Empowering Medical Professionals to Help Victims of Trafficking

Purpose: to provide commentary of two review articles that discuss the role of medical professionals in combating human trafficking: “Health Care Providers' Training Needs Related to Human Trafficking: Maximizing the Opportunity to Effectively Screen and Intervene” by Isaac, Solak, and Giardino, and “Human Trafficking: What is the Role of the Health Care Provider?” by Crane and Moreno. Findings: Both articles provide a good introduction and explanation of the psychosocial and medical issues faced by many trafficking victims; however, they succeed only to varying degrees in describing all the gaps in the medical system and the vital next steps forward. Conclusion: The key next steps in the fight against human trafficking include: multidisciplinary teams need to improve coordination on all forms of human maltreatment; schools for all medical professions and social work need to significantly strengthen their curriculum on diagnosing and treating human maltreatment; and groups that provide training on human trafficking should partner with other agencies and organizations that provide training on child maltreatment and domestic violence.

Health, education and community: Assets and needs of a small urban community in north east Tamaulipas, Mexico: A community based participatory research assessment

This study explored the health, education, social assets, needs, attitudes, and behaviors of residents of Ferrocarril #4, a small urban community in Tamaulipas, Mexico. A collaborative Participatory Action Research approach was used to emphasize community involvement. Using Triangulation to ensure validity, qualitative methods included key informant in depth interviews, participant observation and participatory discussion groups with women and men. A personal interview with a probability sample of women was done. The median age of interviewees was 37 years. The majority was married or had a partner. Over half of respondents completed grades 6-9. Employed women (25%) earned a median weekly salary equivalent to ∼56 USD. Women with health insurance (67.7%) were covered mainly through Social Security and Seguro Popular. One in 5 reported bad health. Barriers to care were primarily money and transportation. To improve health care, women wanted a full service clinic in or close to the community and affordable health care. Socially, 28% of respondents had no close friends in the community and most did not participate in beneficial community activities. Many women did not socialize with others and help from neighbors was situational. Primary school teachers lacked parental support and it interfered with classroom efforts. Healthy community discussion groups focused on personal and environmental hygiene and safety. Valuable assets exist in the community. To date, collaborative efforts resulted in a school First Aid station, a school nurse visit weekly, posting of emergency contact phone numbers in the school and community center, and development of a student health information form. ^

Texas laboratory healthcare workforce: Meeting the needs in 2015

The purpose of this research was to study groups of students and young professionals in the clinical laboratory science field using exploratory discovery and inductive logic regarding the attitudes of four groups in Texas: (1) 3rd and 4th year college biology students, (2) students currently enrolled in Clinical Laboratory Science/Clinical Laboratory Technician (CLS/CLT) programs, (3) young CLS/CLT professionals (1-2 years post education), and (4) mid-career CLS/CLTs (4-10 years post education). It was also a comparative study looking at these four groups and their attitudes and perception regarding: career selection factors and legislative incentive measures which might attract individuals to an allied health care career, the field of practice and factors needed to keep individuals in the chosen field of practice. ^ The study found that the career is attractive to individuals who enjoy laboratory work and find the various areas in which to choose to work very attractive. Government programs offering grants/scholarships or loan forgiveness programs offered by health care institutions would be beneficial in attracting students to study in the clinical laboratory sciences. Students are unsure if there is a viable career ladder associated with the field and are anticipating the possibility of going on to other fields in the future. ^ While young and mid-career professionals share many of the same points of view on some aspects (skills used, trends) of the CLS/CLT profession there were a few areas were opinions diverged; perceptions of the field itself and if they plan to remain in the profession for the next 5 years. The mid-career professionals had a much more negative outlook on the profession (low salary, no visible career ladder, lack of respect from other health care professionals) and only a small number plan to be in the field within the next 5 years. ^ The lower salaries in the profession as compared to other similar health care careers, lack of a career ladder and lack of respect from laboratory and institutional management and other health care providers are critical missing pieces to the retention of CLS/CLT professionals. ^

DISEASE-RELATED INFORMATION NEEDS OF CANCER PATIENTS AGES 11-20: A COMPARISON OF PATIENT-PARENT AND PATIENT-PHYSICIAN PERCEPTIONS

