Memòria justificativa de l'estada de recerca

Estudi elaborat a partir d’una estada a l’Associação para o Desenvolvimento da Aerodinânica Industrial (ADAI) de la Universitat de Coimbra, Portugal, entre març i juliol de 2006. Aquesta disposa d'un laboratori d'assaigs i té medis suficients per a cremar de manera controlada parcel•les prèviament delimitades en terreny forestal. Això permet observar el fenomen dels incendis forestals a dues escales de treball diferents. L’objectiu ha estat l’obtenció de dades experimentals sobre la propagació de fronts de flames que avancen sobre combustible tractat amb retardants sota l’efecte del pendent o el vent. S’ha participat en proves experimentals de camp i se n’han realitzat dues en instal•lacions de laboratori en què l’efecte del pendent o de la velocitat del vent podia ser variat. Degut a l’elevat nombre de variables que entren en joc l’anàlisi acurada de les dades encara està en procés.

Five-year evolution of drug prescribing in a university adult intensive care unit

Introduction: Drug prescription is difficult in ICUs as prescribers are many, drugs expensive and decisions complex. In our ICU, specialist clinicians (SC) are entitled to prescribe a list of specific drugs, negotiated with intensive care physicians (ICP). The objective of this investigation was to assess the 5-year evolution of quantity and costs of drug prescription in our adult ICU and identify the relative costs generated by ICP or SC. Methods: Quantities and costs of drugs delivered on a quarterly basis to the adult ICU of our hospital between 2004 and 2008 were extracted from the pharmacy database by ATC code, an international five-level classification system. Within each ATC first level, drugs with either high level of consumption, high costs or large variations in quantities and costs were singled out and split by type of prescriber, ICP or SC. Cost figures used were drug purchase prices by the hospital pharmacy. Results: Over the 5-year period, both quantities and costs of drugs increased, following a nonsteady, nonparallel pattern. Four ATC codes accounted for 80% of both quantities and costs, with ATC code B (blood and haematopoietic organs) amounting to 63% in quantities and 41% in costs, followed by ATC code J (systemic anti-infective, 20% of the costs), ATC code N (nervous system, 11% of the costs) and ATC code C (cardiovascular system, 8% of the costs). Prescription by SC amounted to 1% in drug quantities, but 19% in drug costs. The rate of increase in quantities and costs was seven times larger for ICP than for SC (Figure 1 overleaf ). Some peak values in costs and quantities were related to a very limited number of patients. Conclusions: A 5-year increase in quantities and costs of drug prescription in an ICU is a matter of concern. Rather unexpectedly, total costs and cost increases were generated mainly by ICP. A careful follow-up is necessary to try influencing this evolution through an institutional policy co-opted by all professional categories involved in the process.

Un estudi de les argumentacions d’estudiants anglesos i catalans en activitats de resolució de problemes no formals en ciències i de les estratègies didàctiques dels professors que afavoreixen l’argumentació a les classes

Una de les contribucions de la recerca sobre concepcions prèvies dels estudiants en ciències durant els darrers 25 anys ha estat mostrar la influència del context sociocultural dels nois i noies en les idees i concepcions que desenvolupen i mantenen des de la seva infància. Hi ha l’acord que algunes diferències en les concepcions poden dependre de la cultura social en la qual s’integren. Alguns investigadors també pensen que els esquemes argumentatius també poden ser influenciats per la cultura de les comunitats. Els contextos Català i Anglès semblen similars, ambdós formen part del context cultural de les societats desenvolupades; per tant, podem pensar que els esquemes argumentatius que els estudiants apliquen, poden tenir moltes similituds, però també importants diferències. Les dades analitzades provenen de les respostes escrites dels estudiants individuals i de les transcripcions de 8 grups de discussió sobre quatre tasques. L’anàlisi es fa a tres nivells: 1)comparació del nombre d’arguments entre tasques i entre països, 2) qualitativa i descriptiva comparació entre tipus d’esquemes argumentatius per tasques i per països i 3) explicació de tipus d’esquemes argumentatius que es donen molt, i identificació d’estructures argumentatives complexes que lliguen diversos esquemes en un argument més gran i que poden caracteritzar l’argumentació d’alguns grups (aplicant Toulmin) i que poden ser indicadors d’aspectes cooperatius i de canvis de punts de vista en les discussions. Els resultants ens indiquen que encara que els estudiants Catalans dediquen més temps a les discussions, la ratio nombre d’esquemes per unitat de temps és similar als dos països. S’han trobar algunes diferències entre tipus d'esquemes per països i per tasques, també que molts arguments es basen en valors i idees preconcebudes. S’han pogut identificar també algunes estructures argumentatives complexes no gaire comunes.

