Producción de información para las políticas públicas: observatorio de salud mental y derechos humanos en la provincia de córdoba. Documented information and indicators for the pubic policies in mental health: human rights obseratory in córdoba

El problema que enfrenta la institucionalidad estatal argentina es que existe un serio déficit de información no solamente en el momento de evaluar un resultado, sino ya al momento de diseñar la política. Las estadísticas oficiales de hechos vitales, salud y educación son difundidas en el mejor de los casos con un año de atraso. La información de indicadores de salud por su nivel de desagregación no permite conocer las realidades locales. Es posible constatar la falta de información sobre las medidas tomadas para asegurar el cumplimiento de las obligaciones del Estado en lo relativo a políticas y programas de salud mental. Del mismo modo que los organismos internacionales determinan los deficits de los sistemas de atención a la salud mental a través de las brechas de tratamiento y aun cuando no se dispone de estimaciones precisas se habla de brechas de información, que expresarían la distancia entre la información necesaria y la efectivamente disponible (OPS, 2009). Desde el mes de diciembre de 2007 se conforma la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos, con el objeto de instalar en agenda la necesidad de contar con una legislación que brinde el marco normativo para la transformación del sector. En los meses de octubre y noviembre de 2010 se aprobaron sendas leyes de salud mental en la Provincia de Córdoba y a nivel nacional. Ambas proponen la transformación progresiva en los sistemas de atención a los problemas de salud mental de la población. Desde la Mesa de Trabajo Permanente en Salud Mental y Derechos Humanos se afirma que la legislación es un marco necesario pero no suficiente, en tanto se constata que las princiales violaciones a los derechos humanos se producen en situaciones concretas. El presente proyecto nace de la necesidad de contar con un sistema de información que permita conocer la transformación de los servicios de salud mental en la provincia de Córdoba a partir de la sanción de la ley 9848 de Salud Mental en el mes de octubre de 2010. Una vez logrado este objetivo legislativo, se pretende monitorear la gestión con la formulación de los siguientes interrogantes: ¿a través de qué indicadores medir, evaluar y monitorear si la producción de los servicios de salud mental se lleva adelante desde la perspectiva del enfoque de derechos sancionada en el marco normativo vigente?; ¿cuáles son los indicadores que desde dicha perspectiva los organismos estatales de producción de servicios deben elaborar para el compromiso de acción y la rendición de cuentas frente a la ciudadanía? ¿cuáles son los indicadores que la ciudadanía debe reclamar a los fines de monitorear el cumplimiento de dichos compromisos? La puesta en marcha del Observatorio de Salud Mental y Derechos Humanos permitirá analizar las políticas y programas de salud mental desde la perspectiva de los derechos humanos y avanzar en el monitoreo de la producción de los servicios de salud mental. Objetivo General: analizar y hacer visible el cumplimiento de los objetivos sancionados en la ley 9848 de Salud Mental a través de la observación, el monitoreo y la incidencia en las políticas de salud mental de la provincia de Córdoba. Metodología: la construcción de indicadores de derechos humanos para la salud mental. El Observatorio de Salud Mental y Derechos Humanos pretende dar cuenta de las transformaciones que van a ocurrir a partir de la sanción de la ley 9848. Los resultados esperados están ligados a la producción y difusión de información sistematizada sobre las transformaciones en salud mental, a la vigilancia y el análisis del efecto/impacto de las políticas e incidir en las decisiones. El Observatorio pretende reconocer e integrar la información disponible y proponer indicadores que den cuenta de la situación inicial al momento de la implementación de los marcos normativos y permitir el monitoreo de las transformaciones emergentes. This project stems from the need for an information system designed to show the transformation of mental health services in the province of Cordoba after the enactment of the Mental Health Act 9848 in October 2010. Once achieved this legislative objective is to monitor the management with the formulation of the following questions: through which indicators to measure, evaluate and monitor whether the production of mental health services are carried forward from the perspective of rights-based approach enacted in two laws?, What are the indicators from that perspective the production agencies should develop services for the commitment to action and accountability to the public? What are the indicators that the public should demand that the purpose of monitoring compliance with these commitments? The launch of the Centre for Mental Health and Human Rights will review the policies and mental health programs from the perspective of human rights and progress in monitoring the production of mental health services. General Objective: to analyze and highlight the achievement of the objectives sanctioned by the Mental Health Act 9848 through the observation, monitoring and impact on mental health policy in the province of Cordoba. Methodology: building human rights indicators for mental health Mental Observatory Health and Human Rights aims to account for the changes that will occur after the enactment of Law 9848. The expected results are linked to production and dissemination of systematic information about changes in mental health, surveillance and analysis of the effect / impact and influence policy decisions. The Centre aims to recognize and integrate the available information and propose indicators that account for the initial situation at the time of implementation of regulatory frameworks and allow monitoring of change emerging.

