Promoting palliative care in the community: production of the primary palliative care toolkit by the European Association of Palliative Care Taskforce in primary palliative care

BACKGROUND A multidisciplinary European Association of Palliative Care Taskforce was established to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe. AIM To document the barriers and facilitators for palliative care in the community and to produce a resource toolkit that palliative care specialists, primary care health professionals or policymakers, service developers, educationalists and national groups more generally could use to facilitate the development of palliative care in their own country. DESIGN (1) A survey instrument was sent to general practitioners with knowledge of palliative care services in the community in a diverse sample of European countries. We also conducted an international systematic review of tools used to identify people for palliative care in the community. (2) A draft toolkit was then constructed suggesting how individual countries might best address these issues, and an online survey was then set up for general practitioners and specialists to make comments. Iterations of the toolkit were then presented at international palliative care and primary care conferences. RESULTS Being unable to identify appropriate patients for palliative care in the community was a major barrier internationally. The systematic review identified tools that might be used to help address this. Various facilitators such as national strategies were identified. A primary palliative care toolkit has been produced and refined, together with associated guidance. CONCLUSION Many barriers and facilitators were identified. The primary palliative care toolkit can help community-based palliative care services to be established nationally.

Work in progress - Exploiting videoconferencing possibilities to promote the European convergence process

This paper introduces the experience of using videoconferencing and recording as a mechanism to support courses which need to be promoted or discontinued within the framework of the European convergence process. Our objective is to make these courses accessible as live streaming during the lessons as well as recorded lectures and associated documents available to the students as soon as the lesson has finished. The technology used has been developed in our university and it is all open source. Although this is a technical project the key is the human factor involved. The people managing the virtual sessions are students of the courses being recorded. However, they lack technical knowledge, so we had to train them in audiovisuals and enhance the usability of the videoconferencing tool and platform. The validation process is being carried out in five real scenarios at our university. During the whole period we are evaluating technical and pedagogical issues of this experience for both students and teachers to guide the future development of the service. Depending on the final results, the service of lectures recording will be available as educational resource for all of the teaching staff of our university.

Metabolic risk score indexes validation in overweight healthy people

The constellation of adverse cardiovascular disease (CVD) and metabolic risk factors, including elevated abdominal obesity, blood pressure (BP), glucose, and triglycerides (TG) and lowered high-density lipoprotein-cholesterol (HDL-C), has been termed the metabolic syndrome (MetSyn) [1]. A number of different definitions have been developed by the World Health Organization (WHO) [2], the National Cholesterol Education Program Adult Treatment Panel III (ATP III) [3], the European Group for the Study of Insulin Resistance (EGIR) [4] and, most recently, the International Diabetes Federation (IDF) [5]. Since there is no universal definition of the Metabolic Syndrome, several authors have derived different risk scores to represent the clustering of its components [6-11].

Latin American Agricultural Trade: The Role of the WTO in Sustainable Virtual Water Flows, European Association of Agricultural Economists

International agricultural trade has been growing significantly during the last decade. Many countries rely on imports to ensure adequate food supplies to the people. A few are becoming food baskets of the world. This process raises issues about the food security in depending countries and potentially unsustainable land and water use in exporting countries. In this paper, we analyse the impacts of amplified farm trade on natural resources, especially water. Farm exports and imports of five Latin America countries (Brazil, Argentina, Mexico, Peru and Chile) are examined carefully. A preliminary analysis indicates that virtual water imports can save valuable water resources in water-short countries, such as Mexico and Chile. Major exporting countries, including Brazil and Argentina, have become big exporters due to abundant natural resource endowments. The opportunity costs of agricultural production in those countries are identified as being low, because of the predominant green water use. It is concluded that virtual water trade can be a powerful tool to alleviate water stress in semi-arid countries. However, for exporting nations a sustainable water use can only be guaranteed if environmental production costs are fully reflected in the commodity prices. There is no basis for erecting environmental trade tariffs on exporters though. Setting up legal foundations for them in full compliance with WTOs processes would be a daunting task.

Resilence, rural development and suistainable management: a working with people model approach

Nowadays, it has become evident the need to seek sustainable development models that address challenges arising in a variety of contexts. The resilience concept appears connected to the ability of people to cope with adversities that inevitably arise due to context dynamics, at different spatial and temporal scales. This concept is related to the model known as Working With People (WWP), focused on rural development projects planning, management and evaluation, from the integration of three dimensions: technical-entrepreneurial, ethical-social and political-contextual. The research reported is part of the RETHINK European Project, whose overall aim is farm modernization and rural resilience. The resilience concept has been analyzed, in the scope of rural development projects management, and a relationship with the WWP model has been established. To this end, a thorough review of the scientific literature concerning this topic has been addressed, in order to develop the state of the art of the different concepts and models involved. A conceptual proposal for the integration of resilience in rural development projects sustainable management, through the three-dimensional WWP model is presented.