"How I Do It"-Radical Right Colectomy with Side-to-Side Stapled Ileo-Colonic Anastomosis.

BACKGROUND AND OBJECTIVE: Standardization of surgical technique helps to reproduce excellent clinical outcomes, especially in teaching institutions. We aim to describe in detail our established approach for oncological right colectomy. TECHNIQUE: The right colon is mobilized in a five-step latero-inferior approach starting off with (1) the terminal ileum, visualizing the duodenum and the head of pancreas. (2) The ascending colon is dissected from the retroperitoneum, and takedown of the hepatic flexure is completed coming retrograde from the transverse colon (3). (4) Transection of the remaining retroperitoneal attachments completes exposure of the duodenum and mobilization of the right colon. (5) Ileocolic vessels are dissected out and divided close to their origin, and the mesocolon is divided. We then establish intestinal continuity by use of a side-to-side stapled technique. (1) The arms of a linear cutting stapler are inserted via transverse incisions at the anti-mesenteric sides of the terminal ileum and the transverse colon (tenia) and fired. (2) The enterotomy site is closed by removal of the specimen using a second transverse firing of the linear cutting stapler. An important final step is the (3) reinforcement of the anastomotic ends and the crossing of the staple lines; an omental patch and closure of the mesenteric window are optional. CONCLUSION: The suggested standardized five-step lateral-to-medial dissection of the right colon and the three-step side-to-side stapled technique for ileo-colonic anastomosis are easy to learn and to reproduce. Careful adherence to pivotal technical details will help to obtain an optimal oncological outcome and a consistently low leak rate around 2 %.

El reciclatge a Cerdanyola del Vallès

Treball de recerca realitzat per alumnes d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. La hipòtesi plantejada ha estat si els joves estan més conscienciats que la gent gran en el reciclatge. Per tal de demostrar aquesta hipòtesi s’ha investigat sobre el procés que segueixen els diferents tipus de residus i les diferents estratègies que s'han de seguir per reciclar. Després de buscar informació sobre l'evolució del reciclatge a Cerdanyola es va elaborar un model d'enquesta per saber els diferents hàbits de reciclatge i es van comparar segons les diferents franges d'edat. Aquestes enquestes també van proporcionar informació sobre els problemes que tenen els ciutadans amb el servei de reciclatge a Cerdanyola. Posteriorment es va visitar la deixalleria de la ciutat i es va realitzar una entrevista a l'encarregat d'aquesta. Finalment, cal destacar tota la informació proporcionada per l'alcalde de Cerdanyola sobre la política mediambiental que té el govern local. La hipòtesi contrastada ha resultat certa.

Estudi comparatiu del sòl d'una vinya de Sant Pere de Ribes

Treball de recerca realitzat per una alumna d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. Anàlisi comparatiu de diferents propietats del sòl d’una vinya on s’ha observat que els peus presenten un creixement desigual. A partir d'una observació a simple vista de les plantes de la vinya i del sòl sobre el qual es desenvolupen, es proposa la hipòtesi de que el sòl pot ser un factor determinant per aquest creixement desigual. Després de fer una recerca bibliogràfica sobre l’edafologia, les propietats del sòl i els tipus de sòl que es poden trobar als voltants de Sant Pere de Ribes, l’autora ha fet una selecció de propietats físico-químiques que poden estar més relacionades amb el creixement de les plantes. Després de fer el mostreig i seguir els protocols de laboratori s’han analitzat els resultats i s’han redactat les conclusions. Les propietats estudiades han permès determinar els tipus de sòl, uns sòls de textures entre franco-arenoses i areno-franques. S’ha trobat també una correlació entre les diverses propietats estudiades: un sòl de porositat elevada, que presenta valors alts de velocitat d’infiltració i per tant amb baixa capacitat de retenció d’aigua disponible, no sembla el sòl ideal per al desenvolupament de les plantes de vinya. A partir del treball es plantegen noves incògnites sobre les adaptacions dels ceps a aquests tipus de sòl o sobre la qualitat del raïm que s'hi pot desenvolupar.

