Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996–2007 (MEDEA project)

Background: Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996–2001 and 2002–2007. Methods: We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Results: Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996–2001 and 10.9 in 2002–2007), though not so clearly among women (3.3% in 1996–2001 and 2.9% in 2002–2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Conclusions: Preventable mortality decreased between the 1996–2001 and 2002–2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more deprived zones. It is in these deprived zones where actions to reduce and monitor health inequalities should be put into place. Primary healthcare may play an important role in this process.

Stigmatisation of EU mobile citizens: a ticking time bomb for the European project. EPC Commentary, 24 January 2014

The 2013 European Year of Citizens was profoundly marked by escalating attacks against one of the EU’s major achievement for EU citizens: freedom of movement. In April 2013, Home Affairs Ministers from Austria, Germany, the Netherlands and the UK were party to a letter claiming that “a significant number of new immigrants draw social assistance in the host countries, frequently without genuine entitlement, burdening host societies’ social welfare systems”. This letter laid the groundwork for a “battle plan”, presented by David Cameron in November, which aimed to make the free movement of persons “less free” and put forward the idea of capping “EU migration”. Furthermore, in December, the German conservative Christian Social Union (CSU) took up a similar petty political discourse. After the end of the transitional period for Romania and Bulgaria on 1 January 2014, the debate continues with Chuka Umunna (British Labour Party) proposing to restrict the freedom of movement to highly skilled EU citizens and to citizens in possession of a firm job offer. Alongside this, the German Chancellor, Angela Merkel announced the formation of a committee to investigate “poverty migration” in Germany. This wave of resentment has been more recently followed by the UK Prime Minister David Cameron, expressing his intention to re-negotiate EU law in order to be able to withdraw child benefits from EU citizens working in the UK, citing Polish citizens working in the UK as an example. Seeing this as a stigmatisation of the Polish population, the Polish foreign minister, Radosław Sikorski, qualified Cameron’s discourse as “unacceptable”. The debate over limiting freedom of movement has continuously escalated and reached a worrying level. With the EP elections approaching in May 2014, this debate is likely to become worse.

Agriculture, Food and the TTIP: Possibilities and Pitfalls. CEPS Special Report No. 99/December 2014. TTIP Series No. 3 and Paper No. 1 in the CEPS-CTR project “TTIP in the balance’’

Progress in agriculture and food issues in the TTIP talks will largely be determined by the level of ambition in the negotiations as a whole. If ambitions are modest, a low-level agreement could probably be reached that includes some limited commitments on agricultural market access and food regulations. These could include promises of mutual support in the area of opening up agricultural markets through the WTO and of further Transatlantic cooperation in trying to resolve conflicts over food regulations. Bolder ambitions would allow more scope for tackling the difficult problems, though at the cost of time. It would be unfortunate if the opportunity were not taken to make some significant progress in removing some longstanding irritants in the area of agricultural policy and food regulations: this is where the economic gains are likely to be significant and the spill-overs useful. This paper argues the case that it is worthwhile making the effort to secure a constructive and imaginative agreement on agriculture and food regulations in the TTIP. A fairly detailed suggestive list of potential sub-deals in agro-food, supported by the analysis in the paper, is the most concrete one of a series of policy conclusions

This time it’s different: Turbo-charging regulatory cooperation in TTIP. Paper No. 7 in the CEPS-CTR project ‘TTIP in the Balance’ and CEPS Special Report No. 110/June 2015

Regulatory cooperation is both one of the most ambitious and contentious parts of the EU-US Transatlantic Trade and Investment Partnership (TTIP) negotiations. In this paper, having identified the many levels of international regulatory cooperation, we show that TTIP regulatory cooperation will be significant, but not ambitious, while political and legal limits on cooperation in both the EU and the US minimise the concerns. For transatlantic regulatory cooperation to work, it must accept these political and legal constraints, build trust and confidence among counterpart regulators so they see that their transatlantic partner can help them do their work better, and provide tools to help regulators on both sides make informed decisions while retaining their regulatory autonomy and accountability to their politicians and citizens. A TTIP that provides these tools – and some more detailed instruments to that effect – will be more ambitious than previous trade agreements, and should, over the longer term, provide both the economic and regulatory benefits that the two sides envisage. The paper incorporates comparisons with the relevant chapters of recent FTAs the US and the EU have concluded, so as to clarify the approaches and degrees of ambition in this area. This comparison suggests that the TTIP regulatory cooperation will probably be more ambitious in terms of commitments and have a wider scope than any of these FTAs.

Greater TTIP Ambition in Chemicals: Why and how. CEPS Special Report, 28 July 2015. Paper No. 10 in the CEPS-CTR project ‘TTIP in the Balance’ and CEPS Special Report No. 114/July 2015.

