Anchored Ambitions: Investigating the Enduring Attractiveness of Seafaring in Greece

Greek shipping is the world’s leading power and is well known for its efficiency and performance. The Greek fleet represents almost 21% of the global fleet in terms of capacity (deadweight tonnes – dwt) and 60% of the European Union’s one (Union of Greek Shipowners, 2023). Apart from the entrepreneurship competence of Greek shipowners, the contribution of Greek seafarers to the development of the so-called “Greek maritime miracle" has been decisive. Greek seafarers are known for their seamanship, qualities as well as their skills. However, according to data from the Hellenic Statistical Authority, the number of Greek seafarers is diachronically decreasing. Indicative of this trend is the fact that from 2000 to 2020, the number of Greek seafarers employed in Greek-owned vessels reduced by 45% (18.450 in 2000 vs. 10.087 in 2020). The aim of this research is twofold: first, to identify the reasons for the decreasing trend in the number of the Greek seafarers and, second, to highlight the initiatives and other actions the Greek shipping community could adopt in order to attract highly qualified seafarers to the Greek-owned fleet. In this context, a qualitative study was conducted, the purpose of which was to investigate the views of industry's stakeholders, in respect to the factors that shape the downward trend of seafarers figures. The outcome of this study sheds light on the reasons affecting the attractiveness of seafaring profession and further actions required for addressing promotion gaps

The identity of the Greek seafarer’s wife. Attitudes and perceptions towards the seafaring profession. The case of Chios Island.

Greece is the dominant force in global shipping and the Greek-owned fleet represents 54,28% of the European Union (EU) fleet in dwt and almost 20% of the world fleet in dwt. Even though there have been many studies for the Greek seafarers, there are no studies for the contribution of the seafarers’ wives to the so-called “Greek shipping miracle”. The purpose of this research is to record and highlight the social profile and the aspects of the daily life of the Greek seafarers’ wives. Furthermore, the research aims to shed light on the attitudes and perceptions of seafarer’s wives towards the seafaring profession. 145 wives of active seafarers, from Chios Island, filled out questionnaires specially made for the purposes of this research. Additionally, 15 in-depth interviews were conducted, in order to analyze and clarify some important findings that were obtained from the completion of the questionnaires

Association of mechanical bowel preparation with oral antibiotics and anastomotic leak following left sided colorectal resection:an international, multi-centre, prospective audit

Introduction: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustment using a mixed-effects multivariable regression model, MBP+Abx was associated with a lower risk of anastomotic leak (OR 0.52, 0.30–0.92, P = 0.02) but MBP was not (OR 0.92, 0.63–1.36, P = 0.69) compared to NBP. Conclusion: This non-randomised study adds ‘real-world’, contemporaneous, and prospective evidence of the beneficial effects of combined mechanical bowel preparation and oral antibiotics in the prevention of anastomotic leak following left sided colorectal resection across diverse settings. We have also demonstrated limited uptake of this strategy in current international colorectal practice

Evaluating the incidence of pathological complete response in current international rectal cancer practice

The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging.Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as 'fair' only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively).The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials

Assessment of the contribution of the blue economy to social cohesion and sustainable development in the regions of the European Union: the case of the North Aegean Region