Sleep 4 less

Treball de recerca realitzat per alumnes d'ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l'any 2009. Aquest treball es tracta en la creació d’un projecte empresarial, és a dir, d’una planificació estratègica que afecta a tots els àmbits de la empresa al llarg d’un període de temps i que té per objectiu analitzar la viabilitat, examinar els objectius i descobrir els inconvenients del mateix. En concret s’ha projectat és un hostal ‘low cost’. Alhora de comprovar la viabilitat del projecte, s’han hagut de realitzar els tests corresponents per saber si tindria èxit o no. I tots han demostrat un resultat factible, ja que, encara que van sorgir problemes amb l’acceptació d’aquest nou estil, concretament en el fet d’haver de compartir habitació amb altres persones, al poder oferir altres tipus d’habitacions i en el cas de compartir habitació donar molta seguretat, els anàlisis ens han donat uns resultats acceptables. S’han realitzat també quadres financers, préstecs, calculat les despeses d’inici d’empresa i de manteniment, publicitat, despeses de personal, i finalment aquest també han donat un resultat de viabilitat positiu.

The Division problem with voluntary participation

The division problem consists of allocating a given amount of an homogeneous and perfectly divisible good among a group of agents with single-peaked preferences on the set of their potential shares. A rule proposes a vector of shares for each division problem. The literature has implicitly assumed that agents will find acceptable any share they are assigned to. In this paper we consider the division problem when agents' participation is voluntary. Each agent has an idiosyncratic interval of acceptable shares where his preferences are single-peaked. A rule has to propose to each agent either to not participate or an acceptable share because otherwise he would opt out and this would require to reassign some of the remaining agents' shares. We study a subclass of efficient and consistent rules and characterize extensions of the uniform rule that deal explicitly with agents' voluntary participation.

Ultrasonography in Schistosomiasis in Africa

Approximately 50 publications have become available in the international literature on ultrasonography in schistosomiasis in Africa. Geographically these cover Congo, Egypt, Kenya, Mali, Mauritius, Niger, Senegal, Sudan, Tanzania and East African Islands as well as Zimbabwe. Further studies are ongoing in many countries, such as Burundi, Ghana, Madagaskar and Uganda. It was shown that ultrasonography is useful in the detection of morbidity induced by schistosomiasis on an individual basis and on the community level. There is indication for varying morbidity patterns in different African foci. Post-treatment monitoring has provided evidence for reversibility of pathological lesions induced by Schistosoma (S.) haematobium and S. mansoni, even though evidence for reversibility of periportal fibrosis in adults is not yet satisfactorily substantiated. A standardized set of criteria for ultrasonographical observations has been worked out and is presently in the process of being refined. It is thus hoped that standardization will contribute to render studies in different endemic settings comparable on a global basis.

Análisis morfométrico de la extremidad anterior en Carnivora

Durante los cuatro años de disfrute de la beca (2006 – 2009) se ha consolidado una base de datos de medidas osteológicas del esqueleto apendicular de numerosas especies del O. Carnivora. Concretamente, se han medido 364 individuos de 126 especies. Los ejemplares pertenecían a las colecciones del Phyletisches Museum (Jena, Alemania), el Museum für Naturkunde (Berlín, Alemania), el Museu de Ciències Naturals de la Ciutadella (Barcelona, España), el Múseum National d'Histoire Naturelle (París, Francia), y el Museo Nacional de Ciencias Naturales (Madrid, España). Asimismo, con estos datos se han estado preparando tres artículos sobre la morfología de ciertos elementos del esqueleto apendicular en carnívoros, dos de los cuales se encuentran actualmente en estado de revisión para su publicación científica. Dos de ellos, "Scapula, habitat and locomotion in Carnivora" y "Size and shape in the carnivore scapula", relacionan la morfología escapular con factores como el tamaño del animal, el tipo de locomoción que presenta y el hábitat en el que se encuentra; el primero mediante metodología multivariante (análisis funcional) y el segundo bajo las nuevas técnicas de morfometría geométrica. El tercer artículo, "Scaling and mechanics in the carnivore calcaneus: A comparison of natural and artificial selection", evalúa el efecto de diferentes tipos de selección, natural frente a artificial, sobre la morfología del calcáneo y su influencia en la biomecánica de este hueso. Finalmente, también se ha desarrollado un estudio experimental sobre la búsqueda de estabilidad durante la locomoción arbórea, cuyos resultados han dado lugar al artículo "The search for stability on narrow supports: An experimental study in cats and dogs", que también se halla bajo revisión actualmente.