To date, the negotiations over chemicals in the Translatlantic Trade and Investment Partnership (TTIP) have not shown sufficient ambition. The talks have focused too much on the differences in the two ‘systems’, rather than on the actual levels of health and environmental protection for substances regulated by both the US and the EU. Given the accomplishments within the OECD and the UN Globally Harmonised System of Classification and Labelling of Chemicals (GHS), the question is whether TTIP can be any more ambitious in the area of chemicals? We find that there is no detailed or systematic knowledge about how the two levels of protection in chemicals compare, although caricatures and stereotypes abound. This is partly due to an obsessive focus on a single US federal law, the Toxic Subtances Control Act (TSCA), whereas in practice US protection depends on many statutes and regulations, as well as on voluntary withdrawals (under pressure from the Environmental Protection Agency) and severe common law liability. This paper makes the economic case for firmly addressing the regulatory barriers, discusses the EU’s proposals, finds that the European Parliament’s Resolution on TTIP of July 2015 lacks a rationale (for chemicals), argues that both TSCA and REACH ought to be improved (based on ‘better regulation’), discusses the link with a global regime, advocates significant improvement of market access where equivalence of health and environmental objectives is agreed and, finally, proposes to lower the costs for companies selling in both markets by allowing them to opt into the other party’s more stringent rules, thereby avoiding duplication while racing-to-the-top. The ‘living agreement’ on chemicals ought to be led by a new TTIP institution authorised to establish the level of health and environmental protection on both sides of the Atlantic for substances regulated on both sides. These findings will lay the foundation for a highly beneficial lowering of trading costs without in any way affecting the level of protection. Indeed, this is exactly what TTIP is, or should be, all about.This paper is the 10th in a series produced in the context of the “TTIP in the Balance” project, jointly organised by CEPS and the Center for Transatlantic Relations (CTR) in Washington, D.C. It is published simultaneously on the CEPS (www.ceps.eu) and CTR websites (http://transatlantic.sais-jhu.edu).

Energising the TTIP: Political economy of the trade policy rationale. Paper No. 9 in the CEPS-CTR project “TTIP in the Balance’’and CEPS Special Report No. 113/July 2015

Despite accounting for a significant share of global trade and the resulting interdependencies from it, energy governance remains largely fragmented and there is no global framework or agreement defining the rules of energy trade. This paper, after presenting the main global and regional energy market developments, discusses the opportunities to ‘energise the TTIP’, i.e. to include a chapter dedicated to trade and cooperation in the sphere of energy. The shale revolution in the US, the ever-rising interconnectedness of energy markets (recently proven by the disappearance of the ‘Asian gas premium’) and the EU’s quest to diversify its energy supplies generally sets favourable conditions to reinforce energy relations between the EU and the US. The question, as is often the case, is whether there is sufficient political will to tighten relations in a strategic sphere with connotations for national security and sovereignty.

The Transatlantic Trade and Investment Partnership: Challenges and Opportunities for Consumer Protection. Paper No. 11 in the CEPS-CTR project ‘TTIP in the Balance’ and CEPS Special Report No. 115/July 2015

This paper examines options for regulatory cooperation in the Transatlantic Trade and Investment Partnership (TTIP) and assesses the challenges and opportunities posed by regulatory cooperation for consumer protection. It looks at existing approaches to regulatory cooperation by referencing a range of case studies. Based on established practice and on the European Commission’s recently published proposal on regulatory cooperation, we discuss a possible approach that could be adopted in the TTIP. Against the significant potential gains from improved regulatory cooperation, one must set the significant challenges of reconciling the different regulatory philosophies of the US and the EU as well as some differences in their respective approaches to cooperation. In broad terms, this analysis finds that regulatory powers on both sides of the Atlantic will not be significantly affected by the TTIP, but suggests that European and American legislators will need to ensure that their priorities shape the TTIP regulatory cooperation agenda and not the other way around.

Quantifying Non-Tariff Measures for TTIP. Paper No. 12 in the CEPS-CTR project ‘TTIP in the Balance’ and CEPS Special Report No. 116/July 2015

This paper provides an overview of methods employed to quantify non-tariff measures (NTMs) and then analyses their differences and looks at what these mean for the Transatlantic Trade and Investment Partnership (TTIP) negotiations. The authors find several similarities in the approaches taken. Because all studies conclude that NTMs matter, they argue that policy-makers are right to focus on ‘regulatory cooperation’ in TTIP. Given the significant differences in NTMs across sectors, policy-makers are urged to dive deep into sector-specific elements of NTMs and focus on those sectors where the largest potential gains can be made (i.e. where NTMs are highest, such as in agriculture, automobiles, steel, textiles and insurance services). An area identified for further research is the fact that unlike trade taxes (i.e. tariffs), regulatory barriers to trade are not generally targeted as the primary policy objective, but rather stem from other strategic policy concerns such as consumer safety and/or social and environmental protection. This element should be further investigated.

