Search Results (358)

Background: Treatment compliant with the Global Initiative for Asthma (GINA) can promote more effective disease control. Single-inhaler triple therapy (SITT) is one method that is used to optimize therapy in this context, but TRIPLE therapy is still employed by physicians to a limited extent. Objective: This study aimed to describe the factors influencing challenges in optimizing asthma therapy. Methods: A 19-question survey, created via the CATI system, was distributed among pulmonologists, allergologists, general practitioners, and internal medicine specialists in Poland, Greece, Sweden, Slovenia, and Austria. Results: Statistically significant percentage differences in the use of TRIPLE therapy in the context of asthma management were observed among countries as well as between pulmonologists, allergists, and other specialists. Overuse of oral corticosteroids (OCSs) to treat nonsevere and severe asthma in the absence of an approach that focuses on optimizing inhalation therapy among asthma patients receiving TRIPLE therapy was observed in different countries as well as among physicians with different specialties. Twenty elements associated with the challenges involved in diagnosing and managing difficult-to-treat and severe asthma were identified. Six clinical categories for the optimization of asthma therapy via SITT were highlighted. The degree of therapeutic underestimation observed among severe asthma patients was assessed by comparing actual treatment with the recommendations of the GINA 2023 guidelines. Conclusions: Physicians of various specialties in Europe are subject to therapeutic inertia in terms of their compliance with the GINA 2023 guidelines. Full article

This study explores the potential of craft-based activities in the context of special education, focusing on a papier mâché sculpting workshop implemented at the Special Kindergarten of Komotini, Greece, as part of the Horizon Europe Craeft project. The initiative aimed to assess how such creative activities could enhance the learning experience of children with intellectual and motor impairments, foster socialization, and develop fine motor skills. With reference to literature in art therapy, craft education, and inclusive pedagogy, the study applied a mixed-methods approach combining observation, visual analysis, and a survey. The findings indicate that, despite varied levels of participation based on individual needs, all students engaged meaningfully with the materials and activities. School professionals observed increased student engagement, emotional comfort, and communication, while also identifying the activity as well adapted and replicable in similar contexts. The results highlight the value of crafts in special education, not only as a sensory and cognitive stimulus but also as a means of fostering inclusion and self-expression. The study concludes with a call for further research into the role of tactile materials and hand gestures in relation to specific impairments. Full article

Urban areas are responsible for most of Europe’s energy demand and emissions and urgently require building retrofits to meet climate neutrality goals. This study evaluates the energy efficiency potential of three public school buildings in western Macedonia, Greece—a cold-climate region with high heating needs. The buildings, constructed between 1986 and 2003, exhibited poor insulation, outdated electromechanical systems, and inefficient lighting, resulting in high oil consumption and low energy ratings. A robust methodology is applied, combining detailed on-site energy audits, thermophysical diagnostics based on U-value calculations, and a techno-economic assessment utilizing Net Present Value (NPV), Internal Rate of Return (IRR), and SWOT analysis. The study evaluates a series of retrofit measures, including ceiling insulation, high-efficiency lighting replacements, and boiler modernization, against both technical performance criteria and financial viability. Results indicate that ceiling insulation and lighting system upgrades yield positive economic returns, while wall and floor insulation measures remain financially unattractive without external subsidies. The findings are further validated through sensitivity analysis and policy scenario modeling, revealing how targeted investments, especially when supported by public funding schemes, can maximize energy savings and emissions reductions. The study concludes that selective implementation of cost-effective measures, supported by public grants, can achieve energy targets, improve indoor environments, and serve as a replicable model of targeted retrofits across the region, though reliance on external funding and high upfront costs pose challenges. Full article

This article investigates the institutional and informational foundations of water governance in Southern Europe amid escalating climate stress. Focusing on Portugal, Spain, Italy, and Greece, it develops a multi-level analytical framework to explore how information asymmetries and governance fragmentation undermine coordinated responses to water scarcity. Integrating theories of information economics, polycentric governance, and critical institutionalism, this study applies a stylized economic model and comparative institutional analysis to assess how agents—such as farmers, utilities, regulators, and civil society—respond to varying incentives, data access, and coordination structures. Using secondary data, normalized indicators, and scenario-based simulations, the model identifies three key structural parameters—institutional friction (θ_i), information cost (β_i), and incentive strength (α_i)—as levers for governance reform. The simulations are stylized and not empirically calibrated, serving as heuristic tools rather than predictive forecasts. The results show that isolated interventions yield limited improvements, while combined reforms significantly enhance both equity and effectiveness. Climate stress simulations further reveal stark differences in institutional resilience, with Greece and Italy showing systemic fragility and Portugal emerging as comparatively robust. This study contributes a flexible, policy-relevant tool for diagnosing governance capacity and informing reform strategies while also underscoring the need for integrated, equity-oriented approaches to adaptive water governance. Full article