Jésus historique: une quête de l'inaccessible étoile? Bilan de la "troisième quête"

La «troisième Quête» du Jésus historique relance le débat sur des acquis de la recherche. Bien qu'il s'agisse d'une nébuleuse de positions dissemblables plutôt que d'un courant homogène, cette constellation de chercheurs remet en cause le consensus antérieur. Son nouveau paradigme peut être saisi sur cinq points : 1) Les sources documentaires sur Jésus sont étendues et leur exploitation modifiée. 2) On relève un puissant retour à la judaïté du Nazaréen. 3) Le coeur de l'agir de Jésus n'est plus nécessairement une position millénariste, mais une conviction sapientiale. 4) L'histoire sociale met en valeur la réaction du messianisme populaire contre une politique d'acculturation gréco-romaine en Palestine. 5) Une christologie implicite redevient pensable au niveau de Jésus lui-même. The third Quest for the historical Jesus has re-opened the debate concerning research findings. Although this consists of a nebulous set of dissimilar positions rather than a homogenous trend, five previous points of consensus are being challenged by the constellation of researchers. The new paradigm may be summarised in five points: 1) The documentary sources on Jesus are spread out and their use is thereby modified. 2) A notable return to the Jewishness of Jesus of Nazareth. 3) The heart of Jesus' action is no longer seen as a millenarist position, but more as a conviction informed by Wisdom. 4) Social history emphasises the reaction of popular messianism confronting Greek-Roman political acculturation. 5) An implicit Christology becomes possible once more at the level of Jesus Himself.

Interpretación en los servicios públicos en el ámbito sanitario en la provincia de Barcelona

El nostre treball pretén observar com estan organitzats els serveis de TISSPP de l'àmbit sanitari de Barcelona. Amb aquesta finalitat, realitzem una observació indirecta detallada mitjançant entrevistes semi-estructurades tant a professionals de la salut, com al personal encarregat de gestionar aquests serveis. Els resultats obtinguts ens van permetre de descriure en què consisteixen els serveis de TISSPP dels centres estudiats, quin és el perfil dels seus usuaris, dels seus prestataris i dels professionals de la salut que els utilitzen. Així mateix, descrivim com s'està duent a terme la pràctica de la TISSPP i quina avaluació rep

Speech by Mr. Micheál Martin TD – Meeting The Challenges Of Cultural Diversity In The Irish Healthcare Sector

