Greater Athens Area Research Articles

An overview from hygroscopic aerosols to cloud droplets: The HygrA-CD campaign in the Athens basin

The international experimental campaign Hygroscopic Aerosols to Cloud Droplets (HygrA-CD), organized in the Greater Athens Area (GAA), Greece from 15 May to 22 June 2014, aimed to study the physico-chemical properties of aerosols and their impact on the formation of clouds in the convective Planetary Boundary Layer (PBL). We found that under continental (W-NW-N) and Etesian (NE) synoptic wind flow and with a deep moist PBL (~2–2.5km height), mixed hygroscopic (anthropogenic, biomass burning and marine) particles arrive over the GAA, and contribute to the formation of convective non-precipitating PBL clouds (with droplets of ~16–20μm mean diameter) with vertical extent up to 500m. Under these conditions, high updraft velocities (1–2ms−1) and cloud condensation nuclei (CCN) concentrations (~2000cm−3 at 1% supersaturation), generated clouds with an estimated cloud droplet number of ~600cm−3. Under Saharan wind flow conditions (S-SW) a shallow PBL (<1–1.2km height) develops, leading to much higher CCN concentrations (~3500–5000cm−3 at 1% supersaturation) near the ground; updraft velocities, however, were significantly lower, with an estimated maximum cloud droplet number of ~200cm−3 and without observed significant PBL cloud formation. The largest contribution to cloud droplet number variance is attributed to the updraft velocity variability, followed by variances in aerosol number concentration.

Multi-tracer approach to characterize domestic wood burning in Athens (Greece) during wintertime

During the last years the atmosphere of the Great Athens Area (GAA) and other Greek cities is burdened from extended residential biomass burning for heating purposes. In this work, a series of near real-time and off-line biomass burning tracers are analyzed during intense wood burning events in Athens. The measurements were conducted at an urban background site located in the center of Athens, and in the heart of wood burning activities (winter 2013–2014). The measured tracers include high resolution measurements of non-sea salt potassium (nss-K+), wood burning black carbon (BCwb), the m/z 60 fragment associated with levoglucosan and monosaccharide anhydrides (levoglucosan, mannosan and galactosan) determined on selected filter samples. The suitability of these tracers was evaluated when the prevailing meteorological conditions with low dispersion and deposition mechanisms (low wind speed, absence of precipitation) were associated with high biomass burning emissions at nighttime. During the severe smog periods, the levels of K+, BCwb, m/z 60 and levoglucosan were up to 2.2 μg m−3, 12.5 μg m−3, 3.4 μg m−3 and 8.6 μg m−3, respectively, higher by a factor of at least two, relatively to the non smog periods due to biomass burning. Correlations between biomass burning tracers as well as between monosaccharide anhydrides provided information about the type of material and wood being burned.

PM10 episodes in Greece: Local sources versus long-range transport—observations and model simulations

