The new trajectory of social policy in Greece: An ambulance service or a sustainable pathway to social policy improvement at the local level?

Το άρθρο εξετάζει το συγχρηµατοδοτούµενο έργο «∆οµές παροχής βασικών αγαθών: κοινωνικό παντοπωλείο, παροχή συσσιτίου, κοινωνικό φαρµακείο» που εφαρµόστηκε στην Ελλάδα κατά την τρέχουσα Προγραµµατική Περίοδο και από το 2014, µε κύριο στόχο την πλοήγηση των ωφελούµενων µακριά από τον κίνδυνο της φτώχειας και του κοινωνικού αποκλεισµού (AROPE). Η έρευνα, µέσω εις βάθος συνεντεύξεων µε ηµι-δοµηµένο ερωτηµατολόγιο, πραγµατοποιήθηκε σε ωφελούµενους του προγράµµατος στο ∆ήµο Σπύρου Μελά. Τα ευρήµατα της µελέτης-περίπτωσης καταδεικνύουν ότι οι παροχές του προγράµµατος υφαίνουν ένα βασικό δίχτυ κοινωνικής ασφάλειας µέσω συνδυασµένων υπηρεσιών υλικής στήριξης αλλά και ψυχολογικής υποστήριξης. Την ίδια στιγµή οι περιορισµένοι πόροι του, αποτυγχάνουν να διαµορφώσουν συνθήκες µονιµότητας στους µηχανισµούς βοήθειας περιορίζοντας τα τυχόν οφέλη των στοχευµένων χωρικά παροχών.This paper examines whether the EU cofinanced project “structures for the provision of essential goods: social grocery, common meals, social pharmacy” that is implemented horizontally in Greece since 2014, can navigate its beneficiaries out of the risk of poverty and social exclusion (AROPE). To this end, the paper surveys, through in-depth semi-structured interviews, beneficaries of the project in the municipality of Pavlos Melas. The findings of the case study suggest that the project constitutes an important safety net, helping beneficiaries experiencing severe material deprivation address manifold needs, including social and psychological. However, at the same time, the project is limited in scope, fails to meet demand and rarely addresses the root causes of poverty. While the project is suggestive of the advantages that a local approach to social policy has to offer, its implications are not far-reachin

Incident Analysis & Digital Forensics in SCADA and Industrial Control Systems

SCADA and industrial control systems have been traditionally isolated in physically protected environments. However, developments such as standardisation of data exchange protocols and increased use of IP, emerging wireless sensor networks and machine-to-machine communication mean that in the near future related threat vectors will require consideration too outside the scope of traditional SCADA security and incident response. In the light of the significance of SCADA for the resilience of critical infrastructures and the related targeted incidents against them (e.g. the development of stuxnet), cyber security and digital forensics emerge as priority areas. In this paper we focus on the latter, exploring the current capability of SCADA operators to analyse security incidents and develop situational awareness based on a robust digital evidence perspective. We look at the logging capabilities of a typical SCADA architecture and the analytical techniques and investigative tools that may help develop forensic readiness to the level of the current threat environment requirements. We also provide recommendations for data capture and retention

The new trajectory of social policy in Greece: An ambulance service or a sustainable pathway to social policy improvement at the local level?

Το άρθρο εξετάζει το συγχρηµατοδοτούµενο έργο «∆οµές παροχής βασικών αγαθών: κοινωνικό παντοπωλείο, παροχή συσσιτίου, κοινωνικό φαρµακείο» που εφαρµόστηκε στην Ελλάδα κατά την τρέχουσα Προγραµµατική Περίοδο και από το 2014, µε κύριο στόχο την πλοήγηση των ωφελούµενων µακριά από τον κίνδυνο της φτώχειας και του κοινωνικού αποκλεισµού (AROPE). Η έρευνα, µέσω εις βάθος συνεντεύξεων µε ηµι-δοµηµένο ερωτηµατολόγιο, πραγµατοποιήθηκε σε ωφελούµενους του προγράµµατος στο ∆ήµο Σπύρου Μελά. Τα ευρήµατα της µελέτης-περίπτωσης καταδεικνύουν ότι οι παροχές του προγράµµατος υφαίνουν ένα βασικό δίχτυ κοινωνικής ασφάλειας µέσω συνδυασµένων υπηρεσιών υλικής στήριξης αλλά και ψυχολογικής υποστήριξης. Την ίδια στιγµή οι περιορισµένοι πόροι του, αποτυγχάνουν να διαµορφώσουν συνθήκες µονιµότητας στους µηχανισµούς βοήθειας περιορίζοντας τα τυχόν οφέλη των στοχευµένων χωρικά παροχών.This paper examines whether the EU cofinanced project “structures for the provision of essential goods: social grocery, common meals, social pharmacy” that is implemented horizontally in Greece since 2014, can navigate its beneficiaries out of the risk of poverty and social exclusion (AROPE). To this end, the paper surveys, through in-depth semi-structured interviews, beneficaries of the project in the municipality of Pavlos Melas. The findings of the case study suggest that the project constitutes an important safety net, helping beneficiaries experiencing severe material deprivation address manifold needs, including social and psychological. However, at the same time, the project is limited in scope, fails to meet demand and rarely addresses the root causes of poverty. While the project is suggestive of the advantages that a local approach to social policy has to offer, its implications are not far-reachin