It gives me great pleasure to accept the invitation to address this conference on “Meeting the Challenges of Cultural Diversity in the Irish Healthcare Sector” which is being organised by the Irish Health Services Management Institute in partnership with the National Consultative Committee on Racism and Interculturalism. The conference provides an important opportunity to develop our knowledge and understanding of the issues surrounding cultural diversity in the health sector from the twin perspectives of patients and staff. Cultural diversity has over recent years become an increasingly visible aspect of Irish society bringing with it both opportunities and challenges. It holds out great possibilities for the enrichment of all who live in Ireland but it also challenges us to adapt creatively to the changes required to realise this potential and to ensure that the experience is a positive one for all concerned but particularly for those in the minority ethnic groups. In the last number of years in particular, the focus has tended to be on people coming to this country either as refugees, asylum seekers or economic migrants. Government figures estimate that as many as 340,000 immigrants are expected in the next six years. However ethnic and cultural diversity are not new phenomena in Ireland. Travellers have a long history as an indigenous minority group in Ireland with a strong culture and identity of their own. The changing experience and dynamics of their relationship with the wider society and its institutions over time can, I think, provide some valuable lessons for us as we seek to address the more numerous and complex issues of cultural diversity which have arisen for us in the last decade. Turning more specifically to the health sector which is the focus of this conference, culture and identity have particular relevance to health service policy and provision in that The first requirement is that we in the health service acknowledge cultural diversity and the differences in behaviours and in the less obvious areas of values and beliefs that this often implies. Only by acknowledging these differences in a respectful way and informing ourselves of them can we address them. Our equality legislation – The Employment Equality Act, 1998 and the Equal Status Act, 2000 – prohibits discrimination on nine grounds including race and membership of the Traveller community. The Equal Status Act prohibits discrimination on an individual basis in relation to the nine grounds while for groups it provides for the promotion of equality of opportunity. The Act applies to the provision of services including health services. I will speak first about cultural diversity in relation to the patient. In this respect it is worth mentioning that the recognition of cultural diversity and appropriate responses to it were issues which were strongly emphasised in the public consultation process which we held earlier this year in the context of developing National Anti-Poverty targets for the health sector and also our new national health strategy. Awareness and sensitivity training for staff is a key requirement for adapting to a culturally diverse patient population. The focus of this training should be the development of the knowledge and skills to provide services sensitive to cultural diversity. Such training can often be most effectively delivered in partnership with members of the minority groups themselves. I am aware that the Traveller community, for example, is involved in in-service training for health care workers. I am also aware that the National Consultative Committee on Racism and Interculturalism has been involved in training with the Eastern Regional Health Authority. We need to have more such initiatives. A step beyond the sensitivity training for existing staff is the training of members of the minority communities themselves as workers in our health services. Again the Traveller community has set an example in this area with its Primary Health Care Project for Travellers. The Primary Health Care for Travellers Project was established in 1994 as a joint partnership initiative with the Eastern Health Board and Pavee Point, with ongoing technical assistance being provided from the Department of Community Health and General Practice, Trinity College, Dublin. This project was the first of its kind in the country and has facilitated The project included a training course which concentrated on skills development, capacity building and the empowerment of Travellers. This confidence and skill allowed the Community Health Workers to go out and conduct a baseline survey to identify and articulate Travellers’ health needs. This was the first time that Travellers were involved in this process; in the past their needs were assumed. The results of the survey were fed back to the community and they prioritised their needs and suggested changes to the health services which would facilitate their access and utilisation. Ongoing monitoring and data collection demonstrates a big improvement in levels of satisfaction and uptake and ulitisation of health services by Travellers in the pilot area. This Primary Health Care for Travellers initiative is being replicated in three other areas around the country and funding has been approved for a further 9 new projects. This pilot project was the recipient of a WHO 50th anniversary commemorative award in 1998. The project is developing as a model of good practice which could inspire further initiatives of this type for other minority groups. Access to information has been identified in numerous consultative processes as a key factor in enabling people to take a proactive approach to managing their own health and that of their families and in facilitating their access to health services. Honouring our commitment to equity in these areas requires that information is provided in culturally appropriate formats. The National Health Promotion Strategy 2000-2005, for example, recognises that there exists within our society many groups with different requirements which need to be identified and accommodated when planning and implementing health promotion interventions. These groups include Travellers, refugees and asylum seekers, people with intellectual, physical or sensory disability and the gay and lesbian community. The Strategy acknowledges the challenge involved in being sensitive to the potential differences in patterns of poor health among these different groups. The Strategic aim is to promote the physical, mental and social well-being of individuals from these groups. The objective of the Strategy on these issues are: While our long term aim may be to mainstream responses so that our health services is truly multicultural, we must recognise the need at this point in time for very specific focused responses particularly for groups with poor health status such as Travellers and also for refugees and asylum seekers. In the case of refugees and asylum seekers examples of targeted services are screening for communicable diseases – offered on a voluntary basis – and psychological support services for those who have suffered trauma before coming here. The two approaches of targeting and mainstreaming are not mutually exclusive. A combination of both is required at this point in time but the balance between them must be kept under constant review in the light of changing needs. A major requirement if we are to meet the challenge of cultural diversity is an appropriate data and research base. I think it is important that we build up our information and research data base in partnership with the minority groups themselves. We must establish what the health needs of diverse groups are; we must monitor uptake of services and how well we are responding to needs and we must monitor outcomes and health status. We must also examine the impact of the policies in other sectors on the health of minority groups. The National Health Information Strategy, currently being developed, and the recently published National Strategy for Health Research – Making Knowledge Work for Health provide important frameworks within which we can improve our data and research base. A culturally diverse health sector workforce – challenges and opportunities The Irish health service can benefit greatly from successful international recruitment. There has been a strong non-national representation amongst the medical profession for more than 30 years. More recently there have been significant increases in other categories of health service workers from overseas. The Department recognises the enormous value that overseas recruitment brings over a wide range of services and supports the development of effective and appropriate recruitment strategies in partnership with health service employers. These changes have made cultural diversity an important issue for all health service organisations. Diversity in the workplace is primarily about creating a culture that seeks, respects, values and harnesses difference. This includes all the differences that when added together make each person unique. So instead of the focus being on particular groups, diversity is about all of us. Change is not about helping “them” to join “us” but about critically looking at “us” and rooting out all aspects of our culture that inappropriately exclude people and prevent us from being inclusive in the way we relate to employees, potential employees and clients of the health service. International recruitment benefits consumers, Irish employees and the overseas personnel alike. Regardless of whether they are employed by the health service, members of minority groups will be clients of our service and consequently we need to be flexible in order to accommodate different cultural needs. For staff, we recognise that coming from other cultures can be a difficult transition. Consequently health service employers have made strong efforts to assist them during this period. Many organisations provide induction courses, religious facilities (such as prayer rooms) and help in finding suitable accommodation. The Health Service Employers Agency (HSEA) is developing an equal opportunities/diversity strategy and action plans as well as training programmes to support their implementation, to ensure that all health service employment policies and practices promote the equality/diversity agenda to continue the development of a culturally diverse health service. The management of this new environment is extremely important for the health service as it offers an opportunity to go beyond set legal requirements and to strive for an acceptance and nurturing of cultural differences. Workforce cultural diversity affords us the opportunity to learn from the working practices and perspectives of others by allowing personnel to present their ideas and experience through teamwork, partnership structures and other appropriate fora, leading to further improvement in the services we provide. It is important to ensure that both personnel units and line managers communicate directly with their staff and demonstrate by their actions that they intend to create an inclusive work place which doesn´t demand that minority staff fit. Contented, valued employees who feel that there is a place for them in the organisation will deliver a high quality health service. Your conference here today has two laudable aims – to heighten awareness and assist health care staff to work effectively with their colleagues from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. There is a synergy in these aims and in the tasks to which they give rise in the management of our health service. The creative adaptations required for one have the potential to feed into the other. I would like to commend both organisations which are hosting this conference for their initiative in making this event happen, particularly at this time – Racism in the Workplace Week. I look forward very much to hearing the outcome of your deliberations. Thank you.