ABSTRACTPeriods of abnormally high concentrations of atmospheric pollutants, defined as air pollution episodes, can cause adverse health effects. Southern European countries experience high particulate matter (PM) levels originating from local and distant sources. In this study, we investigated the occurrence and nature of extreme PM10 (PM with an aerodynamic diameter ≤10 μm) pollution episodes in Greece. We examined PM10 concentration data from 18 monitoring stations located at five sites across the country: (1) an industrial area in northwestern Greece (Western Macedonia Lignite Area, WMLA), which includes sources such as lignite mining operations and lignite power plants that generate a high percentage of the energy in Greece; (2) the greater Athens area, the most populated area of the country; and (3) Thessaloniki, (4) Patra, and (5) Volos, three large cities in Greece. We defined extreme PM10 pollution episodes (EEs) as days during which PM10 concentrations at all five sites exceeded the European Union (EU) 24-hr PM10 standards. For each EE, we identified the corresponding prevailing synoptic and local meteorological conditions, including wind surface data, for the period from January 2009 through December 2011. We also analyzed data from remote sensing and model simulations. We recorded 14 EEs that occurred over 49 days and could be grouped into two categories: (1) Local Source Impact (LSI; 26 days, 53%) and (2) African Dust Impact (ADI; 23 days, 47%). Our analysis suggested that the contribution of local sources to ADI EEs was relatively small. LSI EEs were observed only in the cold season, whereas ADI EEs occurred throughout the year, with a higher frequency during the cold season. The EEs with the highest intensity were recorded during African dust intrusions. ADI episodes were found to contribute more than local sources in Greece, with ADI and LSI fraction contribution ranging from 1.1 to 3.10. The EE contribution during ADI fluctuated from 41 to 83 μg/m3, whereas during LSI it varied from 14 to 67 μg/m3.Implications: This paper examines the occurrence and nature of extreme PM10 pollution episodes (EEs) in Greece during a 3-yr period (2009–2011). Fourteen EEs were found of 49 days total duration, classified into two main categories: Local Source Impact (53%) and African Dust Impact (47%). All the above extreme PM10 air pollution episodes were the result of specific synoptic prevailing conditions. Specific information on the linkages between the synoptic weather patterns and PM10 concentrations could be used in the development of weather/health-warning system to alert the public that a synoptic episode is imminent.

Psychiatric Medication Intake in Suicide Victims: Gender Disparities and Implications for Suicide Prevention.

Frequency and gender differences of psychiatric medication intake in a sample of suicide victims from the Athens Greater Area were investigated with a particular focus on the implications for suicide prevention. Data were collected from the toxicological analyses of the suicide cases of the period November 2007-October 2009. Information was available for 262 individuals, 196 men (74.8%) and 66 women (25.2%); 109 of these (41.6%) were receiving psychiatric medication(s). Women were statistically more frequently under treatment: antidepressants (32.8% vs. 11.3%, p < 0.001), antiepileptics (9.1% vs. 0.5%, p = 0.001), antipsychotics (24.2% vs. 9.2%, p = 0.003), and benzodiazepines (16.7% vs. 6.6%, p = 0.024). Campaigns aiming to bring men with psychological difficulties in contact with mental health services and to lessen the stigma of mental illness, together with better training of nonpsychiatrists into "suspecting" "male" depression, could be particularly helpful for decreasing male suicides. More thoughtful choice of psychiatric medication could possibly already prevent a number of female suicides.

Validation of LIRIC aerosol concentration retrievals using airborne measurements during a biomass burning episode over Athens

In this paper we validate the Lidar-Radiometer Inversion Code (LIRIC) retrievals of the aerosol concentration in the fine mode, using the airborne aerosol chemical composition dataset obtained over the Greater Athens Area (GAA) in Greece, during the ACEMED campaign. The study focuses on the 2nd of September 2011, when a long-range transported smoke layer was observed in the free troposphere over Greece, in the height range from 2 to 3km. CIMEL sun-photometric measurements revealed high AOD (~0.4 at 532nm) and Ångström exponent values (~ 1.7 at 440/870nm), in agreement with coincident ground-based lidar observations. Airborne chemical composition measurements performed over the GAA, revealed increased CO volume concentration (~ 110ppbv), with 57% sulphate dominance in the PM1 fraction. For this case, we compare LIRIC retrievals of the aerosol concentration in the fine mode with the airborne Aerosol Mass Spectrometer (AMS) and Passive Cavity Aerosol Spectrometer Probe (PCASP) measurements. Our analysis shows that the remote sensing retrievals are in a good agreement with the measured airborne in-situ data from 2 to 4km. The discrepancies observed between LIRIC and airborne measurements at the lower troposphere (below 2km), could be explained by the spatial and temporal variability of the aerosol load within the area where the airborne data were averaged along with the different time windows of the retrievals.

Reduced circulating adiponectin levels are associated with the metabolic syndrome independently of obesity, lipid indices and serum insulin levels: a cross-sectional study.