Compilation of results of the STRATAGEM project as ISO-image of the final CD-ROM

The study of the Neogene (Miocene to Holocene) stratigraphic record on the glaciated Atlantic margin of NW Europe has, to date, largely been undertaken on an ad-hoc basis. Whereas a systematic approach to understanding the stratigraphic development of Palaeogene and older strata has been undertaken in areas such as the North Sea, West of Shetland and Norway, the problem of establishing a Neogene framework has been only partly addressed by academia and the oil industry. In most cases where a Neogene stratigraphy has been constructed, this has been largely in response to problem solving and risk assessment in a restricted area. Nevertheless, in the past few years it has become increasingly apparent that there is a common history in the Neogene development of the passive Atlantic margin of NW Europe, between mid-Norway and SW Ireland. The inspection and interpretation of an extensive geophysical and geological database has identified several regionally significant and correlatable unconformities along this continental margin. Thus, a regional approach to the stratigraphical development of the Neogene succession on the glaciated European Atlantic margin is undertaken in this volume.

(Table 1) Major and trace elements analyses from FAMOUS-Project and DSDP Site 54-424

Hydrothermal deposits "sensu stricto" have been recovered during the FAMOUS cruise and Leg 54 of the Deep Sea Drilling Project near the Galapagos Spreading Centre. The studied sediments, mainly composed of clay material, have very poor REE concentrations, below about ten ppm. The shale-normalized patterns are characterized by a significant enrichment in heavy rare earths and show a negative Ce anomaly. The magnitude of this anomaly fluctuates but is generally lower than the seawater Ce anomaly. The geochemical characteristics of these hydrothermal deposits are in contrast with those of metalliferous sediments which are more enriched in trace elements, especially in REE.

Evaluation of incremental allocation alternatives for the prevention of significant deterioration in Illinois /

Project no. 10.096.

Evaluation of the Western Australian Department of Health telehealth project

In 1999, the Department of Health in Western Australia began a telehealth project, which finished in 2004. The 75 videoconferencing sites funded by the project were part of a total state-wide videoconference network of 104 sites. During the period from January 2002 to December 2003, a total of 3266 consultations, case reviews and patient education sessions took place. Clinical use grew to 30% of all telehealth activity. Educational use was approximately 40% (1416 sessions) and management use was about 30% (1031 sessions). The average overhead cost per telehealth session across all regions and usage types was $A192. Meaningful comparisons of the results of the present study with other public health providers were difficult, because many of the available Websites on telehealth were out of date. Despite the successful use of telehealth to deliver clinical services in Western Australia, sustaining the effort in the post-project phase will present significant challenges.

A visiting occupational therapy service to indigenous children in school: Results of a pilot project

The need for additional support for Indigenous children at school is well documented. Occupational therapists are well positioned to form part of this support. However, many occupational therapists report that Indigenous families do not access their services and when they do, the occupational therapist feels uncertain about how best to meet their needs. This article documents a pilot project which delivered occupational therapy services within several schools and preschools in Brisbane which had significant numbers of Indigenous students. The project was evaluated using a qualitative methodology and included focus groups and interviews with teachers and parents. The results indicated that in general the service provided valuable support to students, teachers and parents. In particular, providing the service within the school context was seen as critical to its success. Suggestions for improvements in future support services are also provided.

Balancing curriculum processes and content in a project centred curriculum - In pursuit of graduate attributes

Chemical engineering education is challenged around the world by demands and rapid changes encompassing a wide range of technical and social drivers. Graduates must be prepared for practice in increasingly diverse workplace environments in which generic or transferable attributes such as communication and teamwork together with technical excellence are mandated by prospective employers and society at large. If academe is to successfully deliver on these graduate attributes, effective curriculum design needs to include appropriate educational processes as well as course content. Conventional teacher centred approaches, stand-alone courses and retro-fitted remedial modules have not delivered the desired outcomes. Development of the broader spectrum of attributes is more likely when students are engaged with realistic and relevant experiences that demand the integration and practice of these attributes in contexts that the students find meaningful. This paper describes and evaluates The University of Queensland's Project Centred Curriculum in Chemical Engineering (PCC), a programme-wide approach to meeting these requirements. PCC strategically integrates project-based learning with more traditional instruction. Data collected shows improved levels of student attainment of generic skills with institutional and nationally benchmarked indicators showing significant increases in student perceptions of teaching quality, and overall satisfaction with the undergraduate experience. Endorsements from Australian academic, professional and industry bodies also support the approach as more effectively aligning engineering education with professional practice requirements.

A community leadership web site project: Sustainability and other issues

This paper reports on an ongoing partnership between Queensland University of Technology and Volunteering Queensland regarding the development and revision of a website for community leaders. The website, designed in late 2003, was established to provide a range of learning activities for community leaders including a problem based learning activity, case studies of community leaders and a range of resources deemed significant for leaders in the community. To date, anecdotal evidence as well as some more hard evidence (i.e. number of visits to the site), indicates that the site appears to be a valuable resource for community leaders. The purpose of this paper was firstly to investigate the utility of the site and secondly to consider some bigger issues concerning its sustainability. To achieve this, the paper explores the perceptions of (i) a group of community leaders regarding the strengths and weaknesses of the site; and (ii) key stakeholders (from QUT and Volunteering Queensland) who participated in a focus group discussion to consider important issues relating to its management and sustainability. Themes emerging from the two groups are provided and implications for small scale partnership projects such as this one are discussed.