Due to the potential role of Auchenorrhyncha in the transmission of the bacterium Xylella fastidiosa in a wide variety of cultivations, during recent years in Europe, many studies have focused on species composition, abundance and seasonal appearance of Auchenorrhyncha. However, females and nymphs are difficult to identify, as species-level identification relies primarily on male genitalia morphology. Sampling was conducted over four years in olive fields in Lesvos Island, in the Northeast Aegean, Greece, using sweep nets and Malaise traps. Both adults and nymphs were collected, with males identified to species level, while females and nymphs were separated on different morphotypes. Representatives from each morphotype and identified adults were sequenced using the mitochondrial cytochrome oxidase subunit I (COI) gene. Using a classical morphological approach, 58 species were identified to species level, and using DNA barcoding, nymph morphotypes and females were successfully identified within the families Cicadellidae, Aphrophoridae, Delphacidae and Issidae. A phylogenetic tree was generated, clustering nymphs together with the corresponding adults. Our results demonstrate the utility of combining morphological and molecular methods for accurate species identification and highlight the importance of enriching online databases with additional species records. Full article

Background/Objectives: Childhood obesity is a global epidemic. Addressing the modifiable risk factors with effective policies is crucial for both prevention and intervention. This scoping review aims to provide a situational analysis of childhood obesity in Greece by mapping the available evidence on the prevalence of obesity among Greek children and adolescents and exploring the existing policies implemented to address this issue. Methods: A systematic literature search was conducted on 15 September 2023, using the PubMed, Scopus, and IATROTEK-online databases to identify studies related to childhood obesity and policies in Greece. Keyword groups were developed for “childhood obesity,” “Greece,” and either “prevalence” or “policies”. Additional sources, including Google and Google Scholar, were screened to ensure comprehensiveness. Results: A total of 66 studies were included: 61 on obesity prevalence (≤18 years of age) and 5 on existing policies tackling childhood obesity, all in Greece. The collective prevalence was observed to lie within the subsequent range of values: 2.8–21.2%. Regarding both genders, the observed prevalence ranged from 2.8% to 26.7% in males, and between 1.3% and 33.7% in females. The policies adopted in Greece cover various domains (healthy nutrition, public preferences, physical activity, school policies, and programs related to childhood obesity). Conclusions: Childhood obesity in Greece is a major challenge. Greece currently uses some policies and strategies to combat childhood obesity. There is still work to be done: policies play a pivotal role as a key tool to influence lifestyle habits on a broad scale and exert a considerable impact on the reduction in this prevalent health concern. Full article

Trichomonas vaginalis infection (TVI) is the most common curable sexually transmitted infection (STI). In this study, we aimed to assess the performances of different tests for TVI diagnosis in symptomatic Greek women, evaluating the TVI prevalence rate (PR) in Greece and comparing the latter with TVI-PR estimates from Europe. A laboratory-based cross-sectional analysis and a meta-analysis were conducted. Of 399 symptomatic Greek women, 17 had TVI, corresponding to a TVI-PR of 4.3%. The commercial nucleic acid amplification test (NAAT) achieved a sensitivity of 94.1%, which was 6% higher than the sensitivity of the culture method, 35% higher than that of the wet mount test, and 59% higher than that of the Giemsa stain test. The wet mount test achieved the lowest positive predictive value of 76.9%. All the tests had high specificity levels and negative predictive values. Data from 34 European TVI-PR studies in symptomatic women were pooled. The TVI-PR established in our study was similar to the TVI-PR estimates of 4.8% in Europe and 4.5% in Greece, with the second being higher than those of 2.1% in Northwestern Europe and 1.5% in Southern Europe but closer to that of 6.7% in Türkiye. In Greece, a European country with a relatively high TVI-PR among symptomatic women, the highly sensitive and specific, automated, point-of-care NAAT would facilitate rapid, accurate TVI diagnosis and the treatment of this target population to meet the WHO’s goal of ending STI epidemics by 2030. Full article

Grape marc spirits represent a significant category within the alcoholic beverage sector, particularly across Mediterranean Europe. This study aimed to construct a sensory flavor wheel—covering aroma, taste, and mouthfeel modalities—specifically for non-flavored and non-wood-aged grape marc distillates. To achieve this, we explored the feasibility of a novel methodological approach combining three rapid sensory techniques: Ultra Flash Profiling (UFP), Check-All-That-Apply (CATA), and Rate-All-That-Apply (RATA). Forty-five (45) samples from Greece, Cyprus, and Italy were evaluated by a trained panel of 12 assessors. UFP generated 205 initial descriptors, which were refined to 59 for CATA. Despite the long attribute list, CATA data helped identify the most relevant terms for the final RATA experiment. The sequential application of these methods, along with intermediate data filtering, led to the selection of 45 key descriptors with occurrence frequencies ranging from 33.3% to 97.7%. These were organized into a comprehensive flavor wheel grouped into 12 general categories. This approach offers a flexible framework for future flavor wheel construction in other under-characterized product categories. Full article