Innovative, aggressive treatments and prolonged survival rates for patients with childhood cancers have placed new demands on the patient, parent and physician. As a result, counterproductive coping behaviors are often noted in adolescent cancer patients.^ One of the main ways the environment is manipulated by the individual to achieve personal comfort is through selectivity of information. An individual will usually pull the support personally needed to cope from the environment if sufficient resources are available. However, information provided young cancer patients is often filtered through the physicians and parents perspectives of the patient's needs without systematic input from the patient. In order to ensure that adequate information resources are available to help teenage patients cope with their illness, health professionals must have insights into the information needs of those patients. No previous efforts to address this subject were found in the literature.^ This study was designed to identify adolescent perspectives of their disease-related information needs and to compare their viewpoints with those of their parents and physicians. Sixty-five outpatient cancer patients (ages 11-20) receiving treatment at the University of Texas M. D. Anderson Hospital and Tumor Institute in Houston, Texas, 60 of their parents, and 53 physicians, who were involved in the treatment of pediatric patients at M. D. Anderson, were asked to complete self-administered questionnaires. The questionnaires used were developed, administered and analyzed by the investigator. Specific areas addressed in the questionnaires included: Perceptions of cancer-related tests and treatments, the importance of 30 disease-related items of information, responses evoked by receipt of information, current and preferred sources of information, delivery of information at the time of diagnosis, and disease-related information requested for patients, family, friends and teachers.^ Adolescent perceptions of their information needs and their preferences for delivery of information were determined. The relationships between patient-parent and patient-physician perceptions were then analyzed to determine areas in which agreements and disparities in viewpoint existed. Programmatic and research recommendations were then provided.^ Hopefully, through these efforts, the adolescent patient will be helped to receive relevant information support from those deemed to be most important to his/her efforts to cope with cancer. ^

Cancer screening behaviors among Asian Americans in Houston, Texas

Background: Cancer is the second-leading cause of death in the United States, and Asian Americans/Pacific Islanders are the only racial/ethnic group for which cancer is the leading cause of death. Regular cancer screenings help to identify precancerous lesions and cancer at an earlier stage, when the cancer is more treatable. Ethnic disparities in participation in cancer screenings are also striking, and evidence indicates that Asian Americans may have lower rates of cancer screening participation than other racial/ethnic groups. The Health of Houston Survey 2010 (HHS 2010) is an address-based survey, administered via telephone, website, and mail, of over 5,000 respondents in Houston and Harris County that provides recent data on the health status and needs of the Houston community. HHS 2010 researchers oversampled for Asians and Vietnamese Americans in order to obtain a sample size large enough to obtain statistical power. This dataset provides a unique opportunity to examine the cancer screening behaviors and predictors of Vietnamese and Chinese Americans living in Houston, Texas.^ Methods: This study was a secondary data analysis of HHS 2010 data. The data were analyzed to compare the breast, cervical, and colorectal cancer screening compliance rates of Vietnamese and Chinese Americans with other racial/ethnic groups in Houston, Texas. Key predictors of participation and barriers to cancer screening were identified.^ Results: The results of this study indicate that in Houston, Vietnamese Americans and Asian Americans as a whole have strikingly lower rates of participation in cancer screenings compared to other ethnic groups. Chinese Americans had the highest rate of noncompliance for mammography of all ethnic groups; Asian Americans and Vietnamese Americans also had high rates of noncompliance. Similarly, Vietnamese and Asian Americans had high rates of noncompliance with colorectal cancer screening recommendations. Importantly, Vietnamese, Chinese, and Asian Americans had by far the worst pap test participation, with noncompliance rates more than double that of all other racial/ethnic groups. In general, the findings indicated several key predictors in cancer screening behaviors, including English language proficiency, years lived in the United States, health insurance, college education, and income; however, the significance and patterns of these variables varied by ethnic group as well as cancer site.^ Conclusions: This secondary analysis highlights the disparities in cancer screening participation among Vietnamese, Chinese, and Asian Americans in Houston, Texas and indicate the need to identify Asian Americans as a high-risk group in need of health promotion attention. Barriers to screening and educational needs appear to be specific to each target ethnic group. Thus, health educators and health professionals in Houston must focus on the specific educational needs of the key ethnic groups that make up the Houston population. Further, more ethnic-specific research is needed to examine the health behaviors and needs of Houston's Asian American subgroups.^

Reporting experiments to satisfy professionals’information needs

Although the aim of empirical software engineering is to provide evidence for selecting the appropriate technology, it appears that there is a lack of recognition of this work in industry. Results from empirical research only rarely seem to find their way to company decision makers. If information relevant for software managers is provided in reports on experiments, such reports can be considered as a source of information for them when they are faced with making decisions about the selection of software engineering technologies. To bridge this communication gap between researchers and professionals, we propose characterizing the information needs of software managers in order to show empirical software engineering researchers which information is relevant for decision-making and thus enable them to make this information available. We empirically investigated decision makers? information needs to identify which information they need to judge the appropriateness and impact of a software technology. We empirically developed a model that characterizes these needs. To ensure that researchers provide relevant information when reporting results from experiments, we extended existing reporting guidelines accordingly. We performed an experiment to evaluate our model with regard to its effectiveness. Software managers who read an experiment report according to the proposed model judged the technology?s appropriateness significantly better than those reading a report about the same experiment that did not explicitly address their information needs. Our research shows that information regarding a technology, the context in which it is supposed to work, and most importantly, the impact of this technology on development costs and schedule as well as on product quality is crucial for decision makers.