BackgroundGiven the increasing rate of overweight and the burden of metabolic syndrome (MetS) on cardiovascular disease development, better understanding of the syndrome is of great importance. Therefore, the objectives were to examine whether interleukin-6 (IL-6) and adiponectin are associated with MetS, and whether this association is mediated by components of the MetS.MethodsDuring 2011–2012, 284 individuals (159 men, 53 ± 9 years, 125 women 52 ± 9 years) without cardiovascular disease, type 1 diabetes mellitus, high-grade inflammatory disease, living in the greater Athens area, Greece, participated in clinical examination. Adiponectin and IL-6 were measured in fasting plasma samples. MetS was defined according to the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria.ResultsMetS was present in 37 % (IDF) and 33 % (AHA/NHLBI) of the study population (P < 0.001). Adiponectin was inversely associated with MetS (odds ratio, 95 % confidence interval: 0.829, 0.762- 0.902 for MetS-IDF, and 0.840, 0.772- 0.914 for MetS-AHA/NHLBI). Body mass index (BMI), waist circumference, high density lipoprotein (HDL)-cholesterol, triglyceride and insulin concentration mediated the association between adiponectin and MetS-IDF (z-test, standard error, P-value: 2.898, 0.012, 0.004, for BMI; 2.732, 0.012, 0.006 for waist circumference; 2.388, 0.011, 0.017 for HDL-cholesterol; 2.163, 0.010, 0.031 for triglyceride; 2.539, 0.010, 0.011 for insulin). Similarly, BMI, waist circumference, HDL-cholesterol and insulin concentration mediated the association between adiponectin and MetS-AHA/NHLBI (z-test, standard error, P-value: 2.633, 0.011, 0.008 for BMI; 2.441, 0.011, 0.015 for waist circumference; 1.980, 0.010, 0.048 for HDL-cholesterol; 2.225, 0.009, 0.026 for insulin). However, adiponectin remained significantly associated with MetS. IL-6 was not significantly associated with MetS.ConclusionMetS components, in particular obesity and lipid indices, as well as serum insulin levels, mediate the association between adiponectin and MetS as defined by both the IDF and AHA/NHLBI criteria.

Anti-inflammatory diet and 10-year (2002–2012) cardiovascular disease incidence: The ATTICA study

Background/objectivesThe aim of the present work was to evaluate the association between the inflammatory potential of the diet and the 10-year cardiovascular disease (CVD) incidence in the ATTICA Study, and whether this is modified by the baseline presence or absence of metabolic syndrome (MetS). MethodsDuring 2001–2002, 3042 healthy adults (1514 men and 1528 women) living in the greater area of Athens were voluntarily recruited to the ATTICA study. In 2011–2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD event was recorded using WHO-ICD-10 criteria and MetS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised) definition. A proxy dietary anti-inflammatory index (D-AII) score computed using participants' diet records. ResultsThe 10-year fatal or non-fatal CVD event rate was 157 cases/1000 participants. After adjusting for several confounding factors, an anti-inflammatory diet, as expressed by higher DII scores, was borderline associated with 10-year CVD incidence (OR3rd tertile vs. 1st tertile=0.98, 95%CI: 0.96–1.01). This inverse association was also verified among participants without MetS at baseline (OR3rd tertile vs. 1st tertile=0.97, 95%CI: 0.94–0.99), but not among participants with the MetS. ConclusionsResults of the present work verified the protective effect of an anti-inflammatory diet towards the 10-year CVD incidence among participants without MetS. In contrast, the presence of MetS already at baseline seemed to impede this anti-inflammatory diet protective effect, which underlines the independent importance of MetS on CVD risk.