Address by Michea¡l Martin to the Conference - Legislating for Tobacco Free Society

Thank you Chairman I would like to extend a warm welcome to our keynote speakers, David Byrne of the European Commission, Derek Yach from the World Health Organisation, and Paul Quinn representing Congressman Marty Meehan who sends his apologies. When we include the speakers who will address later sessions, this is, undoubtedly, one of the strongest teams that have been assembled on tobacco control in Europe. The very strength of the team underlines what I see as a shift – a very necessary shift – in the way we perceive the tobacco issue. For the last twenty years, we have lived out a paradox. It isn´t a social side issue. I make no apology for the bluntness of what I´m saying, and will come back, a little later, to the radicalism I believe we need to bring – nationally – to this issue. For starters, though, I want to lay it on the line that what we´re talking about is an epidemic as deadly as any suffered by human kind throughout the centuries. Slower than some of those epidemics in its lethal action, perhaps. But an epidemic, nonetheless. According to the World Health Organisation tobacco accounted for just over 3 million annual deaths in 1990, rising to 4.023 million annual deaths in 1998. The numbers of deaths due to tobacco will rise to 8.4 million in 2020 and reach roughly 10 million annually by 2030. This is quite simply ghastly. Tobacco kills. It kills in many different ways. It kills increasing numbers of women. It does its damage directly and indirectly. For children, much of the damage comes from smoking by adults where children live, study, play and work. The very least we should be able to offer every child is breathable air. Air that doesn´t do them damage. We´re now seeing a global public health response to the tobacco epidemic. The Tobacco Free Initiative launched by the World Health Organisation was matched by significant tobacco control initiatives throughout the world. During this conference we will hear about the experiences our speakers had in driving these initiatives. This Tobacco Free Initiative poses unique challenges to our legal frameworks at both national and international levels; in particular it raises challenges about the legal context in which tobacco products are traded and asks questions about the impact of commercial speech especially on children, and the extent of the limitations that should be imposed on it. Politicians, supported by economists and lawyers as well as the medical profession, must continue to explore and develop this context to find innovative ways to wrap public health considerations around the trade in tobacco products – very tightly. We also have the right to demand a totally new paradigm from the tobacco industry. Bluntly, the tobacco industry plays the PR game at its cynical worst. The industry sells its products without regard to the harm these products cause. At the same time, to gain social acceptance, it gives donations, endowments and patronage to high profile events and people. Not good enough. This model of behaviour is no longer acceptable in a modern society. We need one where the industry integrates social responsibility and accountability into its day-to-day activities. We have waited for this change in behaviour from the tobacco industry for many decades. Unfortunately the documents disclosed during litigation in the USA and from other sources make very depressing reading; it is clear from them that any trust society placed in the tobacco industry in the past to address the health problems associated with its products was misplaced. This industry appears to lack the necessary leadership to guide it towards just and responsible action. Instead, it chooses evasion, deception and at times illegal activity to protect its profits at any price and to avoid its responsibilities to society and its customers. It has engaged in elaborate ´spin´ to generate political tolerance, scientific uncertainty and public acceptance of its products. Legislators must act now. I see no reason why the global community should continue to wait. Effective legal controls must be laid on this errant industry. We should also keep these controls under review at regular intervals and if they are failing to achieve the desired outcomes we should be prepared to amend them. In Ireland, as Minister for Health and Children, I launched a comprehensive tobacco control policy entitled “Towards a Tobacco Free Society“. OTT?Excessive?Unrealistic? On the contrary – I believe it to be imperative and inevitable. I honestly hold that, given the range of fatal diseases caused by tobacco use we have little alternative but to pursue the clear objective of creating a tobacco free society. Aiming at a tobacco free society means ensuring public and political opinion are properly informed. It requires help to be given to smokers to break the addiction. It demands that people are protected against environmental tobacco smoke and children are protected from any inducement to experiment with this product. Over the past year we have implemented a number of measures which will support these objectives; we have established an independent Office of Tobacco Control, we have introduced free nicotine replacement therapy for low-income earners, we have extended our existing prohibitions on tobacco advertising to the print media with some minor derogations for international publications. We have raised the legal age