Análisis de la cadena de valor, canales cortos de comercialización y horticultura multifuncional como opciones de puesta en valor: Caso de la Huerta de Aranjuez

La Vega de Aranjuez ha sido desde hace siglos conocida por la notoriedad de sus jardines y huertas históricas y también, en épocas más recientes, por ser la despensa de Madrid. A mediados del siglo XX, sin embargo, con las transformaciones que el sector agrario ha experimentado no sólo a nivel local, sino a escala global, empezó un proceso de declive que se ha acentuado en los últimos años. Paralelamente, en el año 2001, la Unesco declara el Paisaje Cultural de Aranjuez, como Patrimonio de la Humanidad con un valor universal excepcional. Parte de lo que sustenta este reconocimiento a nivel internacional radica en las peculiaridades del paisaje que conforma la actividad agraria. El cambio de orientación, eminentemente hortofrutícola hacia cultivos extensivos y superficies en barbecho, y la pérdida de importancia del sector, no han pasado desapercibidos para la administración local y han sido varios los intentos de recuperación y dinamización del sector en los últimos años. La investigación de la que es objeto esta Tesis Doctoral surgió por iniciativa del Ayuntamiento de Aranjuez, que en al año 2010 deseó conocer la situación del sector hortícola en el municipio, para lo cual, encargó un estudio a la UPM-ETSIA. Para conocer la realidad desde una perspectiva integral, se planteó abordar el análisis desde la perspectiva de Cadena de Valor. Las implicaciones de este concepto, su evolución y su papel como instrumento de análisis de la cadena alimentaria, han sido revisadas y presentadas en el epígrafe del Marco Conceptual. Por cadena de valor se entiende el conjunto de procesos desde el consumidor, a través de los proveedores que proporcionan productos, servicios e información que añaden valor hacia los clientes (Lambert & Cooper, 2000; Chen, 2004). Para el análisis de la situación del sector hortícola en Aranjuez, se procedió en varios pasos, los cuales constituyeron la primera fase de la investigación y contemplaron lo siguiente: 1. La identificación de los problemas y de las demandas de los actores de la cadena, realizando cortes transversales en el mercado a distintos niveles para conocer los puntos de vista de los operadores de la cadena (Gunasekaran & Patel ,2004; Rojas, 2009; Schiefer, 2007). Para ello se diseñaron cuestionarios y se dirigieron a representantes de cinco eslabones de la cadena presentes en el caso de estudio: Agricultores (15), Mayoristas (11), Detallistas (55), Consumidores (85) y Restaurantes (36), tanto en Aranjuez como en Madrid (un total de 202). 2. Análisis D.A.F.O de cada uno de los eslabones y de la cadena completa, como herramienta para identificar y sintetizar la problemática y las potencialidades del sector. 3. Análisis global de la Cadena de Valor mediante el Método de Organización Sectorial, según Briz, de Felipe y Briz (2010), el cual permite estudiar aspectos de la estructura, la conducta y el funcionamiento de la cadena. 4. Jornada de análisis por parte de un Panel de Expertos en la sede de la Fundación Foro Agrario, en la cual se presentaron las conclusiones del análisis de la cadena de valor y se plantearon estrategias para la dinamización del sector. Con los resultados del análisis en esta primera fase de la investigación, se obtuvo una panorámica de la cadena de valor. Algunos de los aspectos más destacados son los siguientes: • El eslabón productivo en Aranjuez está muy atomizado y trabaja por lo general de forma independiente. Cultiva hasta veinte productos hortícolas diferentes, entre los cuales los frutales están casi en desaparición y hay poca presencia de producto ecológico. Le preocupan los precios poco estables y bajos y por lo general no trabaja con contratos. •El eslabón mayorista prácticamente carece de presencia en Aranjuez y está representado en su mayoría por operadores de Mercamadrid, los cuales demandan mayores volúmenes y mejor normalización de los productos hortícolas procedentes de Aranjuez. • El eslabón detallista consultado es diverso (con representación de comercios minoristas, supermercados e hipermercados) y también demanda mayores volúmenes de producción y mejoras en la normalización. Un 80% conoce los productos de Aranjuez, especialmente el espárrago y la fresa-fresón citados en un 74% y 63% de los casos respectivamente. • En el eslabón de consumidores, el 79% de los encuestados da importancia a la procedencia de los productos hortícolas y un 82% conoce los productos de la Huerta de Aranjuez, siendo los más consumidos el espárrago y el fresón. Un 42% de los encuestados compra producto ecológico por razones de salud, sabor y buscando la ausencia de químicos. • El eslabón de restaurantes es un gran consumidor de hortalizas, la gran mayoría de los productos incluidos en el análisis se oferta en más del 75% de los casos. Las más presentes son tomate y espárrago. La fresa y el fresón (en un 83% de los casos), y el espárrago (72%) seguido de la alcachofa (44%) son los productos de Aranjuez que más se conocen en el conjunto de los restaurantes entrevistados. El 75% de los restaurantes prefiere el producto fresco frente al procesado o congelado. La mayoría de los restaurantes locales (92%) estaría dispuesto a incluir en su carta una diferenciación para los productos de Aranjuez. Sin embargo, en el resto de restaurantes el porcentaje es mucho menor (21%). Entre las conclusiones del análisis se evidenció que un 52% de las ventas de los agricultores se realizaba sin intermediarios y un 69% de los consumidores se manifestaba interesado en adquirir productos de Aranjuez directamente