Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain)

Background: Assessing of the costs of treating disease is necessary to demonstrate cost-effectiveness and to estimate the budget impact of new interventions and therapeutic innovations. However, there are few comprehensive studies on resource use and costs associated with lung cancer patients in clinical practice in Spain or internationally. The aim of this paper was to assess the hospital cost associated with lung cancer diagnosis and treatment by histology, type of cost and stage at diagnosis in the Spanish National Health Service. Methods: A retrospective, descriptive analysis on resource use and a direct medical cost analysis were performed. Resource utilisation data were collected by means of patient files from nine teaching hospitals. From a hospital budget impact perspective, the aggregate and mean costs per patient were calculated over the first three years following diagnosis or up to death. Both aggregate and mean costs per patient were analysed by histology, stage at diagnosis and cost type. Results: A total of 232 cases of lung cancer were analysed, of which 74.1% corresponded to non-small cell lung cancer (NSCLC) and 11.2% to small cell lung cancer (SCLC); 14.7% had no cytohistologic confirmation. The mean cost per patient in NSCLC ranged from 13,218 Euros in Stage III to 16,120 Euros in Stage II. The main cost components were chemotherapy (29.5%) and surgery (22.8%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs but an increase in chemotherapy costs. In SCLC patients, the mean cost per patient was 15,418 Euros for limited disease and 12,482 Euros for extensive disease. The main cost components were chemotherapy (36.1%) and other inpatient costs (28.7%). In both groups, the Kruskall-Wallis test did not show statistically significant differences in mean cost per patient between stages. Conclusions: This study provides the costs of lung cancer treatment based on patient file reviews, with chemotherapy and surgery accounting for the major components of costs. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain.

Impacts of climate change on water resources in the Mediterranean basin : a case study in Catalonia, Spain

Most climate change projections show important decreases in water availability in the Mediterranean region by the end of this century. We assess those main climate change impacts on water resources in three medium-sized catchments with varying climatic conditions in north-eastern Spain. A combination of hydrological modelling and climate projections with B1 and A2 IPCC emission scenarios is performed to infer future stream flows. The largest reduction (22-48% for 2076-2100) of stream flows is expected in the headwaters of the two wettest catchments, while lower decreases (22-32% for 2076-2100) are expected in the drier one. In all three catchments, autumn and summer are the seasons with the most notable projected decreases in stream flow, 50% and 34%, respectively (2076-2100). Thus, ecological flows might be noticeably impacted by climate change in the catchments, especially in the headwaters of those wet catchments.

Technological trampolines for new venture creation in Catalonia: the case of the University of Girona

Recent trends in technology transfer show an intensification of spin-off creation as a modality of university research commercialisation, complementary to the conventional ones, contract research and licensing. In this paper we analyse the evolution, objectives, resources and activities of a specialised unit –Technological Trampoline (TT) - in charge of new venture creation at the University of Girona (Catalonia-Spain). Based on two theoretical frameworks, Resource-based-view and Institutional Theory, we adopt a multi-dimensional approach to study the strategy of spinning-off new ventures at the University of Girona in terms of resources and activities, how this process is organised and if the outputs fit with this UdG’s objectives and the local environment. Our main contribution is an in-depth analysis of the spin-off creation unit with special emphasis on its variety of resources and activities. The results have a series of implications and recommendations at both university and TT level.

The Total fiscal cost of indirect taxation: an approximation using Catalonia's recent input-output table

In this note we quantify to what extent indirect taxation influences and distorts prices. To do so we use the networked accounting structure of the most recent input-output table of Catalonia, an autonomous region of Spain, to model price formation. The role of indirect taxation is considered both from a classical value perspective and a more neoclassical flavoured one. We show that they would yield equivalent results under some basic premises. The neoclassical perspective, however, offers a bit more flexibility to distinguish among different tax figures and hence provide a clearer disaggregate picture of how an indirect tax ends up affecting, and by how much, the cost structure.