On the influence of the urban heat island on the cooling load of a school building in Athens, Greece

The present study investigates the effect of the urban heat island (UHI) phenomenon, measured in the Greater Athens Area (GAA), on the energy consumption of a typical modern school building. The energy performance of the selected building has been calculated using an accurate, extensively validated, transient simulation model for 17 different sites of the GAA, for the summer period. Calculations showed that the urban heat island phenomenon affects remarkably the thermal behavior of the school building, as suburban areas presented much lower cooling loads. The cooling load values fluctuated between 3304.3kWh for the rural stations and 14,585.1kWh for the central stations (for the year 2011) or between 3206.5kWh and 14,208.3kWh (for the year 2012), respectively. Moreover, the mean monthly cooling load values varied between 0.4–2kWh/m2 for the rural stations and 4–6.9kWh/m2 for the central stations, for the selected time period.Furthermore, a neural network model was designed and developed in order to quantify the contribution of various meteorological parameters (such as the mean daily air temperature values, the mean daily solar radiation values, the average wind speed and the urban heat island intensity) to the energy consumption of the building and it was found that the urban heat island intensity is the predominant parameter, influencing remarkably the energy consumption of the typical school building.

Predicting Road Accidents: A Rare-events Modeling Approach

Modeling road accident occurrence has gained increasing attention over the years. So far, considerable efforts have been made from researchers and policy makers in order to explain road accidents and improve road safety performance of highways. In reality, road accidents are rare events. In such cases, the binary dependent variable is characterized by dozens to thousands of times fewer events (accidents) than non-events (non-accidents). Instead of using traditional logistic regression methods, this paper considers accidents as rare events and proposes a series of rare-events logit models which are applied in order to model road accident occurrence by utilizing real-time traffic data. This statistical procedure was initially proposed by King and Zeng (2001) when scholars study rare events such as wars, massive economic crises and so on. Rare-events logit models basically estimate the same models as traditional logistic regression, but the estimates as well as the probabilities are corrected for the bias that occurs when the sample is small or the observed events are very rare. Consequently, the basic problem of underestimating the event probabilities is avoided as stated by King and Zeng (2001). To the best of our knowledge, this is the first time that this approach is followed when road accident data are analyzed. Instead of applying a traditional case-control study, the complete dataset of hourly aggregated traffic data such as flow, occupancy, mean time speed and percentage of trucks, were collected from three random loop detectors in the Attica Tollway (“Attiki Odos”) located in Greater Athens Area in Greece for the 2008–2011 period. The modeling results showed an adequate statistical fit and reveal a negative relationship between accident occurrence and the natural logarithm of speed in the accident location. This study attempts to contribute to the understanding of accident occurrence in motorways by developing novel models such as the rare-events logit for the first time in safety evaluation of motorways.

Metabolic syndrome and 10-year cardiovascular disease incidence: The ATTICA study

AimsTo evaluate the influence of metabolic syndrome (MetS) as well as inflammatory and renal markers on cardiovascular disease (CVD) incidence. Methods and resultsDuring 2001–2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011–2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MetS was defined using three definitions, provided by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III), the International Diabetes Federation (IDF) or the Harmonized definition. Furthermore, the contributory predictive role of C-reactive protein (CRP), inteleukin-6, uric acid and estimated glomerular filtration rate in the aforementioned models was evaluated. History of MetS-NCEP was positively associated with CVD, adjusting for potential confounding factors (OR:1.83, 95%CI:1.24–2.72). Not statistically significant associations with CVD incidence were observed when using the IDF or the Harmonized definition. Additionally, none of the added inflammatory and renal function markers mediated the influence of MetS on CVD incidence (all p's from Sobel test >0.40). C-statistic values for the MetS definitions used exceeded 0.789 (CI:0.751–0.827), indicating fair-to-good predictive probability of the models. ConclusionResults of the present work revealed the negative impact of MetS-NCEP, but not of the other MetS definitions, on CVD incidence, a key-point that may help in better understanding the role of IDF and Harmonized MetS definitions on CVD.