at which a person can be sold tobacco products to eighteen years. We have invested substantially more funds in health promotion activities and we have mounted sustained information campaigns. We have engaged in sponsorship arrangements, which are new and innovative for public bodies. I have provided health boards with additional resources to let them mount a sustained inspection and enforcement service. Health boards will engage new Directors of Tobacco Control responsible for coordinating each health board´s response and for liasing with the Tobacco Control Agency I set up earlier this year. Most recently, I have published a comprehensive Bill – The Public Health (Tobacco) Bill, 2001. This Bill will, among other things, end all forms of product display and in-store advertising and will require all retailers to register with the new Tobacco Control Agency. Ten packs of cigarettes will be banned and transparent and independent testing procedures of tobacco products will be introduced. Enforcement officers will be given all the necessary powers to ensure there is full compliance with the law. On smoking in public places we will extend the existing areas covered and it is proposed that I, as Minister for Health and Children, will have the powers to introduce further prohibitions in public places such as pubs and the work place. I will also provide for the establishment of a Tobacco Free Council to advise and assist on an ongoing basis. I believe the measures already introduced and those additional ones proposed in the Bill have widespread community support. In fact, you´re going to hear a detailed presentation from the MRBI which will amply illustrate the extent of this support. The great thing is that the support comes from smokers and non-smokers alike. Bottom line, Ladies and Gentlemen, is that we are at a watershed. As a society (if you´ll allow me to play with a popular phrase) we´ve realised it´s time to ´wake up and smell the cigarettes.´ Smell them. See them for what they are. And get real about destroying their hold on our people. The MRBI survey makes it clear that the single strongest weapon we have when it comes to preventing the habit among young people is price. Simple as that. Price. Up to now, the fear of inflation has been a real impediment to increasing taxes on tobacco. It sounds a serious, logical argument. Until you take it out and look at it a little more closely. Weigh it, as it were, in two hands. I believe – and I believe this with a great passion – that we must take cigarettes out of the equation we use when awarding wage increases. I am calling on IBEC and ICTU, on employers and trade unions alike, to move away from any kind of tolerance of a trade that is killing our citizens. At one point in industrial history, cigarettes were a staple of the workingman´s life. So it was legitimate to include them in the ´basket´ of goods that goes to make up the Consumer Price Index. It isn´t legitimate to include them any more. Today, I´m saying that society collectively must take the step to remove cigarettes from the basket of normality, from the list of elements which constitute necessary consumer spending. I´m saying: “We can no longer delude ourselves. We must exclude cigarettes from the considerations we address in central wage bargaining. We must price cigarettes out of the reach of the children those cigarettes will kill.” Right now, in the monthly Central Statistics Office reports on consumer spending, the figures include cigarettes. But – right down at the bottom of the page – there´s another figure. Calculated without including cigarettes. I believe that if we continue to use the first figure as our constant measure, it will be an indictment of us as legislators, as advocates for working people, as public health professionals. If, on the other hand, we move to the use of the second figure, we will be sending out a message of startling clarity to the nation. We will be saying “We don´t count an addictive, killer drug as part of normal consumer spending.” Taking cigarettes out of the basket used to determine the Consumer Price Index will take away the inflation argument. It will not be easy, in its implications for the social partners. But it is morally inescapable. We must do it. Because it will help us stop the killer that is tobacco. If we can do it, we will give so much extra strength to health educators and the new Tobacco Control Association. This new organisation of young people who already have branches in over fifteen counties, is represented here today. The young adults who make up its membership are well placed to advise children of the dangers of tobacco addiction in a way that older generations cannot. It would strengthen their hand if cigarettes move – in price terms – out of the easy reach of our children Finally, I would like to commend so many public health advocates who have shown professional and indeed personal courage in their commitment to this critical public health issue down through the years. We need you to continue to challenge and confront this grave public health problem and to repudiate the questionable science of the tobacco industry. The Research Institute for a Tobacco Free Society represents a new and dynamic form of partnership between government and civil society. It will provide an effective platform to engage and mobilise the many different professional and academic skills necessary to guide and challenge us. I wish the conference every success.