Participación de las células supresoras mieloides (CSM) y T regulatorias (Treg) en el control de la infección con Trypanosoma cruzi y el desarrollo de la patología inflamatoria asociada a la infeccion. Role of Myeloid-Derived Suppressor Cells and regulatory T cells in the control of T. cruzi infection and the infection-associated pathology.

La infección de mamíferos con el T. cruzi resulta en diferentes alteraciones inmunológicas que permiten la persistencia crónica del parásito y destrucción inflamatoria progresiva del tejido cardiaco, nervioso y hepático. Los mecanismos responsables de la patología de la enfermedad de Chagas han sido materia de intensa investigación habiéndose propuesto que el daño producido en esta enfermedad puede ser consecuencia de la respuesta inflamatoria del individuo infectado y/o de una acción directa del parásito sobre los tejidos del hospedador. El propósito del presente proyecto es estudiar comparativamente, en dos cepas de ratones con diferente susceptibilidad a la infección y desarrollo de patología, la participación y los mecanismos efectores de las células supresoras mieloides (CSM) y las celulas T regulatorias inducidas por la infección experimental con Trypanosoma cruzi en el control de la infección con este protozoario y en el desarrollo de la patología hepática siendo los objetivos especificos desarrolar: - Investigar la generación y/o reclutamiento de células de CSM en bazo e hígado de ratones infectados con Trypanosoma cruzi y su contribución a la desigual susceptibilidad a la infección y respuesta inmune desarrollada en las cepas de ratones BALB/c y C57BL/6; - Investigar la capacidad de las CSM inducidas por la infección con T. cruzi en bazo e hígado de ratones de ambas cepas para suprimir la respuesta de células T in vitro e indagar sobre los mecanismos de supresión utilizados; - Investigar la generación y/o reclutamiento de células Treg durante la infección experimental con Trypanosoma cruzi, su participación en la desigual susceptibilidad a la infección y respuesta inmune desarrollada en ambas cepas de ratones y los mecanismos de supresión utilizados. - Analizar en tejido hepático o leucocitos infiltrantes la presencia de COX2, PGE2, MMP2 y 9, IL1b, IL6, IDO, IL10 y GM-CSF capaces de inducir la expansión de las CSM; - Dilucidar si la administración del ligando para TLR2 (Pam3CyS) previo a la infección de ratones C57BL/6 (en los cuales se detecta un menor número de CSM) es capaz de modular la respuesta inflamatoria y el daño hepático a través de la inducción de CSM y/o T reg en hígado y bazo. La comprension de los eventos celulares y moleculares que regulan la producción de citoquinas pro- y anti-inflamatorias y otros mediadores, así como el papel de los receptores de la inmunidad innata durante la infección con T. cruzi contribuirá a responder interrogantes que son claves para el diseño de nuevas estrategias de intervención inmune tendientes a preservar los mecanismos de defensa del huésped. Two nonexclusive mechanisms have been proposed to explain the Chagas’s disease pathology: 1) The pathology of the disease seems to be consequence of the inflammatory response triggered for the parasite; or 2) The damage is produced by the parasite direct effect. Recently, we reported that TLR2, TLR4 and TLR9 (innate immune response receptors) are differentially modulated in injured livers from BALB/c (lesser liver pathology) and C57BL/6 (elevated liver pathology) mice during Trypanosoma cruzi infection. The aim of our proposal is the study of role of Myeloid-Derived Suppressor Cells (MDSC) and regulatory T cells in the control of T. cruzi infection and the infection-associated pathology. Our specific aims are: -To study the induction or recruitment of MDSC in splenn and liver of BALB/c and C57BL/6 mice and their relationship with the differential susceptibility and immune response observed in these both mice strains; - To determine the ability and the mechanisms used by the T. cruzi-induced MDSC to suppress the T cell proliferative response; -To study the induction or recruitment of Treg in liver of BALB/c and C57BL/6 mice and their relationship with the differential susceptibility and immune response observed in these both mice strains; -To analize in liver tissue or tissue infiltrating lymphocytes the activation of COX2, PGE2, MMP2 y 9, IL1b, IL6, IDO, IL10 y GM-CSF known to promote the development of MDSC; -To determine whether the treatment with Pam3CyS (TLR2 ligand) is able to modulate the liver inflammatory respose and damage througth the induction of MDSC or Treg.