Metabolic syndrome, adherence to the Mediterranean diet and 10-year cardiovascular disease incidence: The ATTICA study

Background and aimsTo better understand the metabolic syndrome (MS) spectrum through principal components analysis and further evaluate the role of the Mediterranean diet on MS presence. MethodsDuring 2001–2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011–2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III) definition. Adherence to the Mediterranean diet was assessed using the MedDietScore (range 0–55). ResultsFive principal components were derived, explaining 73.8% of the total variation, characterized by the: a) body weight and lipid profile, b) blood pressure, c) lipid profile, d) glucose profile, e) inflammatory factors. All components were associated with higher likelihood of CVD incidence. After adjusting for various potential confounding factors, adherence to the Mediterranean dietary pattern for each 10% increase in the MedDietScore, was associated with 15% lower odds of CVD incidence (95%CI: 0.71–1.06). For the participants with low adherence to the Mediterranean diet all five components were significantly associated with increased likelihood of CVD incidence. However, for the ones following closely the Mediterranean pattern positive, yet not significant associations were observed. ConclusionResults of the present work propose a wider MS definition, while highlighting the beneficial role of the Mediterranean dietary pattern.

Posttraumatic Stress Disorder After Discharge From Intensive Care Units in Greater Athens Area.

Survivors of critical illnesses often exhibit high psychiatric morbidity. The aim of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and the comorbidity between PTSD and major depression, among patients who have been treated in a general (medical-surgical) intensive care unit (ICU group) compared with patients who have been treated in a non-ICU department, medical or surgical (non-ICU group). The study was conducted in 5 general hospitals in the greater Athens, Greece area. The final sample of the study was composed of 198 patients. The point prevalence of PTSD for ICU patients was 35.3%, whereas for non-ICU patients it was 13.5%. In this study, 11.6% of the sample was found to meet the criteria for both PTSD and major depression. The clinical entity of PTSD is common after intensive care treatment, and coordination between health care professionals is necessary for early recognition and treatment of any psychiatric complication.

Sources of atmospheric aerosol from long-term measurements (5 years) of chemical composition in Athens, Greece

To identify the sources of aerosols in Greater Athens Area (GAA), a total of 1510 daily samples of fine (PM2.5) and coarse (PM10–2,5) aerosols were collected at a suburban site (Penteli), during a five year period (May 2008–April 2013) corresponding to the period before and during the financial crisis. In addition, aerosol sampling was also conducted in parallel at an urban site (Thissio), during specific, short-term campaigns during all seasons. In all these samples mass and chemical composition measurements were performed, the latest only at the fine fraction. Particulate organic matter (POM) and ionic masses (IM) are the main contributors of aerosol mass, equally contributing by accounting for about 24% of the fine aerosol mass. In the IM, nss-SO4−2 is the prevailing specie followed by NO3− and NH4+ and shows a decreasing trend during the 2008–2013 period similar to that observed for PM masses. The contribution of water in fine aerosol is equally significant (21±2%), while during dust transport, the contribution of dust increases from 7±2% to 31±9%. Source apportionment (PCA and PMF) and mass closure exercises identified the presence of six sources of fine aerosols: secondary photochemistry, primary combustion, soil, biomass burning, sea salt and traffic. Finally, from winter 2012 to winter 2013 the contribution of POM to the urban aerosol mass is increased by almost 30%, reflecting the impact of wood combustion (dominant fuel for domestic heating) to air quality in Athens, which massively started in winter 2013.

Education status determines 10-year (2002-2012) survival from cardiovascular disease in Athens metropolitan area: the ATTICA study, Greece.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and educational level seems to be an important determinant of the disease occurrence. The aim of this work was to investigate the association between education status and 10-year incidence of CVD, controlling for various socio-demographic lifestyle and clinical factors. From May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. Education status was measured in years of schooling. The 10-year incidence of CVD was 15.7% [95% confidence intervals (CI) 14.1%-17.4%], 19.7% in men and 11.7% in women (Pgender < 0.001). Age-and gender-adjusted analyses revealed that those with low education (<9 years of schooling) were 1.52 times more likely (95% CI 1.03-2.23%) to have CVD compared with those with high education (>12 years of schooling). People in the low education group had higher prevalence of hypertension, diabetes and dyslipidaemias, were more likely to be smokers and sedentary, had less healthy dietary habits, as compared with those in the high education group. When controlling for participants' medical history, smoking, dietary and lifestyle habits, low education was no longer significantly associated with CVD, illustrating the mediating effect of clinical and behavioural factors in the link between education and disease. It was of interest that low education status interacted with alcohol drinking, enhancing the adverse effect of low education on CVD risk (relative risk 1.44, 95% CI 0.94%-2.20%), after various adjustments made. In this study, it was concluded that low educational level was associated with increased CVD risk. This was mainly explained by the intermediate association of low education with unhealthy choices that consequently worsen clinical status.