Essays on Banking and Debt Contracting

This dissertation contains three chapters. In the first chapter, I investigate whether restrictive loan covenants disrupt or improve firm operating performance. Using an instrumental variables approach to address the endogenous relationship between covenant strictness and firms' efficiency, I find stricter loan covenants cause an increase in profitability and a reduction in operating cost. Stricter covenants improve performance only in firms with poor governance: those without large shareholder ownership, with weaker shareholder rights, facing softer competition in their product market, or with inside director dominated boards. The evidence is consistent with the view that the design of debt contracts can mitigate agency costs in firms that lack alternative governance mechanisms. The second chapter focuses on the relationships that banks develop with other lenders through syndicated loans, one of the largest sources of external finance for firms. A small number of interconnected banks increasingly dominate the syndicated loan market. In this chapter, I use measures from network analysis to test whether lender interconnectedness benefits borrowers through efficiency gains, or is harmful due to increased market power. Traditional measures of industry concentration are not relevant in the syndicated loan market because lenders share information and resources. Using bank mergers to identify exogenous variation in lenders' interconnectedness, I find that an increase in lender network centrality reduces firms' cost of borrowing. The effects are larger for borrowers with higher levels of information asymmetry, consistent with theories suggesting that facilitating information sharing increases lending efficiency. The third chapter examines whether creditor protection rights affect the structure of corporate debt. Improving legal protection of creditor interests may expand firms' access to debt markets, but also increases creditors' rights to intervene with firm policies. Using variation from legal rulings in Delaware, I find that increasing creditor protection leads to a reduction in senior secured debt and an increase in unsecured bonds, especially for firms close to bankruptcy. Reducing creditors' ability to sue managers for breach of fiduciary duty leads to a large increase in secured debt with more restrictive covenants. The results suggest that legal protection of creditor interests affects firms' choice of debt structure

The role of immune responses, focussing on herpes virus specificity and interferon-gamma, in Myocardial Infarction with reperfusion and in Chronic Fatigue Syndrome

Background Immune responses targeting microbes can contribute to chronic inflammation, particularly when the microbes are persistent such as herpes-family Cytomegalovirus (CMV) and EpsteinBarr virus (EBV). Such persistence of antigens can cause T cell exhaustion characterized by loss of appropriate effector functions, expression of inhibitory receptors, as well as failure to return to homeostatic pre-inflammatory conditions. This results in immune senescence and dysregulation which may cause disrupted cell populations, homing and cytokine productions that mediate immunopathology and compromise anti-microbial defences. Aims The aim of the study was to determine whether microbe specific particularly, interferongamma immune responses measured in 2 disease states, where a herpes viral inflammatory aetiology and immune dysregulation are suggested, acute Myocardial Infarction (MI) with reperfusion and Chronic Fatigue Syndrome (CFS), are indicative of disease presence and severity. Patients MI occurs due to blockage of the coronary artery, and treatment involves stent insertion, allowing reperfusion (R), which has associated immunopathology due to T cell homing. A total of 52 MI patients were studied. Blood samples were taken before and after reperfusion to investigate the dynamics of specific T cell homing to the heart, that may contribute to disease severity (reperfusion damage). For 50 CFS patients with measured disease levels, blood samples were taken to examine immune responses including those against microbes implicated in disease (CMV & EBV) compared to healthy controls. Methods T cell immunity was measured by ELIspot and flow cytometry, and cytokine levels in cell culture supernatants were measured using multiplex technology. Statistical analyses were carried out for normality in data sets. The Mann-Whitney test or unpaired t test was used to determine the difference between two unrelated groups. Differences between repeat or paired measurements were determined by Wilcoxon signed rank tests or paired t tests. Associations between measurements were investigated using Spearman correlation. Results and Discussion In MI patients, compared to before reperfusion, levels of the following cell populations fell significantly after reperfusion: terminally-differentiated CD8+ PD-1+ effector memory cells (p=0.016) and CMV-specific IFN-secreting CD4+ T cells (p=0.002) the latter also being associated with injury. This suggests specific pathogenic T cell homing to the heart during reperfusion. In CFS patients, increased disease severity was associated with increased non-specific IFNy production (p=0.008), and reduced percentage of NK cells (p=0.0047). NK cell deficiency may reduce antiviral defences and allow detrimental viral reactivation. Conclusion T cell responses against CMV appeared to have greater involvement in MI + R than CFS. Immune responses involving IFN-γ are demonstrated in both conditions as being associated with disease, and so this cytokine may be considered a disease biomarker and a therapeutic target for both