Political elites in federalized countries: the case of Spain (1980-2005)

This paper explores the social profile of the regional elite that has emerged in Spain since the federalization of the State. For the first time, researchers present data about crucial variables like gender, place of birth, age, education, and profession. They make interregional comparisons, and try to explain some unexpected findings like the behavior of political elites in some regions like Catalonia. The authors compare also the social profile of MPs of the two largest parties.

Modelling of bird distribution under complex mediterranean landscape dynamics: open habitat birds and fire (MEDFIRE)

Report for the scientific sojourn at the Simon Fraser University, Canada, from July to September 2007. General context: landscape change during the last years is having significant impacts on biodiversity in many Mediterranean areas. Land abandonment, urbanisation and specially fire are profoundly transforming large areas in the Western Mediterranean basin and we know little on how these changes influence species distribution and in particular how these species will respond to further change in a context of global change including climate. General objectives: integrate landscape and population dynamics models in a platform allowing capturing species distribution responses to landscape changes and assessing impact on species distribution of different scenarios of further change. Specific objective 1: develop a landscape dynamic model capturing fire and forest succession dynamics in Catalonia and linked to a stochastic landscape occupancy (SLOM) (or spatially explicit population, SEPM) model for the Ortolan bunting, a species strongly linked to fire related habitat in the region. Predictions from the occupancy or spatially explicit population Ortolan bunting model (SEPM) should be evaluated using data from the DINDIS database. This database tracks bird colonisation of recently burnt big areas (&50 ha). Through a number of different SEPM scenarios with different values for a number of parameter, we should be able to assess different hypothesis in factors driving bird colonisation in new burnt patches. These factors to be mainly, landscape context (i.e. difficulty to reach the patch, and potential presence of coloniser sources), dispersal constraints, type of regenerating vegetation after fire, and species characteristics (niche breadth, etc).

Testing low-altitude infrared digital photography from a mini-UAV to retrieve information for biological conservation

Satellite remote sensing imagery is used for forestry, conservation and environmental applications, but insufficient spatial resolution, and, in particular, unavailability of images at the precise timing required for a given application, often prevent achieving a fully operational stage. Airborne remote sensing has the advantage of custom-tuned sensors, resolution and timing, but its price prevents using it as a routine technique for the mentioned fields. Some Unmanned Aerial Vehicles might provide a “third way” solution as low-cost techniques for acquiring remotely sensed information, under close control of the end-user, albeit at the expense of lower quality instrumentation and instability. This report evaluates a light remote sensing system based on a remotely-controlled mini-UAV (ATMOS-3) equipped with a color infra-red camera (VEGCAM-1) designed and operated by CATUAV. We conducted a testing mission over a Mediterranean landscape dominated by an evergreen woodland of Aleppo pine (Pinus halepensis) and (Holm) oak (Quercus ilex) in the Montseny National Park (Catalonia, NE Spain). We took advantage of state-of-the-art ortho-rectified digital aerial imagery (acquired by the Institut Cartogràfic de Catalunya over the area during the previous year) and used it as quality reference. In particular, we paid attention to: 1) Operationality of flight and image acquisition according to a previously defined plan; 2) Radiometric and geometric quality of the images; and 3) Operational use of the images in the context of applications. We conclude that the system has achieved an operational stage regarding flight activities, although with meteorological limits set by wind speed and turbulence. Appropriate landing areas can be sometimes limiting also, but the system is able to land on small and relatively rough terrains such as patches of grassland or short matorral, and we have operated the UAV as far as 7 km from the control unit. Radiometric quality is sufficient for interactive analysis, but probably insufficient for automated processing. A forthcoming camera is supposed to greatly improve radiometric quality and consistency. Conventional GPS positioning through time synchronization provides coarse orientation of the images, with no roll information.