del campo a su casa. Se identificó de esta manera que el acortamiento de la cadena se está utilizando como una forma de crear valor. Para profundizar en este aspecto, se planteó una segunda fase en la investigación. Además de estudiar diversos aspectos de los canales cortos de comercialización, se planteó estudiar el enfoque multifuncional de la horticultura, como estrategia para poner en valor la Huerta ribereña. Para dar una coherencia con la fase anterior, el planteamiento se realizó también desde la perspectiva de la cadena de valor, orientando la consulta hacia el eslabón consumidor. De esta manera, se realizó una consulta mediante cuestionario a 221 consumidores sobre diferentes aspectos relativos a los Canales Cortos de Comercialización (CCC) y la Horticultura Multifuncional (HM)1, lo cual permitió realizar un análisis cuantitativo de diferentes variables. Para completar la visión integral de la cadena corta, se seleccionaron 6 proyectos significativos que son ejemplos de diversas tipologías de canales cortos de comercialización en Aranjuez y Madrid, como representantes del denominado eslabón de “Promotores de CCC” y se consultó también a la Asociación de Productores de la Huerta de Aranjuez, constituida formalmente en el año 2014, como representante del eslabón Productor. Para la obtención de información, la cual tiene un carácter cualitativo en el caso de estos dos eslabones de la cadena, se realizaron cuestionarios y Estudios de Caso de cada proyecto. Los cuestionarios de esta segunda fase de consulta a los eslabones de la cadena corta contuvieron cuestiones relativas a los canales cortos de comercialización, tanto a nivel general (concepto de canal corto, puntos fuertes y ventajas que aportan, dificultades para su desarrollo, factores clave para su éxito) como para el caso concreto de la Huerta de Aranjuez (perfil del consumidor, factores implicados en la compra de verduras, utilización de diversas modalidades de canal corto, relación con las tecnologías de la información y comunicación (TICs) y la producción ecológica o la importancia del factor confianza). También aspectos relacionados con la Horticultura Multifuncional, como son, la valoración de diferentes actividades o proyectos de carácter agro-turístico, educativo, social o terapéutico, o la percepción del consumidor de las actividades de huerta como fuente de bienestar y como agente satisfactor de diversas necesidades humanas. Para completar la visión sobre estos dos temas, CCC y HM, se realizó una consulta mediante cuestionario a Expertos en el campo de los canales cortos de comercialización, procedentes del ámbito académico, y a Profesionales en activo trabajando en proyectos de horticultura social y terapéutica. La información aportada, aunque tiene carácter cualitativo, complementa el estudio ofreciendo la perspectiva académica en el caso de los canales cortos y amplía la información sobre la horticultura multifuncional, tratando cuestiones relativas al desempeño profesional o a la formación existente en España en el campo de la horticultura social y terapéutica. Los resultados de esta segunda fase de la investigación, entre otras cuestiones, evidenciaron que: • Los canales cortos de comercialización implican mucho más que la simple reducción de intermediarios y comprenden una gran diversidad de tipologías. • Los casos estudiados, están enfocados en su mayoría al producto ecológico y su funcionamiento está muy fundamentado en el uso de TICs y en el factor confianza. • En relación a la compra de verduras en el ámbito de los canales cortos, son aspectos muy valorados por el consumidor la calidad del producto, la rapidez y frescura con la que llega del campo a la mesa y que el Producto sea recogido en su punto óptimo de maduración. • Las actividades en el ámbito de la horticultura multifuncional son valoradas positivamente por los consumidores, siendo las más puntuadas las de huerto educativo, huerto terapéutico, seguidas de visitas guiadas y degustaciones de productos de huerta en restaurantes. • Por lo general existe una valoración muy alta de la huerta como fuente de bienestar y de satisfacción de necesidades humanas básicas, especialmente las de una alimentación saludable y de conexión con la naturaleza. Para terminar esta síntesis de la investigación realizada, se presentan las principales conclusiones a nivel global de la Tesis, que son las siguientes: 1. La metodología de cadena de valor ha resultado adecuada para conocer la complejidad y el funcionamiento del sector hortícola arancetano desde una perspectiva integral. 2. La Huerta de Aranjuez cuenta con importantes fortalezas, sustentadas en la calidad de sus suelos y en la fama que mantienen sus productos, pero también debilidades. Esto supone poco volumen de producción, que dificulta la relación con mayoristas y grandes detallistas. 3. El acortamiento de la cadena, mediante canales cortos de comercialización se ha identificado como una forma de creación de valor en la cadena. Existen oportunidades de abastecimiento a consumidores de Madrid mediante canales cortos, sin embargo, las modalidades que requieren mayor organización o requisitos de producción ecológica todavía no están desarrolladas. 4. La producción ecológica podría ser una estrategia para crear valor pero todavía es un método de cultivo muy minoritario en la cadena productiva arancetana. 5. Las peculiaridades de la Huerta de Aranjuez propician la puesta en práctica del enfoque multifuncional de la horticultura como vía de desarrollo económico. Los resultados apuntan a una posible demanda de servicios que contemplen actividades de horticultura de carácter educativo, terapéutico y agro-turístico, conducidas por profesionales. Existe una percepción positiva sobre el potencial de la huerta como fuente de bienestar y de satisfacción de necesidades humanas básicas. 