La responsabilidad patrimonial de la Administración Pública Urbanística

En la memoria del trabajo se detallan las tareas realizadas durante los cuatro años en los que he sido beneficiaria de la beca FI, que me permitió incorporarme en el área de Derecho Administrativo de la Universidad de Girona, bajo la dirección del Dr. Joan M. Trayter Jiménez, para la elaboración del proyecto de investigación "La responsabilidad patrimonial de la Administración Púbica Urbanística", que una vez terminado dará lugar a la Tesis Doctoral. Durante el primer año realizé y superé los cursos del programa de Doctorado “Globalización y Derecho: el Derecho Europeo como referencia”; que me permitió obtener la renovación de la Beca FI, para la elaboración y defensa en el año posterior de la tesina titulada "La responsabilidad patrimonial de la Administración Pública por cambio de la ordenación territorial o urbanística”; con la consiguiente obtención del Diploma de Estudios Avanzados en Derecho. En líneas generales, puedo destacar -además de la investigación en la elaboración de la Tesis-, la realización de dos estancias de investigación en la University of Oxford, bajo la tutorización del Prof. Paul Craig, del St. John's College; gracias a la concesión de una beca por parte del "Institut d'Estudis Autonòmics de Catalunya" y otra, por la Generalitat de Catalunya, dirigida a estancias de investigación en el extrangero. También diversas publicaciones traducidas en la participación en dos libros, un artículo, una recensión y una comunicación; así como la asistencia a distintos Congresos de Derecho Administrativo y seminarios, la realización de distintos cursos entre ellos un Posgrado de Derecho Urbanístico en la UdG y la docencia realizada. Asimismo he devenido miembro de los proyectos de investigación del grupo de investigación del Área; importantes por formar parte del Plan Nacional I+D, financiados por el Ministerio de Educación y Ciencia.