CT Diagnosis of an Abortion-Related Retroperitoneal Space Abscess

A female patient with a history of recent abortion was transferred in critically ill condition in our hospital. CT imaging on emergency basis depicted an abscess in the right retroperitoneal space that included the head of fetus, along with rupture of the right lateral wall of uterus. Spiral CT enabled prompt diagnosis and therapy of this rare abortion-related complication

Telomerase as a Therapeutic Target in Cardiovascular Disease.

Shortened telomeres have been linked to numerous chronic diseases, most importantly coronary artery disease, but the underlying mechanisms remain ill defined. Loss-of-function mutations and deletions in telomerase both accelerate telomere shortening but do not necessarily lead to a clinical phenotype associated with atherosclerosis, questioning the causal role of telomere length in cardiac pathology. The differential extranuclear functions of the 2 main components of telomerase, telomerase reverse transcriptase and telomerase RNA component, offer important clues about the complex relationship between telomere length and cardiovascular pathology. In this review, we critically discuss relevant preclinical models, genetic disorders, and clinical studies to elucidate the impact of telomerase in cardiovascular disease and its potential role as a therapeutic target. We suggest that the antioxidative function of mitochondrial telomerase reverse transcriptase might be atheroprotective, making it a potential target for clinical trials. Graphic Abstract: A graphic abstract is available for this article.Work in the VA laboratory is supported by the Spanish Ministerio de Ciencia e Innovación (MCIN) (PID2019-108489RB-I00) and the Instituto de Salud Carlos III (ISCIII) (AC17/00067) with co-funding from the European Regional Development Fund (ERDF, “Una manera de hacer Europa”), and the Progeria Research Foundation (Award PRF 2019–77). The CNIC is supported by the ISCIII, the MCIN, and the Pro CNIC Foundation. I. Spyridopoulos is funded by the British Heart Foundation (PG/18/25/33587) and National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. The work of J. Haendeler and J. Altschmied is in part supported by the Deutsche Forschungsgemeinschaft (DFG) SFB1116, A04 (J. Haendeler and J. Altschmied), HA2868/14-1 (J. Haendeler) and AL288/5-1 (J. Altschmied). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health’. I. Spyridopoulos also receives a grant from TA-Science for the TACTIC trial (Telomerase Activator to Reverse Immunosenescence in Acute Coronary Syndrome).S

Myocardial Ischemia and Reperfusion Leads to Transient CD8 Immune Deficiency and Accelerated Immunosenescence in CMV-Seropositive Patients

Rationale: There is mounting evidence of a higher incidence of coronary heart disease (CHD) in cytomegalovirus (CMV) seropositive individuals. Objective: The aim of this study was to investigate whether acute MI triggers an inflammatory T-cell response that might lead to accelerated immunosenescence in CMV-seropositive patients. Methods and Results: Thirty-four patients with acute MI undergoing primary PCI (PPCI) were longitudinally studied within 3 months following reperfusion (Cohort A). In addition, 54 patients with acute and chronic MI were analyzed in a cross-sectional study (Cohort B). CMV-seropositive patients demonstrated a greater fall in the concentration of terminally differentiated CD8 effector memory T cells (TEMRA) in peripheral blood during the first 30 min of reperfusion compared with CMV-seronegative patients (-192 vs. -63 cells/µl; p=0.008), correlating with the expression of programmed cell death-1 (PD-1) before PPCI (r=0.8; p=0.0002). A significant proportion of TEMRA cells remained depleted for at least 3 months in CMV-seropositive patients. Using high-throughput 13-parameter flow cytometry and HLA class I CMV-specific dextramers, we confirmed an acute and persistent depletion of terminally differentiated TEMRA and CMV-specific CD8+ cells in CMV-seropositive patients. Long-term reconstitution of the TEMRA pool in chronic CMV-seropositive post-MI patients was associated with signs of terminal differentiation including an increase in KLRG1 and shorter telomere length in CD8+ T cells (2225 bp vs. 3397 bp; p<0.001). Conclusions: Myocardial ischemia and reperfusion in CMV-seropositive patients undergoing PPCI leads to acute loss of antigen-specific, terminally differentiated CD8 T-cells, possibly through PD-1-dependent programmed cell death. Our results suggest that acute MI and reperfusion accelerate immunosenescence in CMV-seropositive patients