6. La puesta en marcha de proyectos empresariales en el ámbito de la horticultura social es una apuesta interesante para crear valor en la huerta que ha sido valorada positivamente por los eslabones de la cadena corta consultados. 7. El campo de la Horticultura Multifuncional que contempla aspectos educativos, sociales y terapéuticos conforma una disciplina con posibilidades de desarrollo que en la investigación se perciben como limitadas por la falta de profesionales y su acceso a una formación adecuada en España. El estudio de los Canales Cortos de Comercialización y de la Horticultura Multifuncional como vías de puesta en valor en el caso de la Huerta de Aranjuez ha tenido un carácter exploratorio y en gran parte cualitativo en esta Tesis Doctoral. Ambos conceptos han desvelado cierta complejidad y requieren de un mayor conocimiento en diversos aspectos para su puesta en práctica con éxito. Se abre, por tanto, un campo para futuras investigaciones que profundicen en estos ámbitos. ABSTRACT La Vega de Aranjuez has been known for centuries for the reputation of its orchards and historic gardens and, more recently, as the pantry of Madrid. However, in the mid-twentieth century, with the transformations in agriculture, not only locally, but globally, began a process of decline that has been accentuated in recent years. Meanwhile, in 2001, Unesco declared Aranjuez Cultural Landscape, as a World Heritage Site with outstanding universal value. Part of what underpins this international recognition lies in the peculiarities of the landscape created by farming. The shift, from an eminently horticultural vocation to extensive field crops and fallow surfaces, and the loss of importance of the sector, have not gone unnoticed for local authorities and have been several attempts at recovery and revitalization of the sector in recent years. The beginning of this research came at the initiative of the municipality of Aranjuez, which in 2010 wanted to know the situation of the horticultural sector, for which he commissioned a study by the UPM-ETSIA. To know reality from an integral perspective, it was proposed to approach the analysis from the perspective of value chain. The implications of this concept, its evolution and its role as an instrument of analysis of the food chain, have been reviewed and presented in Chapter 3.2. The value chain concept refers to all the processes from the consumer, through suppliers who provide products, services and information that add value to customers (Lambert & Cooper, 2000; Chen, 2004). For the analysis of the situation of the horticultural sector in Aranjuez, which constituted the first phase of research, it proceeded in several steps: 1. Identifying the problems and demands of the actors in the chain, making transverse cuts in the market at different levels to meet the views of the chain operators (Gunasekaran & Patel , 2004; Rojas, 2009; Schiefer, 2007). Questionnaires were designed for it and went to representatives of the five links in the chain: Farmers (15), Wholesalers (11), Retailers (55), Consumers (85) and Restaurants (36), both in Aranjuez and Madrid (a total of 202). 2. SWOT analysis of each chain actor and of the whole supply chain, as a tool to identify and synthesize the problems and potential of the sector. 3. Analysis of the whole supply chain by Industrial Organization Method according to Briz et al. (2010), which allows to study aspects of the structure, conduct and performance of the chain. 4. Analysis by a Panel of Experts at Foro Agrario Foundation headquarters, where the conclusions of the analysis were presented and strategies for the revitalization of the sector were raised. The results of the analysis in this first phase of the research, presented an overview of the value chain. Some of the highlights are: - The productive sector in Aranjuez is very fragmented and usually works independently. With a wide variety of horticultural products (up to 20), fruit crops almost disappearing and little presence of organic product. Is concerned about the unstable and low prices and usually does not work with contracts. - The wholesale sector with virtually no presence in Aranjuez is represented mostly by Mercamadrid operators, who demand higher volumes and better standardization of horticultural products from Aranjuez. - The retailer sector is diversified (with representation from retailers, supermarkets and hypermarkets) and also demand higher production volumes and improved standardization. 80% know the products of Aranjuez, especially asparagus and strawberry-strawberry cited by 74% and 63% of cases respectively. - Among the consumers, 79% give importance to the origin of horticultural products and 82% know the products from Aranjuez, the most consumed asparagus and strawberries. 42% buy organic products for health, taste and absence of chemicals. - Restaurants are big consumers of vegetables, most of the products included in the analysis is offered in over 75% of cases. The most: tomato and asparagus. Strawberry (83% of cases), and asparagus (72%) followed by the artichoke (44%) are the products of Aranjuez more known in all the surveyed restaurants. 