Today, the global production of plastic packaging reaches a million tons annually, resulting in significant amounts of plastic waste in the environment, which causes serious pollution issues and negatively affects the health of all living beings. However, the recycling rate for plastic packaging waste in Europe currently remains limited (~38%). With this in mind, this study focuses on the collection, characterization, and recycling, through pyrolysis, of 23 random plastic samples collected from food and non-food packaging waste in Greece. The samples were analyzed using thermal characterization techniques, such as Differential Scanning Calorimetry (DSC) and Evolved Gas Analysis (EGA), in conjunction with FTIR spectroscopy to gather important information and identify the polymers present in each sample. Furthermore, the samples underwent pyrolysis, resulting in valuable products such as the monomers styrene or ethylene, along with other useful secondary compounds, including benzoic acid, depending on the polymer type of each sample. The most prevalent polymer identified was PE (35%), while the remaining samples consisted of PET (22%), PP (22%), and PS (17%); only one sample was a blend of PE/PP. DSC facilitated the identification of the polyethylene type (LDPE, HDPE, or LLDPE). Full article

The aim of this study was to evaluate the suitability of eight softwood species most commonly used by Greek timber industries, including furniture manufacturers and companies producing roundwood, sawn timber, and plywood. The analysis was based on integrated Multi-Criteria Decision Analysis (MCDA), using a combined approach of the PROMETHEE method and the Analytical Hierarchy Process (AHP), taking into consideration some important criteria that affect timber quality. According to the PROMETHEE complete ranking, Aleppo pine (Pinus halepensis Mill.) achieved the best performance under the selected criteria among the examined softwood species, underlying the importance of Aleppo pine to the Greek timber industry. Our findings could be highly beneficial to the wood industry, promoting the recovery and advancement of the forest sector in general, taking into account that sustainable wood supply is lower than the total biomass available in Europe. Policymakers should prioritize the selection of conifer tree species that can strengthen Greece’s forestry sector, promote sustainable management practices, and increase the economic value derived from the country’s diverse forest resources. Full article

Background: Greece is among the fastest-aging countries globally, with one of the highest proportions of elderly individuals. As a result, the prevalence of mild cognitive impairment (MCI) and dementia is among the highest in Europe. The distribution of affected individuals varies considerably across different regions of the country. Method: We estimated the number of people living with MCI or dementia in Greece and visualized these estimates using heatmaps by regions for four census years: 1991, 2001, 2011, and 2023 (the 2023 census was delayed due to the COVID-19 pandemic). Age- and sex-specific prevalence rates of MCI and dementia were obtained from the Hellenic Longitudinal Investigation of Aging and Diet. These prevalence rates were then applied to population data from each census to estimate the number of affected individuals per region. Results: There was a consistent increase in the number of people living with MCI, rising from 177,898 in 1991 to 311,189 in 2023. Dementia cases increased from 103,535 in 1991 to 206,939 in 2023. Projections based on future census data for 2035 and 2050 suggest that the number of people with MCI will reach 375,000 and 440,000, respectively, while dementia cases will increase to 250,000 in 2035 and 310,000 in 2050. Conclusion: Given that each person with dementia typically requires care from at least two caregivers over time, these projections highlight the profound impact the dementia epidemic will have on Greece. The heatmaps developed in this study can serve as valuable tools for policymakers in designing and implementing clinical care programs tailored to the needs of each region based on the projected burden of disease. Full article

The REPowerEU Plan calls for a massive speed-up of renewable energy, which can undermine nature conservation. We explored the impact of an industrial-scale wind power project planned inside a Natura 2000 site (Special Protected Areas for birds) in the mountains of Central Evvoia, in Greece. If approved, the project could cause significant land artificialization, land take, and habitat fragmentation, having a land take intensity of 4.5 m²/MWh. An important part of forested land (14%) would be artificialized. The wilderness character would sharply decline from 49% to 4%, with a large roadless area (51.4 km²) shrinking by 77% and a smaller one (16.1 km²) lost. The project greatly overlaps with the Natura 2000 network (97%), a regional Key Biodiversity Area and Important Bird Area (84%), and a potential Global Key Biodiversity Area (27%). It might affect 23 globally threatened and 44 endemic species. This case study is a typical example of the poor implementation of the Natura 2000 and EIA legislation and highlights their recurring inability to prevent harmful human activities across Europe from affecting protected species of European interest and ecosystem functions. We conclude with policy recommendations to help increase renewables’ sustainability and minimize land artificialization in the EU. Full article

