The foreign policy of Greece towards its northern frontier problems (1990-93)

n the beginning of the 1990s Greece found itself facing a number of foreign policy problems in its northern frontiers. Although these problems had historic character, they had been staying dormant for years. The collapse of communism in Eastern Europe, the end of the Cold War and the resurgence of ethnic conflicts which followed caused the re-emergence of these problems: the Macedonian issue, the issue of th e Muslim minority in Western Thrace (in Greece) and the issue of the Greek minority in Northern Epirus (Albania), began to trouble Greek foreign and domestic politics. Today these issues remain unresolved although they cause less tension. Greek foreign policy between 1990-93 was pre-occupied with these issues which caused many additional international and domestic problems for Greece. By the end of the summer of 1993 the Greek government fell under fierce domestic rows over the outcome of these issues. Greek foreign policy over these years was characterised by nationalism and incompetence to grasp the opportunities which appeared in the changing Balkans. The political changes in the Balkans initially were welcomed in Greece. The government and the nation believed that Greece could use the new situation to its own advantage by achieving a more influential role in the region and thus extending its prestige within the European Union. The Yugoslav conflict and the frontier issues that Greece began to face raised fears over security concerns. The initial hope which characterised Greek foreign pol icy in the beginning of th e 1990s was substituted by insecurity over the future power position of the state and its own survival. However, Greek foreign policy was also characterised by arrogance which was evident in the government' s way of dealing with the Macedonian issue. Security concerns and power games were two aspects of Greek foreign policy. These aspects are based on the dual character of the perception that Greeks have about the position of their country in the world: arrogance and fear. Historic reasons have led to the building of this perception: the twentieth century conflicts which led to the creation of the present day frontier. So, in order to understand contemporary Greek foreign policy one has to look to these twentieth century developments which built Greece and shaped the identity of its people (Part A of the thesis). Second, one has to look carefully to the specific details of contemporary Greek foreign policy in order to see and describe the number of different policy aspects. The combination of different aspects in Greek foreign policy appear to be: nationalism, fear, power competition, domestic political antagonisms, European and American interventions. The particularities of the frontier problems that emerged in the 1990s can give further insight in one's efforts to understand this policy (Part B). By looking to history and the contemporary situation a number of questions can be put forward. This is the first step towards explanation. It appears that psychological factors as well as objective ones play significant part in shaping Greek foreign policy. The author of this study believes that subjective criteria play a significant role during policy-making. The policy-makers interact between them, they bear a number of values, and understand and act through their subjective interpretation of the environment. A theoretical model which focuses on the policy-maker and could help the process of explanation is offered in Part C. The Realist school of thought with its focus on the individual gave to the author th e opportunity to put together a theoretical background. This theory discusses the interaction of the following dimensions offoreign policy-making which influence the persons responsible for it: the operational environment provides the set of rules: the psychological environment, the national images and values which shape the national myth (ideology) shape the attitude of the policy-maker; the national interest as a powerful psychological and pragmatic concept shapes attitudes by focusing on the question of survival and power; the domestic environment provides different meanings of th e national interest and competitions within it affect the foreign policy-making process; the dimension of the small and weak state in international relations also shape the psychology of the policy-maker; territorial identities and disputes can create attitudes which see frontiers at ri sk of being violated. The explanation which follows in Part D, the result of a combination of interviews, documents and literature concludes in proposing a model of Greek foreign policy explanation which can be extended to the rest of the Balkar1s: history, domestic politics, images and values, nationalism, fear, arrogance, survival and power, real and imag inary notions contribute in shaping the attitude of the policy-makers and their policies. The explanation that this thesis offers shows why the 1990-93 period was not an unfortunate time in history. This period of crisis simply showed in a conspicuous way the dimensions which are always present in the Greek foreign policy-making process

The need for biokineticists in the South African public health care system

Background: Noncommunicable diseases (NCDs) are increasingly prevalent within South Africa. Physical inactivity is a significant, independent and modifiable risk factor increasing the prevalence of NCDs.Discussion: The integration of physical activity programmes into the primary health care system through multidisciplinary platforms is thus advocated for and envisioned to be more cost-effective than current practices. However, currently within the primary health care setting of South Africa, there is an absence of health care professionals adequately equipped to develop and implement physical activity programmes. Biokineticists, whose scope of practice is to improve physical functioning and health through exercise as a modality, are ideally suited to developing and implementing physical activity programmes in the public sector. Yet despite their evident demand, the role of the biokineticist is not incorporated into the national public health care system.Conclusion: This short report calls firstly, for the inclusion of biokinetics into the public health care sector, and secondly, for the funding of multidisciplinary community health programmes supporting education, healthy eating and physical activity levels.Keywords: noncommunicable disease, physical activity, community health programme, primary health car

Assessment of aortic stiffness by cardiovascular magnetic resonance following the treatment of severe aortic stenosis by TAVI and surgical AVR

Aortic stiffness is increasingly used as an independent predictor of adverse cardiovascular outcomes. We sought to compare the impact of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) upon aortic vascular function using cardiovascular magnetic resonance (CMR) measurements of aortic distensibility and pulse wave velocity (PWV).A 1.5 T CMR scan was performed pre-operatively and at 6 m post-intervention in 72 patients (32 TAVI, 40 SAVR; age 76 ± 8 years) with high-risk symptomatic severe aortic stenosis. Distensibility of the ascending and descending thoracic aorta and aortic pulse wave velocity were determined at both time points. TAVI and SAVR patients were comparable for gender, blood pressure and left ventricular ejection fraction. The TAVI group were older (81 ± 6.3 vs. 72.8 ± 7.0 years, p < 0.05) with a higher EuroSCORE II (5.7 ± 5.6 vs. 1.5 ± 1.0 %, p < 0.05). At 6 m, SAVR was associated with a significant decrease in distensibility of the ascending aorta (1.95 ± 1.15 vs. 1.57 ± 0.68 × 10(-3)mmHg(-1), p = 0.044) and of the descending thoracic aorta (3.05 ± 1.12 vs. 2.66 ± 1.00 × 10(-3)mmHg(-1), p = 0.018), with a significant increase in PWV (6.38 ± 4.47 vs. 11.01 ± 5.75 ms(-1), p = 0.001). Following TAVI, there was no change in distensibility of the ascending aorta (1.96 ± 1.51 vs. 1.72 ± 0.78 × 10(-3)mmHg(-1), p = 0.380), descending thoracic aorta (2.69 ± 1.79 vs. 2.21 ± 0.79 × 10(-3)mmHg(-1), p = 0.181) nor in PWV (8.69 ± 6.76 vs. 10.23 ± 7.88 ms(-1), p = 0.301) at 6 m.Treatment of symptomatic severe aortic stenosis by SAVR but not TAVI was associated with an increase in aortic stiffness at 6 months. Future work should focus on the prognostic implication of these findings to determine whether improved patient selection and outcomes can be achieved