75% of the restaurants prefer fresh product against processed or frozen. Most local restaurants (92%) would be willing to include in their menu a differentiation for products of Aranjuez. However, for those restaurants from Madrid the percentage is much lower (21%). Among the conclusions of the analysis it showed that 52% of sales were realized from farmers without intermediaries and 69% of consumers expressed interest in acquiring products directly from field to table. It has been identified that the shortening of the chain is being used as a way to create value. To deepen this aspect, a second phase investigation arose. Besides studying various aspects of the short supply chains, it was also proposed to study the functional approach of horticulture as a strategy to add value. To provide consistency with the previous phase, the focus was also conducted from the perspective of the value chain, directing the query to consumers. Thus, again it was used the questionnaire as a methodological tool, and 221 consumers were asked about different aspects of the Short Suppy Chains (SSC) and Multifunctional Horticulture (MH)2, which allowed a quantitative analysis of several variables. To complete the comprehensive view of the short chain, 6 significant projects were selected as examples of different types of short supply chains in Aranjuez and Madrid, representing "SSC Promoters" and also the “Asociación de Productores de la Huerta de Aranjuez”, formally constituted in 2014, was asked representing the productive sector. The Study Case and again the questionnaire were elected as methodological tools in a qualitative analysis. The questionnaires of this second phase of research contained short supply chain issues, as a general topic (short supply chain concept, strengths and advantages they bring difficulties for its development, key factors success) and also refered to the case of Aranjuez (consumer profile, factors involved in the purchase of vegetables, use of several types of short supply chains, relation with information and communication technologies (ICTs) and organic production or the importance of trust in short supply chains). It also contemplated aspects of multifunctional horticulture, such as the valuation of different activities (agro-tourism, educational, social or therapeutic horticulture) and consumer perception about horticultural activities as a source of welfare and satisfactor of human needs. To complete the vision of these two issues, SSC and MH, experts in the field of short supply chains and professionals working in the field of social and therapeutic horticulture were asked. The qualitative information provided, complements the study offering a new perspective in the value chain analysis, such as those relating to job performance, the difficulties encountered or training existing in our country in the field of social and therapeutic horticulture. The results of this second phase of research showed that: Short supply chains involve much more than simply reducing intermediaries and cover a wide range of types. The cases studied are mostly focused on ecological product and its operation is heavily based on the use of ICTs and the trust factor. In connection with the purchase of vegetables in the field of short supply chains, product quality, speed and freshness with which comes from the field to the table and products picked at its peak maturation, are aspects highly valued by the consumer. Activities in the field of multifunctional horticulture are positively valued by consumers, the most scored: the educational garden, therapeutic garden, followed by guided tours and tastings of vegetables from Aranjuez in restaurants. Horticultural activities were highly valuated as a source of welfare and satisfaction of human needs, especially those of healthy eating and connection with nature. To complete this summary, the main conclusions of the research are presented as follows: 1. The value chain approach has been adequate to meet the complexity and operation of the horticultural sector in Aranjuez from a holistic perspective. 2. La Huerta de Aranjuez has important strengths, underpinned by the quality of its soils and fame that keep their products, but also weaknesses. This implies low volume of production, which makes difficult the link with wholesalers and large retailers. 3. The shortening of the chain by short supply chains has been identified as a way of creating value in the chain. Opportunities exist to supply consumers from Madrid by short supply chains, however, methods that require greater organization or requirements of organic production are not yet developed. 4. Organic production could be a strategy to create value but is not generally being implemented in the production chain. 5. The peculiarity of the Huerta de Aranjuez favours the implementation of the multifunctional approach as a means of economic development. The results point to a possible demand for multifunctional horticulture that include educational, therapeutic and agro-tourism activities. There is a positive perception of the potential of horticultural activities as a source of welfare and satisfaction of basic human needs. 6. The implementation of business projects in the field of social horticulture are an interesting way to create value that has been highly valued in the short supply chain. 7. The field of Multifunctional Horticulture which includes educational, social and therapeutic aspects, forms a discipline with possibilities of development, which in research are seen as limited by the lack of professionals and access to adequate training in our country. The study of Short Supply Chains and Multifunctional Horticulture as strategies to create value in the case of the Huerta de Aranjuez has an exploratory character and largely qualitative in this research. Both concepts have revealed some complexity and require greater knowledge in various aspects for successful implementation. It opens therefore a field for future research to deepen in these areas.