Air pollution is a major environmental and public health challenge, especially in urban areas where fine-grained air quality data are essential to effective interventions. Traditional monitoring networks, while accurate, often lack spatial resolution and public engagement. This study presents a novel wearable wireless sensor node (WSN) that was developed within the Horizon Europe SOCIO-BEE project to support air quality monitoring through citizen science (CS). The low-cost, body-mounted WSN measures NO₂, O₃, and PM_2.5. Three pilot campaigns were conducted in Ancona (Italy), Maroussi (Greece), and Zaragoza (Spain), and involved diverse user groups—seniors, commuters, and students, respectively. PM_2.5 sensor data were validated through two approaches: direct comparison with reference stations and spatial clustering analysis using K-means. The results show strong correlation with official PM_2.5 data (R² = 0.75), with an average absolute error of 0.54 µg/m³ and a statistical confidence interval of ±3.3 µg/m³. In Maroussi and Zaragoza, where no reference stations were available, the clustering approach yielded low intra-cluster coefficients of variation (CV = 0.50 ± 0.40 in Maroussi, CV = 0.28 ± 0.30 in Zaragoza), indicating that the measurements had high internal consistency and spatial homogeneity. Beyond technical validation, user engagement and perceptions were evaluated through pre-/post-campaign surveys. Across all pilots, over 70% of participants reported satisfaction with the system’s usability and inclusiveness. The findings demonstrate that wearable low-cost sensors, when supported by a structured engagement and data validation framework, can provide reliable, actionable air quality data, empowering citizens and informing evidence-based environmental policy. Full article

The Southeastern European territory is under severe climatic pressure owing to accelerating dry–thermal trends. The present survey illustrates the spatial and temporal evolution of the climate regime over the natural and agricultural landcover of South-eastern Europe and individual countries (Albania, Bosnia Herzegovina, Bulgaria, Croatia, Greece, N. Macedonia, Montenegro, Romania, Serbia, and Slovenia). For this purpose, a high spatial resolution of the Johansson Continentality index, the Kerner Oceanity index and the Pinna Combinative index was first estimated over two climatic periods (1964–1993; 1994–2023). The Johansson index depicts increasing continentality over the southern and eastern regions, majorly by the spatiotemporal expansion of the Continental climate over the agricultural and natural areas of Bulgaria (respectively, from 49.9% to 73.7% and from 13.3% to 36.8%) followed by Serbia, Romania, and Greece. The Kerner index illustrates increasing continentality over most of the study area owing to the spatiotemporal increase in the Sub-Continental climate type over the agricultural and the natural regions of Bosnia Herzegovina (from 68.6% to 84% and from 41.4% to 63.2%), N. Macedonia, Slovenia and the natural areas of Croatia and Serbia. The extension of the Continental over the agricultural and natural areas of Romania is also shown. The Pinna index exhibits an increasing aridity trend, which is more intense in the central and eastern regions. This trend is demonstrated by the higher distribution of the Semi-Dry in the second period mostly over the agricultural and natural areas of Bulgaria (2.4% to 23.1% and 0.7% to 5.8%), and a remarkable expansion of the Moderate Wet climate over both area types of Romania (from 3.3% to 44.8% and from 5.6% to 15.2%) and Bosnia Herzegovina (from 13.7% to 33.5% and from 3.5% to 13.2%). This study’s results highlight the necessity for intensifying adaptation plans and actions aiming at the feasibility of agricultural practices and the conservation of natural areas. Full article

The European Union’s 2030 target of decreasing net greenhouse gas emissions by at least 55% has resulted in a significant uptake of renewable energy sources (RESs) in the European power system, primarily wind and solar power, as well as the closure of conventional power plants that mostly used fossil fuels. The European Union’s members have accelerated the process of energy transition driven by climate change, and public authorities’ involvement in this process is impressive. The goal of this study is to present a broad overview of the existing challenges for the energy transition in Europe and how they can affect the reliability and stability of the interconnected power system in Europe and future investments, focusing especially on Greece. Unfortunately, this environmentally friendly transition is taking place without the required amount of investment in electrical energy storage technology, which raises the risk of a blackout due to the high predicted variability of RES. The gradual abandonment of conventional energy production units such as natural gas in the coming decades will intensify the problem of frequency regulation, which will become even more acute due to the particularly increased installed capacity in RESs across Europe and Greece. The European Power System, being partially unprepared for the energy transition, frequently faces a paradox: it rejects green power originating from high-RES production because of low demand, a lack of transmission line interconnections, or extremely low energy storage capacity. This paper examines all the prerequisites, including how the European electrical transmission system will be developed in the future and how new energy storage technologies will be used. Lastly, Greece’s energy future and potential risks associated with realizing the environmental goals of the European Green Deal is studied using a PESTEL analysis. Full article