Water scarcity, social power and the production of an elite suburb: the political ecology of water in Matadepera, Catalonia

This article investigates the history of land and water transformations in Matadepera, a wealthy suburb of metropolitan Barcelona. Analysis is informed by theories of political ecology and methods of environmental history; although very relevant, these have received relatively little attention within ecological economics. Empirical material includes communications from the City Archives of Matadepera (1919-1979), 17 interviews with locals born between 1913 and 1958, and an exhaustive review of grey historical literature. Existing water histories of Barcelona and its outskirts portray a battle against natural water scarcity, hard won by heroic engineers and politicians acting for the good of the community. Our research in Matadepera tells a very different story. We reveal the production of a highly uneven landscape and waterscape through fierce political and power struggles. The evolution of Matadepera from a small rural village to an elite suburb was anything but spontaneous or peaceful. It was a socio-environmental project well intended by landowning elites and heavily fought by others. The struggle for the control of water went hand in hand with the land and political struggles that culminated – and were violently resolved - in the Spanish Civil War. The displacement of the economic and environmental costs of water use from few to many continues to this day and is constitutive of Matadepera’s uneven and unsustainable landscape. By unravelling the relations of power that are inscribed in the urbanization of nature (Swyngedouw, 2004), we question the perceived wisdoms of contemporary water policy debates, particularly the notion of a natural scarcity that merits a technical or economic response. We argue that the water question is fundamentally a political question of environmental justice; it is about negotiating alternative visions of the future and deciding whose visions will be produced.

Els primers llums del Delta

Treball de recerca realitzat per un alumne d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. El treball és un estudi de l’evolució, tan tècnica com estètica dels fars paral•lela als avenços tecnològics i prenent com a protagonistes els singulars fars de ferro que es varen construir durant la segona meitat del segle XIX i varen funcionar durant un llarguíssim període en el delta de l’Ebre. L’estructura de ferro, ancorada directament sobre les sorres del delta va donar un caràcter especial a aquestes construccions que, d’altra banda, constituïen una tipologia única a Catalunya i a Espanya. Aquests fars van rebre el nom del lloc on foren ubicats estratègicament. De sud a nord: far de la Banya, far de Buda i far del Fangar. Els van projectar conjuntament, es van encendre per primera vegada el mateix dia, van ser l’habitatge dels seus faroners, van anar evolucionant tècnicament tots tres però el final de cadascun d’ells va ser molt diferent. La història dels fars de ferro ha anat lligada al paisatge i la vida d’aquestes singulars terres del Delta i després de més d’un segle de servei foren substituïts per altres que estèticament i tècnicament res tenen a veure amb els seus antecessors.

Association between HIV status and HIV knowledge in the population attending Non-Governmental Organizations to perform the rapid HIV test in Catalonia

Human Immunodeficiency Virus continues to be a pandemic. Spain is one of the European countries with the highest incidence of HIV. Within Catalonia, Spain many projects have been implemented with the intention of improving HIV knowledge and lowering the incidence. HIV knowledge is also known to have a positive effect on lowering stigma and discrimination of the people living with HIV. However, few studies study the distribution of HIV knowledge and its association to HIV status, age, sex, geographical zone of origin and level of education within the same study. Objectives: To identify if HIV knowledge is associated with HIV status, age, sex, geographical zone of origin and level of education. Method: Quantitative, cross-sectional, centre-based study comprising of people receiving an HIV test in Catalonia, Spain. Data will be collected from the 11 HIV Non-Governmental Organisations in Catalonia, Spain. The Brief HIV Knowledge Scale will be used to assess HIV knowledge; information from the HIV test session will be used to assess HIV status, age, sex, geographic zone of origin and level of education. The association between HIV knowledge and the afore mentioned variables will then be calculated.