De la desintegración Espacial a la Conformación regional en la Sabana de Bogotá. Una Propuesta para el desarrollo de la Ciudad Región en el siglo XXI

El presente trabajo de investigación aborda el tema del desarrollo regional en torno a una gran metrópoli como Bogotá y la Sabana de Bogotá. El crecimiento, expansión y relación con los municipios vecinos. Su entorno territorial; es un tema de discusión que cada día adquiere más fuerza desde hace varias décadas. Bogotá y la Sabana de Bogotá, se consideran en la actualidad como un caso representativo del caótico modelo de expansión urbana y crecimiento demográfico, enfrentado al desarrollo urbano como paradigma de la desigualdad de la ciudad latinoamericana. Son muchos los procesos y conflictos de naturaleza Regional y metropolitana que atraviesa la capital colombiana. Sin embargo esta investigación abordada el tema desde la necesidad de gobernanza y coordinación para el desarrollo territorial consensuado y equilibrado de la Región. La sabana de Bogotá está conformada por ciudades dormitorio, ciudades industriales, turísticas, agropecuarias, etc., es atravesada por el Río Bogotá, y en su centro la gran metrópoli, Bogotá D.C. centro de trabajo muy importante a nivel nacional, su área de influencia más próxima llega hasta: Caqueza, Zipaquira, Facatativa, Soacha, Fusagasuga y Girardot. Principales polos de desarrollo en la sabana y el departamento. Cundinamarca está compuesto por 15 provincias y Bogotá. Conformando un sistema de redes urbanas con necesidades comunes y demanda servicios públicos, de transporte, aseo, movilidad, salud, educación, espacio público y calidad ambiental. La metodología de esta investigación consiste en el análisis de la región a partir de la articulación de planes de ordenamiento territorial en un área de estudio propuesta. Mediante entrevistas con profesionales, expertos, funcionarios y empleados públicos y teniendo en cuenta las posibilidades legales en Colombia para el desarrollo territorial regional, establecer la situación real en materia de desarrollo para el departamento de Cundinamarca, evidenciando las necesidades del territorio y su desarrollo de una forma más compleja, valorando las sinergias y necesidades sociales, ambientales y económicas propias del crecimiento urbano, para proponer una serie de directrices que estructuren un desarrollo regional equilibrado en Bogotá y Cundinamarca. El análisis de los modelos del caso contribuye a fortalecer iniciativas para el desarrollo Regional de la Sabana de Bogotá como territorio sostenible: ambiental, económico y socialmente. En un sistema de redes que interconecte a Bogotá, con Cundinamarca, Colombia y el resto del mundo. Cundinamarca como región debe fijar estrategias y articular políticas en función de un modelo de desarrollo urbano regional para el departamento y la Sabana de Bogotá. Directrices departamentales básicas y fundamentales para el desarrollo territorial equilibrado que promueva ciudades sostenibles, compactas y con Calidad de vida para todos sus habitantes. ABSTRACT: This research addresses the issue of regional development around a big metropolis like Bogotá and Sabana de Bogota. The growth, expansion and relations with neighboring municipalities. Your local environment; It is an issue that becomes stronger every day for decades. Bogotá and Sabana de Bogotá, are considered today as a representative case of the chaotic model of urban expansion and population growth, urban development faced as a paradigm of inequality in Latin American city. Many processes and conflicts of Regional and metropolitan nature that crosses the Colombian capital. However this research addressed the issue from the need for governance and coordination for consensual and balanced territorial development of the region. The savannah of Bogota consists of bedroom communities, industrial cities, tourism, agriculture, etc., is crossed by the Bogota River, and at its center the great metropolis, Bogota DC center very important work at the national level, the area closest influence reaches: Caqueza, Zipaquira, Facatativa, Soacha, Fusagasuga and Girardot. Main centers of development in the savannah and the department. Cundinamarca is composed of 15 provinces and Bogota. Forming a system of urban networks with common needs and demand utilities, transportation, grooming, mobility, health, education, public space and environmental quality. The methodology of this research is the analysis of the region from the joint land use plans in the proposed study area. Through interviews with professionals, experts, public officials and employees and taking into account the legal possibilities in Colombia for regional territorial development, establish the real situation in development for the department of Cundinamarca, showing the region's needs and development of a more complex form, assessing synergies and own social, environmental and economic needs of urban growth, to propose a set of guidelines to structure a balanced regional development in Bogota and Cundinamarca. The analysis of case models helps to strengthen initiatives for regional development of the Sabana de Bogota and sustainable region: environmentally, economically and socially. In a network system that interconnects to Bogotá with Cundinamarca, Colombia and elsewhere. Cundinamarca region should set as joint strategies and policies based on a model of regional urban development for the department and the Sabana de Bogota. Basic and fundamental to balanced territorial development that fosters sustainable, compact and quality of life for all its inhabitants cities departmental guidelines.