An investigation of soil quality parameters relating to agricultural reuse and land disposal options for the management of biosolids

Sludge provides valuable nutrients to soil. Application of sludge to land is subject to a number of limitations. Its use as a soil conditioner represents a "beneficial reuse option". Primary and secondary sludge from Dublin city is treated in Ringsend treatment plant where it undergoes thermal drying. This study investigates the feasibility of land application of thermally dried biosolids (TDB) from Ringsend treatment plant.

Implementing a site waste management plan: a case study of a medium sized building contractor in Ireland

Construction and demolition waste management is becoming increasingly important on construction sites as landfill space in Ireland is rapidly depleting and waste management costs are rising. Due to these factors waste management plans are seen as a good response to minimising waste on site and this thesis aims to investigate how to implement such a plan on a practical case study as well as investigating the legislation regarding construction and demolition waste along with market availability for the reuse of the waste. Main contractor surveys were also carried out in order to gain a better understanding of current attitudes within the industry and these surveys are analysed in chapter five. A survey was also carried out among sub-contractors but this survey has not been used for this thesis as the study is on-going. The primary aim of this thesis is to examine the waste hierarchy opportunities that are available for construction and demolition waste in Ireland and to examine the effects of management strategies on construction and demolition waste reduction at the project level. A partnership was developed with Carey Developments Ltd in Co. Galway and an analysis of their waste management practices was undertaken. The primary case study will be the ‘Taylors Hill’ project in Co. Galway where work commenced in March, 2012. The secondary aim of the thesis is to develop specific waste minimisation strategies for the company and to develop a training tool kit for use on site.

The Irish Pub: past, present – whither the future?

The purpose of this research is to examine the main economic, legislative, and socio- cultural factors that are currently influencing the pub trade in Ireland and their specific impact on a sample of publicans in both Galway city and county. In approaching this task the author engaged in a comprehensive literature review on the origin, history and evolution of the Irish pub; examined the socio-cultural and economic role of the public house in Ireland and developed a profile of the Irish pub by undertaking a number of semi-structured interviews with pub owners from the area. In doing so, the author obtained the views and opinions of the publicans on the current state of their businesses, the extent to which patterns of trade have changed over recent years, the challenges and factors currently influencing their trade, the actions they believed to be necessary to promote the trade and address perceived difficulties and how they viewed the future of the pub business within the framework of the current regulatory regime. In light of this research, the author identified a number of key findings and put forward a series of recommendations designed to promote the future success and development of the pub trade in Ireland. The research established that public houses are currently operating under a very unfavourable regulatory framework that has resulted in the serious decline of the trade over the last decade. This decline appears to have coincided initially with the introduction of the ban on smoking in the workplace and was exacerbated further by the advent of more severe drink-driving laws, especially mandatory breath testing. Other unfavourable conditions include the high levels of excise duty, value added tax and local authority commercial rates. In addition to these regulatory factors, the research established that a major impediment to the pub trade is the unfair competition from supermarkets and other off-licence retail outlets and especially to the phenomenon of the below-cost selling of alcohol. The recession has also been a major contributory factor to the decline in the trade as also has been the trend towards lifestyle changes and home drinking mirroring the practice in some continental European countries.

Environmental management systems implementation

All organisations make some contribution to the degradation of the environment through their use of resources and production of waste. Environmental management systems (EMS) standards can provide a tool for companies to systematically reduce their environmental impacts. ISO 14001 was published in 1996. This fitted in with plans of the case study company to take proactive action in this area, even though there was no legislative requirement for them to do so. As EMS implementation was a new area at the time, appropriate methodologies were developed to address different aspects of the implementation, and ISO 14001 was successfully implemented in the company. The results of the primary research included: ♦ Drawing up a methodology for identifying and interpreting the environmental legislation that may have an impact on the organisation and compiling a register of such regulations. ♦ Developing a robust methodology for assessing significant environmental aspects and impacts and applying this to the software company. ♦ Establishing objectives and targets for those aspects identified as significant and implementing environmental management programmes to meet these. ♦ Developing an internal environmental audit procedure based on auditing against the significant aspects. ♦ Integrating areas of the EMS with the existing quality management system in order to avoid duplication of effort. ♦ Undergoing an external assessment process in order to achieve certification of the system. The thesis concludes that the systematic approach defined in ISO 14001 provided a mechanism that the organisation was able to adopt to bring about improvement in its environmental performance. The system was based on a thorough evaluation of the organisation's significant environmental aspects in order to bring about a reduction in its negative impacts. The ISO 14001 requirement for continual improvement is the key driver of the system, and this is what differentiates it from ISO 9000.