Proposta de desenvolupament urbanístic per un municipi turístic de la Costa Brava : pla parcial evolutiu i d’ús mixt al municipi de Calonge

Anàlisi de les pautes de creixement que han seguit els municipis turístics de la Costa Brava a fi i efecte de proposar un nou model de desenvolupament per la demanda creixent de sòl i allotjament. Tenint en compte la incertesa del sector turístic, es pretén repensar el model actual de tendència a l’especialització en segona residència mitjançant un cas pràctic de planejament urbanístic de caràcter mixt (residencial, comercial i hoteler), transformable i evolutiu

Projecte d'instal·lacions ecoeficients d'un habitatge bioclimàtic

L'objectiu del projecte és dissenyar i dimensionar les instal·lacions d’un habitatge unifamiliar aïllat bioclimàtic i d’eficiència ecològica al terme municipal de Rabós d’Empordà. La finca on es vol construir l’habitatge està pendent de formar part de l’ampliació de la Xarxa Ecològica Europea Natura 2000, que inclou el Paratge Natural de les Alberes. Per això, en aquest projecte s’ha posat molt èmfasi en l’impacte paisatgístic i el respecte al medi ambient. La finca només disposa de connexió a la xarxa elèctrica a través d’una línia aèria, paral·lela a la carretera, i un pou de captació d’aigua, amb capacitat suficient per abastar l’habitatge

Art i Baix Ter : artistes actuals i paisatge

Aquest projecte de recerca proposa un estudi emmarcat en la realitat actual de lazona geogràfica del Baix Ter enfocat des d’un prisma transversal que col·labori a feraflorar noves reflexions sobre el territori i el paisatge a partir d’algunes de les aportacionsque s’estan produint des de les arts plàstiques.La investigació pretén omplir un buit historiogràfic existent pel que fa alpatrimoni d’art contemporani de la zona, tenint en compte la notorietat de la sevariquesa cultural i artística. Es proposa analitzar algunes de les figures artístiques mésrellevants que hi treballen i seleccionar d’aquelles que treballin més directament sobre elterritori, el paisatge i la formació de nous valors al seu entorn

Al di là del fiume - attraverso il fiume: il basso corso del Ter in Catalogna

La ricerca prende in considerazione dal punto di vista dell’architettura e dell’urbanistica la relazione tra la città e il fiume che la attraversa o la lambisce; l’insediamento umano viene analizzato nel contesto del bacino idrografico al quale appartiene. La ricerca è stata sviluppata in seno alla tesi dottorale ora in fase di elaborazione presso il Departamento de Urbanismo y Ordenación del Territorio dell’Universidad Politecnica de Catalunya. La tesi ha come caso studio il tratto basso del fiume Ter in Catalogna. Nella discussione sul paesaggio urbano contemporaneo oggi la riflessione è centrata sulla città che si territorializza; la dimensione urbana interferisce con gran parte della superficie della terra facendo sfumare le tradizionali distinzioni tra urbano e non-urbano, tra spazio costruito e spazio aperto. In questo contesto, quale termine di conciliazione tra la dinamica naturale e la costruzione storica dei luoghi prodotta dall’intervento umano, il fiume si rivela uno strumento essenziale di analisi e progetto. L’obiettivo di questa ricerca è suggerire un’approssimazione al progetto della città che si sviluppa lungo il corso fluviale costruendo strumenti per la riflessione “attraverso il fiume”. Partendo dall’ipotesi che la città si insedia lungo un corso d’acqua secondo una sintassi territoriale stabilita dalla geografía e dalla geomorfologia del fiume stesso, il fine è fornire strumenti per il processo di recupero degli spazi fluviali in contesti urbanizzati. Il fiume diviene componente geografica chiave degli insediamenti dispersi e risorsa per costruirne l’abitabilità.

Contextual effects on subjective national identity and nationalist vote in Catalonia

The important inflow of foreign population to western countries has boosted the study of acculturation processes among scholars in the last decades. By using the case of Catalonia, a receiver region of international and national migration since the fifties, this paper seeks to intersect a classic acculturation model and a newly reemerging literature in political science on contextual determinants on individual behavior. Does the context matters for understanding individual’s subjective national identity and, therefore, its voting behavior? Multilevel models show that environment matters. Percentage of Spain-born population in the town is statistically significant to account for variance in the subjective national identity and nationalist vote, even after controlling for age, sex, origin, language and left – right orientation and other contextual factors. This conclusion invites researchers not to underestimate the direct effect of the environment on individual outcomes such as feelings of belonging and vote orientation in contexts of rival identities.