Frequency and Characteristics of Suicide “warners” in a Sample of Suicide Victims From Greece

Introduction Suicide completers have often communicated their intention to die or their deep desperation to their loved ones. Methods We retrospectively collected data on the suicide victims of the period 2007-2009 from the Athens Greater Area and completed psychological autopsy questionnaires after phone interviews with the victims' relatives. The specific question was: 'Has your relative expressed to you his/her suffering or the intention to end his/her life the six months prior to the suicide?' Results Data on this parameter were collected for 248 victims -out of a total of 335. 121 of them (48.8%) had verbally communicated their intention to die -or their immense suffering- to their relatives. Suicide 'warners' used phrases indicating extreme desperation being often very descriptive about their intentions. They were older (p Conclusions Relatives are keen observers of the suicidal feelings of their loves ones, a piece of information that health professionals should not miss. This fact, coupled with the particular characteristics of the suicide 'warners', could provide valuable insights for suicide prevention.

A study of the hourly variability of the urban heat island effect in the Greater Athens Area during summer

Measurements of air temperature and humidity in the urban canopy layer during July 2009 in 26 sites in Athens, Greece, allowed for the mapping of the hourly spatiotemporal evolution of the urban heat island (UHI) effect. City districts neighboring to the mountains to the east were the hottest during the afternoon, while being among the coolest during the early morning hours. While during the early morning some coastal sites were the hottest, the warm air plume slowly moved to the densely urbanized center of the city until 14:00–15:00, moving then further west, to the Elefsis industrial area in the afternoon. Results from the UrbClim model agree fairly well with the observations. Satellite-derived land surface temperature (LST) data from AATSR, ASTER, AVHRR and MODIS, for pixels corresponding to ground stations measuring Tair, showed that LST can be up to 5K lower than the respective Tair during nighttime, while it can be up to 15K higher during the rest of the day. Generally, LST during late afternoon as acquired from AATSR is very near to Tair for all stations and all days, i.e., the AATSR LST afternoon retrieval can be used as a very good approximation of Tair. The hourly evolution of the spatial Tair distribution was almost the same during days with NE Etesian flow as in days with sea breeze circulation, indicating that the mean wind flow was not the main factor controlling the diurnal UHI evolution, although it influenced the temperatures attained. No unambiguous observation of the urban moisture excess (UME) phenomenon could be made.

A 2-year psychological autopsy study of completed suicides in the athens greater area, Greece.

ObjectiveTo study the characteristics of a sample of suicide victims from the Athens Greater Area using the psychological autopsy method for the first time in Greece.MethodsWe studied all recorded cases of completed suicide for the 2-year time period November 2007-October 2009 collecting data from the victims' forensic records as well as from the completion of a psychological autopsy questionnaire.Results335 persons were recorded as suicide victims. We contacted relatives of 256 victims interviewing those of 248 of them (96.9%). The differences regarding sex, marital and employment status between our sample and the general population were statistically significant (p<0.001). The male/female ratio was 3:1. Comparatively more victims were divorced, separated or single and a greater proportion were pensioners or unemployed. 26.0% of the victims had history of prior attempts (64.4% once, 20.3% twice and 15.3% more times). 42.6% were taking psychiatric medication-significantly more women than men according to blood tests; 14.2% had been hospitalized in a psychiatric clinic the year prior to their death. 84.8% have deceased at the place of suicide and 15.2% died in the hospital; 80.3% died indoors and 19.7% outdoors. Men died primarily by hanging or shooting by a firearm while women preferred jumping from height instead (p<0.001). As many as 48.8% had expressed their intention to die to their relatives; 26.6% left a suicide note.ConclusionOur study has shown that the psychological autopsy method is applicable and widely accepted yielding results comparable to the international literature. Specific parameters associated with suicide have been studied for the first time in Greece.

