the HTA process in Greece improved significantly over time, with increased MP appraisals, backlog reduction, and decreased timelines. Delays in reimbursement of NAS were mainly caused by the long gap between regulatory approval and HTA application. Overall, HTA review times in Greece are now on par with that of well-established European HTA systems.
Eleonora's falcon (Falco eleonorae Géné, 1839) is a well-known long-distance migrant of the Afro-Palaearctic flyway, a summer breeder of the Mediterranean region and North-west Africa and a winter resident of Madagascar and surrounding areas, thus characterized as a double endemic. Within the context of a long-term monitoring and conservation programme on Antikythira Island, Greece, which accommodates one of the largest concentrations of breeding pairs of Eleonora's falcons globally, birds were subjected to regular inspections for the presence of ticks from 2017 to 2023. In total, 104 adults and 149 nymphs (all belonging to Haemaphysalis genus) were collected. All ticks, apart from 2 nymphs, exhibited broadly salient palpi and did not possess the pronounced palpal segment 2 spurs or spur-like angles that are characteristic of adults, nymphs and most larvae of Rhipistoma, thus placed them in the Ornithophysalis subgenus. Following comprehensive morphological assessment and genetic analysis of the mitochondrial genome by means of next-generation sequencing of both adult and nymphal stages of the ticks, our empirical findings substantiate the delineation of a previously unclassified species. This taxonomic assignment situates the newly described species within the Ornithophysalis subgenus and the Haemaphysalis doenitzi group, marking its presence for the first time within the Western Palaearctic region.