The health care needs of UK pensioners living in Spain: an agenda for research

There is a growing interest in learning how older migrants adapt to their new country of residence, in understanding their motivations for migration and the factors that influence international retirement migration patterns. However, there has been little research into the health and health care needs of international migrants retiring to other countries. This paper presents findings on health status and utilisation of health services with a particular focus on UK pensioners retiring to Spain. Future research should focus on the health needs of pensioners and their perspectives as to whether and how these health needs are met.

Research in Tourism Course Presentation

Research in Tourism is an optional course that is taught during the second semester of the fourth year of the Undergraduate Degree in Sociology. It is directly linked to Sociology of Tourism. It is held in English.

Liberalising trade in services: creating new migration opportunities? Research Paper in Law, 1/2010

Introduction. It is quite uncommon to associate migration with the rules on services trade. Indeed, all economic definitions of services insist on their immaterial nature and on the increased possibility of trading them ‘virtually’ over networks or else, without any physical movement of the parties involved. Somehow this ‘immaterial’ nature of services reflects on their providers/recipients which seem to be ‘invisible’. Even though most services still require the physical contact of the provider with the recipient1 and, when provided over national borders, do entail migration, service providers and/or recipients are rarely thought of as ‘immigrants’. This may be due to the fact that they enter the foreign territory with a specific aim and, once this aim accomplished, move back to their state of origin; technically they only qualify as short term non-cyclical migrants and are of little interest to policy-makers. A second reason may be that both service providers and recipients are economically desirable: the former are typically highly skilled and trained professionals and the latter are well-off ‘visitors’, increasing consumption in the host state. The legal definition of services in Article 57 TFEU (ex Art. 50 EC) further nourishes this idea about service providers/recipients not being migrants: the relevant Treaty rules only apply when the provisions on free movement of workers and freedom of establishment – themselves clearly linked to migration – do not apply. This distinction has been fleshed up by the ECJ which has consistently held that the distinction between the rules on establishment, on the one hand, and the rules on services, on the other, lies on duration.2 Indeed, all EC manuals state four types of service provision falling under the EC Treaty: a) where the service provider moves to the recipient’s state, for a short period of time (longer stay would amount to establishment), b) where the service recipients themselves move to the state where the service is offered (eg for medical care, education, tourism etc), c) where both service providers and recipients move together in another member state (eg a tourist guide accompanying a group travelling abroad) and d) where the service itself is provided across the borders (typically through the use of ICTs). None of these situations would typically qualify as migration. The above ‘dissociation’ between services and migration has been gradually weakened in the recent years. Indeed, migration is increasingly connected to the transnational provision of services. This is the result of three kinds of factors: developments in the European Court of Justice’s (ECJ) case law; legislative initiatives in the EU; and the GATS. Each one of these is considered in some detail below. The aim of the analysis which follows is to show the extent to which (legislative and judicial) policies aimed at the free provision of services actively affect migration conditions within the EU. The EC rules on the provision of services primarily affect the movement of EU nationals. As it will be shown below, however, third country nationals (TCNs) may also claim the benefits of the rules on services, either as recipients thereof or as employees of some EC undertaking which is providing services in another member state (posted workers).