Evaluating the spatial and social equity effects of road pricing in the European urban context: the Madrid Metropolitan Area.

The paper explores the spatial and social impacts arising from implementation of a road-pricing scheme in the Madrid Metropolitan Area (MMA). Our analytical focus is on understanding the effects of the scheme on the transport accessibility of different social groups within the MMA. We define an evaluation framework to appraise the accessibility of different districts within the MMA in terms of the actual and perceived cost of using the road infrastructure "before" and "after" the implementation of the scheme. The framework was developed using quantitative survey data and qualitative data from focus group discussions with residents. We then simulated user behaviors (mode and route choice) based on the empirical evidence from a travel demand model for the MMA. The results from our simulation model demonstrated that implementation of the toll on the orbital metropolitan motorways (M40, M30, for example) decreases accessibility, mostly in the districts where there are no viable public transport alternatives. Our key finding is that the economic burden of the road-pricing scheme particularly affects unskilled and lower income individuals living in the south of the MMA. Consequently lower income people reduce their use of tolled roads and have to find new arrangements for these trips: i.e. switch to the public transport, spend double the time for their commuter trips or stay at home. The results of our research could be applicable more widely for anyone wishing to better understand the important relationship between increased transport cost and social equity, especially where there is an intention to introduce similar road-pricing schemes within the urban context.

Using cloud technologies for engaging people with cultural heritage

Cultural heritage is an important asset of Europe which is largely underexplored. One of the main reasons is that the general public do not really incorporate cultural activities in their life style. Currently, curators and professionals in the heritage sector face the toughest challenges on how to attract, engage and retain visitors of heritage institutions (libraries, museums, archives and historical societies). TAG CLOUD FP7 European project seeks to overcome this situation and promote lifelong engagement with culture by personalising the visitors? cultural experiences through cloud technologies.

Genetics and the origin of European languages.

A new set of European genetic data has been analyzed to dissect independent patterns of geographic variation. The most important cause of European genetic variation has been confirmed to correspond to the migration of Neolithic farmers from the area of origin of agriculture in the Middle East. The next most important component of genetic variation is apparently associated with a north-south gradient possibly due to adaptation to cold climates but also to the differentiation of the Uralic and the Indo-European language-speaking people; however, the relevant correlations are not significantly different from zero after elimination of the spatial autocorrelation. The third component is highly correlated with the infiltration of the Yamna ("Kurgan") people, nomadic pastoralists who domesticated the horse and who have been claimed to have spread Indo-European languages to Europe; this association, which is statistically significant even when taking spatial autocorrelations into account, does not completely exclude the hypothesis of Indo-European as the language of Neolithic farmers. It is possible that both expansions were responsible for the spread of different subfamilies of Indo-European languages, but our genetic data cannot resolve their relative importance.

Land, Labour and Capital Markets in European Agriculture: Diversity under a Common Policy. CEPS Paperback. October 2013

Well-functioning factor markets are an essential condition for the competitiveness and sustainable development of agriculture and rural areas. At the same time, the functioning of the factor markets themselves is influenced by changes in agriculture and the rural economy. Such changes can be the result of progress in technology, globalisation and European market integration, changing consumer preferences and shifts in policy. Changes in the Common Agricultural Policy (CAP) over the last decade have particularly affected the rural factor markets. This book analyses the functioning of factor markets for agriculture in the EU-27 and several candidate countries. Written by leading academics and policy analysts from various European countries, these chapters compare the different markets, their institutional framework, their impact on agricultural development and structural change, and their interaction with the CAP. As the first comparative study to cover rural factor markets in Europe, highlighting their diversity − despite the Common Agricultural Policy and an integrated single market − Land, Labour & Capital Markets in European Agriculture provides a timely and valuable source of information at a time of further CAP reform and the continuing transformation of the EU's rural areas.

Could an independent Scotland join the European Union? EPC Policy Brief, 28 May, 2014

The people of Scotland vote on 18 September 2014 in a referendum on the question "Should Scotland be an independent country?" The Scottish Government aims, if the result is 'yes', for Scotland to become independent in March 2016 and to join the main international organisations including the European Union. Would that be possible? How could Scotland join the EU? What is the link between Scotland's referendum on independence and a British referendum on EU membership?