The main objective of this thesis is the development of a system for assessing the contribution and impact of strategies/policies with the integration of the spatial dimension, using the Sustainability Impact Assessment (SIA) method and its evolution into Sustainable Development Impact Assessment with Territorial Approach (SDIATA). The case of Greece after the long period of austerity, recession and fiscal adjustment, and the subsequent health crisis is indicative, as the country is called upon to adopt a new production and development model. This can be economically viable if Greece builds on sectors where it has a competitive advantage such as the maritime economy while having a blue, environmental-friendly approach aimed at meeting the Sustainable Development Goals (SDGs).In this context, an assessment of the European Union (EU) Blue Economy strategy on social cohesion and sustainable development of a Greek island region is carried out. The North Aegean Region was chosen as a case study due to its low performance in social and economic indicators (e.g., unemployment, GDP, risk of poverty and social exclusion, etc.) at national and European level.The SDIATA method combines the use of secondary data with indicators related to social cohesion and sustainable development. In addition, the method incorporates citizens' attitudes and perceptions of the sectors and activities of the Blue Economy, as well as an assessment of the degree of their social acceptance, which is a novelty of the thesis. In this light, a survey was conducted using a special questionnaire among the members of the North Aegean Regional committee of consultation and the North Aegean Regional Council. The results obtained were prioritized and dimensioned by a team of experts through a questionnaire and consultation, so that they could serve as a decision support tool based on parameters related to sustainability, social cohesion and social acceptance and are related to the Blue Economy. This system supports decision-making and strengthens the involvement of local communities in the implementation of the Sustainable Blue Economy strategy, a condition that has been identified as essential for the effectiveness of the strategy in the context of governance, but which, however, has not yet been achieved.Κύριος στόχος της παρούσας διατριβής είναι η ανάπτυξη ενός συστήματος αξιολόγησης της συμβολής και των επιπτώσεων στρατηγικών/πολιτικών με ενσωμάτωση της χωρικής διάστασης, με τη χρήση της μεθόδου Sustainability Impact Assessment (SIA) και τη μετεξέλιξή της σε Sustainable Development Impact Assessment with Territorial Approach (SDIATA). Η περίπτωση της Ελλάδας μετά τη μακροχρόνια περίοδο λιτότητας, ύφεσης και δημοσιονομικής προσαρμογής, αλλά και την υγειονομική κρίση που ακολούθησε είναι ενδεικτική, καθώς καλείται να υιοθετήσει ένα καινούργιο παραγωγικό και αναπτυξιακό μοντέλο. Αυτό μπορεί να είναι οικονομικά βιώσιμο, αν στηριχτεί σε τομείς στους οποίους διαθέτει ανταγωνιστικό πλεονέκτημα όπως η θαλάσσια οικονομία έχοντας ταυτόχρονα γαλάζιο, φιλοπεριβαλλοντικό πρόσημο στοχεύοντας στην ικανοποίηση των Στόχων Βιώσιμης Ανάπτυξης (ΣΒΑ - SDGs). Σε αυτό το πλαίσιο, πραγματοποιείται αξιολόγηση της στρατηγικής της Ευρωπαϊκής Ένωσης (ΕΕ) για τη Γαλάζια Οικονομία στην κοινωνική συνοχή και στη βιώσιμη ανάπτυξη μίας ελληνικής νησιωτικής Περιφέρειας. Ως μελέτη περίπτωσης επιλέχθηκε η Περιφέρεια Βορείου Αιγαίου λόγω των χαμηλών επιδόσεων της σε κοινωνικούς και οικονομικούς δείκτες (π.χ. ανεργία, ΑΕΠ, κίνδυνος φτώχειας και κοινωνικού αποκλεισμού κλπ.) σε εθνικό και ευρωπαϊκό επίπεδο. Η μέθοδος SDIATA συνδυάζει τη χρήση δευτερογενών δεδομένων με δείκτες που σχετίζονται με την κοινωνική συνοχή και τη βιώσιμη ανάπτυξη. Επιπλέον, στη μέθοδο ενσωματώνονται οι στάσεις και οι αντιλήψεις των πολιτών για τομείς και δραστηριότητες της Γαλάζιας Οικονομίας, καθώς και η εκτίμηση του βαθμού της κοινωνικής αποδοχής τους, στοιχεία που αποτελούν πρωτοτυπία της διατριβής. Υπό αυτό το πρίσμα πραγματοποιήθηκε έρευνα με τη χρήση ειδικού ερωτηματολογίου στα μέλη της Περιφερειακής Επιτροπής Διαβούλευσης (ΠεΔΒΑ) και του Περιφερειακού Συμβουλίου Βορείου Αιγαίου (ΠεΣΒΑ). Τα αποτελέσματα που προέκυψαν ιεραρχήθηκαν και διαστασιοποιήθηκαν από ομάδα εμπειρογνωμόνων μέσω ερωτηματολογίου και διαβούλευσης, ώστε να μπορέσουν να λειτουργήσουν ως εργαλείο υποστήριξης λήψης αποφάσεων με βάση παραμέτρους οι οποίες σχετίζονται με τη βιωσιμότητα, την κοινωνική συνοχή και την κοινωνική αποδοχή και αφορούν τη Γαλάζια Οικονομία. Με αυτό το σύστημα υποστηρίζεται η λήψη αποφάσεων και ενισχύεται η εμπλοκή των τοπικών κοινωνιών στην υλοποίηση της στρατηγικής για τη βιώσιμη Γαλάζια Οικονομία, συνθήκη που έχει κριθεί απαραίτητη για την αποτελεσματικότητα της στρατηγικής, στο πλαίσιο της διακυβέρνησης, αλλά ακόμη δεν έχει επιτευχθεί