Mediterranean diet and cognitive decline over time in an elderly Mediterranean population.

Evidence suggests that dietary patterns compatible with the traditional Mediterranean diet (MD) may protect against cognitive decline. We prospectively assessed whether adherence to MD in the Mediterranean country of Greece is inversely associated with cognitive decline in the elderly and whether any particular MD component may play a key role. Elderly men and women (N = 401) residing in the greater Athens area had dietary variables ascertained in 1994-1999. Adherence to MD was represented by the MD score [MDS, 0-3 (low), 4-5 (intermediate), 6-9 (high)]. The mini-mental state examination (MMSE) was administered by trained professionals to individuals aged 65 years or older in 2004-2006 (first assessment) and re-administered in 2011-2012 (second assessment). MMSE change (cMMSE) was categorized as: improved/unchanged (cMMSE ≥ 0), mildly lower (cMMSE -1 to -4) or substantially lower (cMMSE ≤ -5). Associations were evaluated through multinomial logistic regression. Decline in MMSE performance was inversely associated with adherence to MD. For mild versus no decline, odds ratio (OR) comparing high to low MD adherence was 0.46 [95% confidence interval (CI) 0.25-0.87, p = 0.012]. For substantial versus no decline, OR comparing high to low MD adherence was 0.34 (95% CI 0.13-0.89, p = 0.025). Among the nine MDS components, only vegetable consumption exhibited a significant inverse association with cognitive decline. Closer adherence to the traditional MD is highly likely to protect against cognitive decline in this elderly Mediterranean population. Higher vegetable consumption appears to play a key role, possibly in synergy with additional components of the diet.

Ten-year (2002–2012) cardiovascular disease incidence and all-cause mortality, in urban Greek population: The ATTICA Study

AimThe 10-year incidence of cardiovascular disease (CVD) and all-cause mortality, as well as its determinants, in a sample of men and women from Greece, was evaluated. MethodsFrom May 2001 to December 2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, in Greece, were enrolled. In 2011–12, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to World Health Organization (WHO)–International Coding Diseases (ICD)-10 criteria. ResultsThe 10-year CVD incidence was 19.7% in men and 11.7% in women (p<0.001). Multi-adjusted analysis revealed that the determinants of CVD events were increased age (Hazard ratio (HR) per year=1.06, 95%Confidence Interval (CI): 1.04, 1.08), male sex (HR=1.40, 95%CI: 0.90, 2.19), smoking (HR=1.53, 95%CI: 1.03, 2.27), C-reactive protein levels (HR per 1mg/L=1.06, 95%CI: 1.02, 1.15), as well as adherence to Mediterranean diet (protective) (HR per 1/55 units=0.98, 95%CI: 0.95, 1.01). ConclusionThe burden of CVD and its related risk factors is at emerging rates, in Greece, making the need for effective public health actions, more necessary than ever before.

Energy consumption based on heating/cooling degree days within the urban environment of Athens, Greece

The degree-day method is considered to be a fundamental and a rather simple method to estimate heating and cooling energy demand. This study aims in a detailed and accurate assessment of cooling and heating degree days in different locations within the Greater Athens area (GAA), Greece. To achieve this goal, hourly values of air temperature from eight different locations within the GAA, covering the period 2001–2005, were used. Thus, the monthly and the annual number of cooling and heating degree days for each one of the examined locations could be estimated separately. Furthermore, an effort is made to evaluate the energy consumption for a specific building, based on the degree-day method, to indicate the impact of the canopy layer urban heat island on neighboring regions within the GAA. Results reveal that there is great spatial variability of energy demand and energy consumption along with significant differences in expenses for heating and cooling among neighboring regions within the GAA. Finally, regarding the energy demands of buildings, it is important to take into account intra-urban variability of canopy layer climates against an ensemble mean throughout the city, because the latter can result in inaccurate estimations and conclusions.