The identity of the Greek seafarer’s wife. Attitudes and perceptions towards the seafaring profession. The case of Chios Island.

Greece is the dominant force in global shipping and the Greek-owned fleet represents 54,28% of the European Union (EU) fleet in dwt and almost 20% of the world fleet in dwt. Even though there have been many studies for the Greek seafarers, there are no studies for the contribution of the seafarers’ wives to the so-called “Greek shipping miracle”. The purpose of this research is to record and highlight the social profile and the aspects of the daily life of the Greek seafarers’ wives. Furthermore, the research aims to shed light on the attitudes and perceptions of seafarer’s wives towards the seafaring profession. 145 wives of active seafarers, from Chios Island, filled out questionnaires specially made for the purposes of this research. Additionally, 15 in-depth interviews were conducted, in order to analyze and clarify some important findings that were obtained from the completion of the questionnaires.</jats:p

Technological Readiness and Implementation Pathways for Electrifying Greek Coastal Ferry Operations: Insights from Norway&rsquo;s Zero-Emission Ferry Transition

The decarbonization of short sea shipping is emerging as a critical priority for Mediterranean countries. This paper presents key findings from the ELECTRA-GR project, funded by the EEA Financial Mechanism (MIS 5202231), which aimed to evaluate the feasibility, technical readiness, and legislative requirements for the electrification of coastal ferry services in Greece. The study focused on two pilot routes&mdash;Salamis&ndash;Perama and Chios&ndash;Oinousses&mdash; representative of the high-frequency, short-distance ferry operations characteristic of the Greek archipelago. A comprehensive assessment was conducted combining technical fleet profiling, stakeholder consultations, legislative analysis, cost&ndash;benefit evaluations, and international benchmarking with Norway. For the base scenario of the high-traffic Salamis&ndash;Perama route, full electrification yields an annual reduction of approximately 900 tons of CO2 compared to diesel operation and achieves a Net Present Value (NPV) of &euro;1.6 million over a 15-year period. In contrast, the Chios&ndash;Oinousses route, characterized by lower traffic volume, achieves a reduction of 85 tons of CO2 annually through hybrid conversion, but results in an NPV of &euro;&minus;1.69 million, underscoring the need for financial support mechanisms or targeted subsidies to ensure economic feasibility. The results indicate that electrification of short ferry routes in Greece is technically feasible and environmentally advantageous but faces significant challenges, including inadequate port infrastructure, regulatory gaps, and limited industrial readiness. The study proposes a structured roadmap toward electrification, emphasizing the modernization of shipyards, tailored policy instruments, and public&ndash;private cooperation. The findings contribute to the formulation of a scalable strategy for clean maritime transport in peripheral and island regions of Greece

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

AimThe Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units.MethodAn online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted.ResultsOf hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017.ConclusionsUptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.AimThe Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units.MethodAn online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted.ResultsOf hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017.ConclusionsUptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.A

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation