Suchergebnisse

Contract and labour law: towards a more flexile concept of employer? The contract within the sphere of the labour law seems to rediscover a "second youth" , lend itself to act as from "pole of attraction" regarding most important and debated profiles of surveying of the labour law doctrine. If the contract, from the point of view of its "pathological" use, captured the attentions of theoretical and practical operators of labour law, above all regarding the issue of the entrepreneurial removal from the so called "garantismo individuale e collettivo" through the phenomenon of the illegal hiring, on the physiological side the institute in question is led back, in a generally residual dimension, the within of the widest phenomenon of the outsourcing. The intervention of the legislator in matter, always increasing and more detailed regarding the past, reproposes, however in partially new terms, the problematic, particularly "felt" in years seventy of the past century, of the protection, legislative and contractual, of the labour in "small" enterprise. The relative criticalities to the anchorage of the protection to a dimensional requirement, any it is, united to those relative ones to the uncertainty and to the caducity of the "borders" of the enterprise of XXI the century, placed in a perspective, by now, not more exclusively national, make to meet towards the labour law discipline of the contract an interesting series of interpretative and reconstructive issues, a lot on the level of qualifying and protective profile, than on that, to "regulatory" one. These are, as mentioned, profiles that are interlaced and "crossed" among them, which are not compartmentalized, within a dimension that is also European and international. The qualifying profile, in fact, proposes, next and beyond the distinction between public and private contract, the most traditional e controversial profile of the distinction between contract, temporary work and illegal hiring, on one side, and transfer of undertaking and/or a its business unit and contract (above all contract of services), from the other. The protective profile in strict sense finds a progressive development and "updating" of not unknown institutes and instruments to the labour law discipline, like the so called social clause of fair treatment, or in the public contracts or in those private ones. At European level, the crucial theme of labour protection concerning the posting of workers in the framework of the provision of services is regulated, mostly, by the Directive CE 96/71, which tries to link social and economic-competitive considerations in a context of mobility of labour and services within the European market. The attempt of linking the foretold aspects seems to be the central fulcrum of the ulterior characterizing profile of the labour law discipline of the contract and that I have characterized like regulative profile. With regard to, and for a first example, it is analyzed, on one side, technique of the jointly legal responsibility, which redistributes the employer "responsibilities" with reference to the economic and normative treatments to guarantee to the interested workers within the relationships of contractual integration arising from the outsourcing processes, and, from the other, trade-union control of the phenomena of outsourcing. The embryonic regulative profile shows, among other things, the emerging of new institutional and socio-economic actors (like authorities, observatories, but also not governmental organizations, consumer and environmental associations), and instruments (like global framework agreements, codes of conduct, but also the, so called, indici di congruità), that prelude to incipient and additional, regarding those "traditional ones", forms of labour regulation within outsourcing processes, also in a global perspective. Finally, as regards to the contract in particular, an interconnected analysis of the three above qualified profiles offers to us an interesting reconstructive framework in order to inquire a possible and embryonic tendency towards a "flexibilisation" of the "employer concept", at least in terms of Co-employment, that links competitive regulation, labour protection and socio-economic development in a systematic and coherent framework. 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Peggy Grimm Pierce ; The Weber State University Oral History Project began conducting interviews with key Weber State University faculty, administrators, staff and students, in Fall 2007. The program focuses primarily on obtaining a historical record of the school along with important developments since the school gained university status in 1990. The interviews explore the process of achieving university status, as well as major issues including accreditation, diversity, faculty governance, changes in leadership, curricular developments, etc. ; This is an oral history interview with Peggy Grimm Pierce. It was conducted on November 11, 2011 and concerns her recollections and experiences with Weber State University and specifically the Stewart Library. The interviewer is Ruby Licona. ; 18p.; 29cm.; 2 bound transcripts; 4 file folders. 1 video disc: digital; 4 3/4 in. ; i Oral History Program Peggy Grimm Pierce Interviewed by Ruby Licona 11 November 2011 ii Oral History Program Weber State University Stewart Library Ogden, Utah Peggy Grimm Pierce Interviewed by Ruby Licona 11 November 2011 Copyright © 2012 by Weber State University, Stewart Library iii Mission Statement The Oral History Program of the Stewart Library was created to preserve the institutional history of Weber State University and the Davis, Ogden and Weber County communities. By conducting carefully researched, recorded, and transcribed interviews, the Oral History Program creates archival oral histories intended for the widest possible use. Interviews are conducted with the goal of eliciting from each participant a full and accurate account of events. The interviews are transcribed, edited for accuracy and clarity, and reviewed by the interviewees (as available), who are encouraged to augment or correct their spoken words. The reviewed and corrected transcripts are indexed, printed, and bound with photographs and illustrative materials as available. Archival copies are placed in Special Collections. The Stewart Library also houses the original recording so researchers can gain a sense of the interviewee's voice and intonations. Project Description The Weber State University Oral History Project began conducting interviews with key Weber State University faculty, administrators, staff and students, in Fall 2007. The program focuses primarily on obtaining a historical record of the school along with important developments since the school gained university status in 1990. The interviews explore the process of achieving university status, as well as major issues including accreditation, diversity, faculty governance, changes in leadership, curricular developments, etc. ____________________________________ Oral history is a method of collecting historical information through recorded interviews between a narrator with firsthand knowledge of historically significant events and a well-informed interviewer, with the goal of preserving substantive additions to the historical record. Because it is primary material, oral history is not intended to present the final, verified, or complete narrative of events. It is a spoken account. It reflects personal opinion offered by the interviewee in response to questioning, and as such it is partisan, deeply involved, and irreplaceable. ____________________________________ Rights Management All literary rights in the manuscript, including the right to publish, are reserved to the Stewart Library of Weber State University. No part of the manuscript may be published without the written permission of the University Librarian. Requests for permission to publish should be addressed to the Administration Office, Stewart Library, Weber State University, Ogden, Utah, 84408. The request should include identification of the specific item and identification of the user. It is recommended that this oral history be cited as follows: Peggy Grimm Pierce, an oral history by Ruby Licona, 11 November 2011, WSU Stewart Library Oral History Program, University Archives, Stewart Library, Weber State University, Ogden, UT. Peggy Grimm LaDianaeda Sorority 1956 Peggy Grimm Pierce & Don Pierce 50th Wedding Anniversary 2008 Peggy Grimm Pierce ca. 1977 1 Abstract: This is an oral history interview with Peggy Grimm Pierce. It was conducted on November 11, 2011 and concerns her recollections and experiences with Weber State University and specifically the Stewart Library. The interviewer is Ruby Licona. RL: I'm Ruby Licona from the Stewart Library at Weber State University. Today is November 11, 2011. I'm speaking today with Peggy Grimm Pierce, who worked at the Stewart Library from 1977 to 2000. She retired as the Coordinator of the Interlibrary Loan Department. We are speaking at her home in Santa Clara, Utah. Peggy, why don't we start with some general background information? Tell me about your family background, where you were born, and how you ended up at Weber State. PP: I was born and raised in Grand River, Iowa. My father was a truck driver so we moved all over. When I was fifteen, he decided to move to Ogden and we stayed put. That was wonderful for me. I didn't want to leave Iowa because I was dating Don, who is now my husband. My mother caught me in my room crying a few times, but I loved Weber High School. Dr. Rowley, who is also a professor at Weber State, was the drama coach at the high school at the time. I'd never done anything like that before, but I signed up for the class and he took me under his wing. So while I was in high school, I was in a few plays. I came from a hillbilly background in Iowa and I blossomed under Dr. Rowley's care. I was also the homecoming queen, junior prom queen and vice president of the student body. My world had changed immensely from where I came from. Don would come to 2 visit Utah on occasion to see my brother. While I was at Weber State, he came to visit and we got back together again. Before that, I had signed up for a scholarship at Weber under the directions of the girls' advisor. She found out that I didn't intend to go to college because we were too poor. She insisted that I sign up for this scholarship and I got it. I attended Weber State for four quarters, intending to become an elementary school teacher—that was the desire of my heart—but then Don and I decided to get married. I transferred from the telephone company, where I was working even though I was a student at Weber State, and I transferred to Des Moines. We got married in 1958 and Don went to school at the University of Iowa. I longed to complete my degree, but it wasn't possible. We had three children very quickly and I was working. We eventually ended up moving out of state so Don could get his degree. I put him through his Bachelor's and his Master's at Texas A&M. The agreement was that he would then put me through school. But we ended up in Redmond, Oregon, and it was not possible to attend college there, I would have had to leave my family for extended periods of time, which I wasn't willing to do. Don decided, after five years as an administrator in the Redmond School District, that we would come back to Utah. We came back for a summer vacation in the summer of 1977—my parents still lived here—and Don decided to look for work. He went to the Weber State campus to look and when he came back, he told me that there was a job for a Reserve librarian. I said, "I'm not going to interview for a job until you get one." He said, "Just go ahead and interview, at least, and I'll be interviewing in other places." I interviewed with 3 Craige Hall and we then went home to Oregon because Don hadn't found a job. When we got home, Craige called and told me that he'd like to offer the Reserve librarian job to me. I said, "Thank you, I appreciate the offer, but I will not be taking it because my husband did not get a job in Utah." I hung up and took our three daughters and went shopping. While we were shopping, Don called Craige back and told him I'd take the job. [Laughter] Craige, then, was laboring under the false impression that I was this little lady who did everything her husband said. RL: He was in for a rude awakening. [Laughter] PP: When I did accept the position, I told Craige that I would be working for three years because I intended to get my degree and then become an elementary teacher. Well, seven years later I was still working in the library and I did, finally, graduate with an elementary education degree. RL: When was that? PP: That was in 1984. I then had to go to the hospital and have gall bladder surgery, but I had already interviewed for an Interlibrary Loan position. While I was in the hospital, Scott Burkenshaw peeked around the corner and said, "Peggy, you got the job." I said, "Oh my goodness, you must be desperate." That was the Interlibrary Loan coordinator position and I just loved it. RL: You did it for a long time. PP: There was so much that had to be learned. I had to learn the OCLC system. It was like getting another degree and I thoroughly enjoyed it. Working with all the faculty and staff was a real treat, as well. During that time, I was selected as the 4 Presidential Outstanding Staff Member. I think it must have been just because I had so many contacts with faculty and they had been so happy to get the materials that they needed for their research. Here's a funny story from Interlibrary Loan: there was a student who was doing research on swine waste and methane gas. I did a lot of searching in order to get the materials that he needed for his research. He earned an award for his research. He came in and told me how happy he was and said, "I just wish there was something I could do for you." Over the course of the conversation, we had talked about how he was gardening and I was gardening and he had a lot better tomatoes than his dad had and it was because of this swine waste. Then it was like a light bulb went on above his head and he said, "Oh! That's what I can do for you—I can bring you swine manure!" [Laughter] A couple of weeks before that, I had been talking to Joan Hubbard because she had worked in Interlibrary Loan also. She said, "That's the only job in the library that I know of where you get candy and flowers for your efforts." I could hardly wait to tell her that there was one other thing that you could get as a reward for your efforts. RL: After forty years of working in libraries, I have to say that you're the first person I've ever heard of that got swine waste as a thank you gift. I can imagine that it was very rewarding to be able to help people with their research. I know that in Interlibrary Loan you get to work with people all over the world. PP: You certainly do. Some of them were the students working in the library under my supervision. I started out with Kim Wynn working there as a student; she was from Vietnam. Her family was still in Vietnam, but she had been working for the 5 United States government. Without any warning, she was told that she needed to pack a sack of belongings and get on the plane because the Communists were coming and she would be killed because she was working for the United States government. So she did and ended up in a small apartment working at Weber. She was an excellent worker. She came to me one day and said, "I have two brothers that are in Communist prisons who are working for South Vietnam in the military." A while later, she came back and said, "My brothers have escaped." She got them to the United States—I don't know how. She came to me one day and said, "Peggy, I need for my brothers to have jobs." They could barely speak English. I told her I could employ one, but not both. So Tuan started working in the Reserve Department. He had a wonderful work ethic. When we had days that the campus was closed because of snow, the library wouldn't be closed, but Tuan would get to work before I did and he was always there. Very dependable. Later on, Tuan asked me if his nephew, who had just arrived from Vietnam, could work in the library. They were a very fine family. I had a Japanese boy who worked for the library under my supervision and an Iranian man, too. It was just delightful. RL: It sounds like you had your own little Diversity Department right there in the library. PP: We really did. [Laughter] RL: Let's back up a little bit. When you arrived and took the position as the Reserve librarian, how many people were employed by the library at that point? Do you have any idea? 6 PP: I do not, but it certainly did grow after that. RL: When you arrived, was the library already in both wings? PP: Yes. We had both—with the accompanying heat problems. RL: Do you remember some of the people that you worked with at the beginning? PP: Louise Larkin comes to mind. And the lady who worked with her—they were delightful. They were working in the back—classifying and cataloging books as they came in. One of my very best friends was Linda Heinze. It turns out that Linda went to Weber High School at the same time I did. RL: Did you know one another? PP: No. She joked about how she was in the parking lot crowd while I was in with the student counsel trying to decide what to do about the parking lot crowd. She was working on the keypunch. RL: Doing the cards for the checkout system? PP: Yes. I had done that when I was employed by Internal Revenue, so I was well aware of what kind of work she was doing there. I don't want to digress, but I don't want to miss telling you about this, too. The summer that Craige decided to become a part-time director of the library— RL: He became part-time director of the library and also the director over the computer center. PP: Yes. That was the most horrendous summer that I have spent on the campus. It was partly because of Craige having to leave, but mostly because we had this huge steel corrugated panel that was being pounded into the earth behind the library to prevent water from coming into the basement. They pounded that all 7 summer long. If that wasn't enough, we also had a new online system come into the library that summer. RL: The online checkout and cataloging? PP: Yes. That had to all be learned from scratch. It was so demanding. But we got through it and what a wonderful library. RL: That was in the middle of the '80s? PP: Probably. When you talk to Craige, you'll be able to figure it out. I'm sure he remembers it well. RL: So you essentially worked with Reserve and then went to Interlibrary Loan? PP: Yes. I also worked at the Reference desk while I was the coordinator of Interlibrary Loan. Boy, that was interesting. My favorite saying about working in the library was that I never had a day working there when I didn't learn something. It was stimulating. I have worked for JC Penney, for the Bell Telephone Company, for the Army, and for the Air Force, and I have never found better people to work with than the people on that campus. I found the morals to be higher and the friendships to be long-lasting. The help, when you needed it, was there. RL: Now, I believe that the Presidential Distinguished Staff Award that you got was not only for your work in the library but you were also involved in things on campus outside of the library. PP: Yes. I was part of the Employee's Association. It was state-wide and it was to negotiate for salaries and to try to get better benefits and so on. I became the president for that association on campus. One summer, some officials from 8 campus came to me and said that they had a Centennial Court that they had built on campus and that they were going to dedicate it and that it would have my name on it. I went to the dedication and found out that my sister's name was also on the wall. RL: That would have been 1989? PP: Yes. My sister had been vice president of the student body when she was a student there. So it was fun to see that my name was there along with hers. RL: That puts you into the Weber State history. PP: Well, you know, I started as a student in the old campus before we had a dedicated library building. It was in what we called "the tub." I attended classes on the lower campus. In fact, I was taking a swimming class and then I would have to rush to my photography class on the upper campus. They wanted me to do the modeling for their class even though I didn't have a hairdryer and all the things that you have now in order to fix yourself up rapidly. That was interesting. [Laugher] I loved my classes when I finally got into the elementary education classes. We had the "Wilkits" at that point. If you weren't organized, then you very well better get organized. You had things you had to do at a specified time. RL: Were these teaching kits? Kind of teaching you pedagogy? PP: Yes. Teaching all the kinds of things you had to know in order to teach elementary education. RL: Lesson plans and activities and so forth? PP: Yes, we also had formal classes, but those "Wilkits" were the primary part of that course work. A few years later, my daughter was in the same program. In fact, I 9 have three daughters that graduated from Weber State. My brother and my sister did, as well, and my husband and my niece attended there. RL: Other than the Employee's Association, were there other associations or committees on campus that you were involved in? PP: Yes, but I'm sorry, I can't recall the name of the committee. I spent a lot of time on it, too. It was for employees but it wasn't with the Employee's Association. RL: I seem to remember that when Paul and Carolyn Thompson came to campus, you had known them from when you were in school. PP: I had known them from high school. They were a little bit younger than I was. We weren't super close because I was older than them. RL: So you were not on campus at Weber when they were students there? PP: I think I left just before they became active at Weber State. RL: And were you able to interact with them after you came back to the campus? PP: Yes, I think they're really very fine people. I said to Paul one time, "Paul, I'm going to have to just start shaking hands with you when I meet you in a line of people because I think there's some people who don't like it when I get a big hug." [Laughter] He said, "That's ridiculous." We've been friends for a long time and he knows my family. RL: Now, you mentioned some of the different places you've worked. When you worked for JC Penney, was that in Ogden? PP: Yes, it was in Ogden. Let me tell you how I started there. I was sixteen years old. We'd lived in Ogden for a year—I came from a background of wearing flannel shirts, jeans, moccasins and two pairs of socks—and I found out that that was 10 not the way you dressed in Ogden. When you went downtown in the '50s, you wore your best attire and gloves. So here I was, sixteen, by myself, downtown, and dressed up with my gloves. I was going through the JC Penney store and a very distinguished-looking gentleman came up to me and he said, "Miss, how would you like to work here?" I tipped my nose in the air and I walked off. I didn't know him and I didn't know what he was up to. It turned out that he was Ted Schmidt, the manager of JC Penney and Mayor of Ogden, as well. RL: Oh my goodness. PP: So one year later, I was walking through JC Penney with my aunt and we were both dressed up with our gloves. Ted Schmidt came up to me and made the same approach and I started to tip my nose up and Auntie said, "Just a minute, dear, let's go talk to the gentleman." So Ted took us upstairs to his office and offered me a job as a model. I'd never modeled before in my life! But I accepted the job and Ted taught me how to pivot, how to hold my hands, how to dress and how to walk. Then, there was a stand by the elevator where the models stood and wore the dresses that were on sale in the store. One day as I was turning, the elevator door opened and this little boy came out with his mom and he looked up and said, "Wow, look Mom, the dummy moved!" [Laughter] Another day, I caught a lady shoplifting while I was standing on that platform. Another time, it was approaching Easter and they had a lot of hats for sale. They set up a store window with all of these hats on the floor, a dressing table, a mirror, and me. I was sitting there and as people would walk by, they'd point to a hat and I'd model it for them. It was so much fun! 11 RL: You also mentioned that you worked for the military. What did you do there? PP: I was a keypunch operator for the Air Force. I also worked for Internal Revenue as a keypunch operator. I didn't do well at typing. My worst class and lowest grade in high school was in typing. So when this job came up with Internal Revenue Service as a keypunch operator— RL: Was that in Ogden? PP: Yes, it was in Ogden. For the job, you needed to be able to do twenty-five words per minute typing. I rented a typewriter and practiced and practiced. I took the test three times and never got to twenty-five words per minute. Finally, the gentleman in the employment office took pity on me and said, "I'm going to put you through, anyway." So I took the training and eventually, after I had worked there for a while, my accuracy and speed got so good that I received a monetary award. RL: In your time at Weber, are there particular incidents or movements that stand out? PP: The emphasis on diversity really changed all of us, I think. While we may have already believed in the premise, there wasn't much said about diversity until that time. We even had contests where we decorated doors with the diversity theme. I did that for a few years in the library. RL: They also started making a lot more services available for the different groups. PP: Yes. They also installed the little island, if you will, in the back parking lot. That was during President Nadauld's terms. At the time, it was suggested that the staff could use that for breaks and lunches and things. 12 RL: They took away the parking lot and put in that little plaza. PP: There was a lot of debate at the time. I didn't agree with it, but it looks nice now. I don't know how it's used. I hope the fire trucks can get around it. RL: Yes, the fire trucks can get around there. This past year, they made that back area of the library the only spot where the shuttle buses from the Dee Events Center stop. We get a lot of traffic in the library because it drops the students right there. PP: Very good. There was quite a long time there where they weren't able to be dropped off close to the library. It was quite a trip for them. RL: Anything in the library in terms of the organization of it? You mentioned the summer that Craige became part-time director of the library and was over the computing center. Did that affect the people in the library? He was a good administrator and he was organized. PP: He did and he had a lot of experience before that. I really didn't notice huge problems as far as him being gone. He managed to keep us working smoothly in spite of all that was going on during that summer. RL: Were there things that happened that were less than perfect? I'm not asking for dirt or anything, but are there things that stand out in your mind from your time? PP: It was a time when most people in the library didn't think that the evaluation form that we were using—and it was the same that they were using daily—was something that we should continue with. They were considering changing that, but it just happened to fall on me to be the first person that they evaluated. RL: Was this under Craige? 13 PP: Yes, but he wasn't involved. Five faculty members evaluated me for one hour and the very first thing that one of them said was, "Your previous evaluation forms looks like you can walk on water and that's just not possible." They then decided to downgrade my evaluation. Not because I hadn't performed adequately, but because they didn't think that I—or anybody else—should be graded so highly. So after an hour of this grueling situation, we were closing and one of the faculty said, "Peggy, how do you feel about this?" I said, "I feel like I've been run over by a truck and you'll be hearing from me again." Then I went to Human Resources and told the director what had happened. RL: Was that Stan Greenhalgh? PP: Yes, it was. Stan said that should not have occurred because an evaluation is to make you feel better, not worse. You should not be evaluated by five people; it should be a one-on-one. RL: And it should be your direct supervisors. PP: They weren't. The result was that I was evaluated again by Craige. I think, eventually, we got a different evaluation form. I remember going to Enable Industries, the firm where my husband was president. Every time I heard negative remarks in the library about the work and the jobs, I kept thinking off all of these disabled people at Enable Industries and everything they had to go through to get a job and keep a job. Joan suggested that we take a group of people over there and we decided to take a group from the library to tour Enable Industries. During that time, Joan was with us and she 14 was quite intrigued by the evaluation methods that they were using there. I think that some of those methods were initiated later on. RL: We can always learn from one another. I think the people on that tour benefited from seeing how bad they didn't have it. PP: Absolutely. That was an eye-opener. RL: I remember that in addition to your responsibilities in working at the Reference desk, you acted as the bibliographer for the children's books for a while. Was that because of your teaching experience and background? PP: When I was taking classes in elementary education, several times I would take an armload of books from the young people's collection to class and tell them about them. They weren't aware of having such a wonderful young people's collection in the Stewart Library. Even the faculty was intrigued by the beautiful books that I was showing. When it became my opportunity to work directly with the young people's collection, I loved it. RL: Did you buy the books? PP: I ordered a minimum amount of them. Our library budget, at that time, was very small. We would regularly get the Newberry Award books and so on. When we had a tour that was being scheduled to come through with children in it, the other faculty members would shy away from that group. Finally, they asked if I wanted to do it and so I got to conduct several tours with children's groups. I got to read them stories in the library. 15 RL: We had a group just two weeks ago that came through. I think they were three and four years old. It is a great resource for the education students—knowing about that collection is important. PP: True. I took a class on children's literature. What helped my interest to grow was that I had been the children's librarian in several different schools in Oregon, so I was aware of the many books available. I had children of my own and I found it fun to give birthday gifts and Christmas gifts to my children and grandchildren in the form of books. I've always loved books. RL: It's good for a librarian to love books. It's a disappearing art. So, Peggy, any more memories that you'd like to share from the years of your tenure at the library? PP: There's one disturbing situation involving a student worker and a student who used Interlibrary Loan heavily. Actually, let me backtrack a little bit. My sister-in-law works at the University of Iowa where they had a shooting incident. I think three people were killed because of a student being angry. After that, there was a lot of work in compiling information and finding out what could be done to avoid that sort of thing. I called Linda and asked her if she could send me some of this information. I gave the information to Joan and it wasn't very long after that that we had a student from Vietnam or Thailand who was a student worker at the main desk and used Interlibrary Loan extensively. A brilliant young man. He got involved with a young woman whose husband was still in Asia. He loaned her a large amount of money and was very fond of her. When her husband came to 16 Ogden, everything kind of fell apart. We started having meetings about this trio of people and what could be done because it was very disruptive. RL: Disruptive in what way? PP: He was angry at her because she had gone back to her husband and had not paid him back his loan. He still cared for her and he was losing face, which is upsetting in the Asian culture. Well, a meeting was called. It was to be held in the Union Building with the campus attorney, the three individuals, and the head of the department where he worked in the library. RL: Circulation? PP: Yes, Circulation. So they all congregated for the meeting and this young man came in with a backpack. RL: It was a disciplinary hearing, wasn't it? PP: Yes, it was. It just happened that the campus police officer was there, as well. That was unusual because he didn't usually attend those meetings. Well, the student employee pulled a gun out of his backpack and started shooting. He shot the attorney in the arm. He was trying to shoot and kill the woman's husband. He shot the police officer in the nose. Finally, the student was killed by the police officer. It was so very upsetting to all the library personnel who had known him and to the young woman, as well. RL: It created a lot of grief and consternation. It must have been about the lowest point in your library career. What was the highest point? 17 PP: It was very good to receive an award and be recognized for the hard work that I had done in Interlibrary Loan. I had a couple of people mention me on books that they had written. RL: Dedications? PP: That I had helped contribute. That was great. RL: In any work situation, there's the good and there's the bad and those are the incidents we remember. PP: And here I am now, retired. When I retired in 2000, it was in winter—January. I went home to cold, wintery days and I realized, "What have I done?" Then Joan offered me the opportunity to come back part-time at the Reference desk. I think it was about two years that I worked there so I could transition into being retired. RL: My memory of your time in the library was a time when we had had a horrible snow storm. I had a house that had a triple-wide driveway and I had spent an hour and a half clearing the snow off of it, then I went inside, showered, got dressed, got to work, and you were the only one in the building. You had this really nonplussed expression on your face and I said, "What's going on?" You said, "They closed the university." [Laughter] Essentially, we both laughed that someone had called off the party and didn't bother to let us know. PP: Most of the time, the library stayed open. We maintained that there were still students on campus that needed to have a place to go to. I remember one time, the sky light on the third floor was blown off and there we were with Reference on the third floor. We were still working and all the buildings around the library had been closed because of the wind. And here we were, still working. 18 RL: At least you can laugh about it. I know that your time in the library was very much appreciated and the time that you've taken to talk with me today is appreciated. Thank you. PP: You're sure welcome.

Smoking is a major heritable and modifiable risk factor for many diseases, including cancer, common respiratory disorders and cardiovascular diseases. Fourteen genetic loci have previously been associated with smoking behaviour-related traits. We tested up to 235,116 single nucleotide variants (SNVs) on the exome-array for association with smoking initiation, cigarettes per day, pack-years, and smoking cessation in a fixed effects meta-analysis of up to 61 studies (up to 346,813 participants). In a subset of 112,811 participants, a further one million SNVs were also genotyped and tested for association with the four smoking behaviour traits. SNV-trait associations with P < 5 × 10-8 in either analysis were taken forward for replication in up to 275,596 independent participants from UK Biobank. Lastly, a meta-analysis of the discovery and replication studies was performed. Sixteen SNVs were associated with at least one of the smoking behaviour traits (P < 5 × 10-8) in the discovery samples. Ten novel SNVs, including rs12616219 near TMEM182, were followed-up and five of them (rs462779 in REV3L, rs12780116 in CNNM2, rs1190736 in GPR101, rs11539157 in PJA1, and rs12616219 near TMEM182) replicated at a Bonferroni significance threshold (P < 4.5 × 10-3) with consistent direction of effect. A further 35 SNVs were associated with smoking behaviour traits in the discovery plus replication meta-analysis (up to 622,409 participants) including a rare SNV, rs150493199, in CCDC141 and two low-frequency SNVs in CEP350 and HDGFRP2. Functional follow-up implied that decreased expression of REV3L may lower the probability of smoking initiation. The novel loci will facilitate understanding the genetic aetiology of smoking behaviour and may lead to the identification of potential drug targets for smoking prevention and/or cessation. ; The authors would like to thank the many colleagues who contributed to collection and phenotypic characterisation of the clinical samples, as well as genotyping and analysis of the GWA data. Special mentions are as follows: CGSB participating cohorts: Some of the data utilised in this study were provided by the Understanding Society: The UK Household Longitudinal Study, which is led by the Institute for Social and Economic Research at the University of Essex and funded by the Economic and Social Research Council. The data were collected by NatCen and the genome wide scan data were analysed by the Wellcome Trust Sanger Institute. The Understanding Society DAC have an application system for genetics data and all use of the data should be approved by them. The application form is at: https://www.understandingsociety.ac.uk/about/health/data. The Airwave Health Monitoring Study is funded by the UK Home Office, (Grant number 780-TETRA) with additional support from the National Institute for Health Research Imperial College Health Care NHS Trust and Imperial College Biomedical Research Centre. We thank all participants in the Airwave Health Monitoring Study. This work used computing resources provided by the MRC- funded UK MEDical Bioinformatics partnership programme (UK MED-BIO) (MR/L01632X/1). Paul Elliott wishes to acknowledge the Medical Research Council and Public Health England (MR/L01341X/1) for the MRC-PHE Centre for Environment and Health; and the NIHR Health Protection Research Unit in Health Impact of Environmental Hazards (HPRU-2012-10141). Paul Elliott is supported by the UK Dementia Research Institute which receives its funding from UK DRI Ltd funded by the UK Medical Research Council, Alzheimer's Society and Alzheimer's Research UK. Paul Elliott is associate director of the Health Data Research UK London funded by a consortium led by the UK Medical Research Council. SHIP (Study of Health in Pomerania) and SHIP-TREND both represent population-based studies. SHIP is supported by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung (BMBF); grants 01ZZ9603, 01ZZ0103, and 01ZZ0403) and the German Research Foundation (Deutsche Forschungsgemeinschaft (DFG); grant GR 1912/5-1). SHIP and SHIP-TREND are part of the Community Medicine Research net (CMR) of the Ernst-Moritz-Arndt University Greifswald (EMAU) which is funded by the BMBF as well as the Ministry for Education, Science and Culture and the Ministry of Labor, Equal Opportunities, and Social Affairs of the Federal State of Mecklenburg-West Pomerania. The CMR encompasses several research projects that share data from SHIP. SNP typing of SHIP and SHIP-TREND using the Illumina Infinium HumanExome BeadChip (version v1.0) was supported by the BMBF (grant 03Z1CN22). LifeLines authors thank Behrooz Alizadeh, Annemieke Boesjes, Marcel Bruinenberg, Noortje Festen, Ilja Nolte, Lude Franke, Mitra Valimohammadi for their help in creating the GWAS database, and Rob Bieringa, Joost Keers, René Oostergo, Rosalie Visser, Judith Vonk for their work related to data-collection and validation. The authors are grateful to the study participants, the staff from the LifeLines Cohort Study and Medical Biobank Northern Netherlands, and the participating general practitioners and pharmacists. LifeLines Scientific Protocol Preparation: Rudolf de Boer, Hans Hillege, Melanie van der Klauw, Gerjan Navis, Hans Ormel, Dirkje Postma, Judith Rosmalen, Joris Slaets, Ronald Stolk, Bruce Wolffenbuttel; LifeLines GWAS Working Group: Behrooz Alizadeh, Marike Boezen, Marcel Bruinenberg, Noortje Festen, Lude Franke, Pim van der Harst, Gerjan Navis, Dirkje Postma, Harold Snieder, Cisca Wijmenga, Bruce Wolffenbuttel. The authors wish to acknowledge the services of the LifeLines Cohort Study, the contributing research centres delivering data to LifeLines, and all the study participants. Niek Verweij was supported by NWO VENI (016.186.125). Fenland authors thank Fenland Study volunteers for their time and help, Fenland Study general Practitioners and practice staff for assistance with recruitment, and Fenland Study Investigators, Co-ordination team and the Epidemiology Field, Data and Laboratory teams for study design, sample/data collection and genotyping. We thank all ASCOT trial participants, physicians, nurses, and practices in the participating countries for their important contribution to the study. In particular we thank Clare Muckian and David Toomey for their help in DNA extraction, storage, and handling. We would also like to acknowledge the Barts and The London Genome Centre staff for genotyping the Exome Chip array. The BRIGHT study is extremely grateful to all the patients who participated in the study and the BRIGHT nursing team. We would also like to thank the Barts Genome Centre staff for their assistance with this project. Patricia B. Munroe, Mark J. Caulfield, and Helen R. Warren wish to acknowledge the NIHR Cardiovascular Biomedical Research Unit at Barts and The London, Queen Mary University of London, UK for support. Mark J. Caulfield are Senior National Institute for Health Research Investigators. EMBRACE Collaborating Centres are: Coordinating Centre, Cambridge: Daniel Barrowdale, Debra Frost, Jo Perkins. North of Scotland Regional Genetics Service, Aberdeen: Zosia Miedzybrodzka, Helen Gregory. Northern Ireland Regional Genetics Service, Belfast: Patrick Morrison, Lisa Jeffers. West Midlands Regional Clinical Genetics Service, Birmingham: Kai-ren Ong, Jonathan Hoffman. South West Regional Genetics Service, Bristol: Alan Donaldson, Margaret James. East Anglian Regional Genetics Service, Cambridge: Joan Paterson, Marc Tischkowitz, Sarah Downing, Amy Taylor. Medical Genetics Services for Wales, Cardiff: Alexandra Murray, Mark T. Rogers, Emma McCann. St James's Hospital, Dublin & National Centre for Medical Genetics, Dublin: M. John Kennedy, David Barton. South East of Scotland Regional Genetics Service, Edinburgh: Mary Porteous, Sarah Drummond. Peninsula Clinical Genetics Service, Exeter: Carole Brewer, Emma Kivuva, Anne Searle, Selina Goodman, Kathryn Hill. West of Scotland Regional Genetics Service, Glasgow: Rosemarie Davidson, Victoria Murday, Nicola Bradshaw, Lesley Snadden, Mark Longmuir, Catherine Watt, Sarah Gibson, Eshika Haque, Ed Tobias, Alexis Duncan. South East Thames Regional Genetics Service, Guy's Hospital London: Louise Izatt, Chris Jacobs, Caroline Langman. North West Thames Regional Genetics Service, Harrow: Huw Dorkins. Leicestershire Clinical Genetics Service, Leicester: Julian Barwell. Yorkshire Regional Genetics Service, Leeds: Julian Adlard, Gemma Serra-Feliu. Cheshire & Merseyside Clinical Genetics Service, Liverpool: Ian Ellis, Claire Foo. Manchester Regional Genetics Service, Manchester: D Gareth Evans, Fiona Lalloo, Jane Taylor. North East Thames Regional Genetics Service, NE Thames, London: Lucy Side, Alison Male, Cheryl Berlin. Nottingham Centre for Medical Genetics, Nottingham: Jacqueline Eason, Rebecca Collier. Northern Clinical Genetics Service, Newcastle: Alex Henderson, Oonagh Claber, Irene Jobson. Oxford Regional Genetics Service, Oxford: Lisa Walker, Diane McLeod, Dorothy Halliday, Sarah Durell, Barbara Stayner. The Institute of Cancer Research and Royal Marsden NHS Foundation Trust: Ros Eeles, Nazneen Rahman, Elizabeth Bancroft, Elizabeth Page, Audrey Ardern-Jones, Kelly Kohut, Jennifer Wiggins, Jenny Pope, Sibel Saya, Natalie Taylor, Zoe Kemp and Angela George. North Trent Clinical Genetics Service, Sheffield: Jackie Cook, Oliver Quarrell, Cathryn Bardsley. South West Thames Regional Genetics Service, London: Shirley Hodgson, Sheila Goff, Glen Brice, Lizzie Winchester, Charlotte Eddy, Vishakha Tripathi, Virginia Attard. Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton: Diana Eccles, Anneke Lucassen, Gillian Crawford, Donna McBride, Sarah Smalley. Understanding Society Scientific Group is funded by the Economic and Social Research Council (ES/H029745/1) and the Wellcome Trust (WT098051). Paul D.P. Pharoah is funded by Cancer Research UK (C490/A16561). SHIP is funded by the German Federal Ministry of Education and Research (BMBF) and the German Research Foundation (DFG); see acknowledgements for details. F.W. Asselbergs is funded by the Netherlands Heart Foundation (2014T001) and supported by UCL Hospitals NIHR Biomedical Research Centre. The LifeLines Cohort Study, and generation and management of GWAS genotype data for the LifeLines Cohort Study is supported by the Netherlands Organization of Scientific Research NWO (grant 175.010.2007.006), the Economic Structure Enhancing Fund (FES) of the Dutch government, the Ministry of Economic Affairs, the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the Northern Netherlands Collaboration of Provinces (SNN), the Province of Groningen, University Medical Center Groningen, the University of Groningen, Dutch Kidney Foundation and Dutch Diabetes Research Foundation. Niek Verweij is supported by Horizon 2020, Marie Sklodowska-Curie (661395) and ICIN-NHI. Phenotype collection in the Lothian Birth Cohort 1921 was supported by the UK's Biotechnology and Biological Sciences Research Council (BBSRC), The Royal Society and The Chief Scientist Office of the Scottish Government. Phenotype collection in the Lothian Birth Cohort 1936 was supported by Age UK (The Disconnected Mind project). Genotyping was supported by Centre for Cognitive Ageing and Cognitive Epidemiology (Pilot Fund award), Age UK, and the Royal Society of Edinburgh. The work was undertaken by The University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (MR/K026992/1). Funding from the BBSRC and Medical Research Council (MRC) is gratefully acknowledged. Paul W. Franks is supported by Novo Nordisk, the Swedish Research Council, Påhlssons Foundation, Swedish Heart Lung Foundation (2020389), and Skåne Regional Health Authority. Nicholas J Wareham, Claudia Langenberg, Robert A Sacott, and Jian'an Luan are supported by the MRC (MC_U106179471 and MC_UU_12015/1). The BRIGHT study was supported by the Medical Research Council of Great Britain (Grant Number G9521010D); and by the British Heart Foundation (Grant Number PG/02/128). The BRIGHT study is extremely grateful to all the patients who participated in the study and the BRIGHT nursing team. The Exome Chip genotyping was funded by Wellcome Trust Strategic Awards (083948 and 085475). We would also like to thank the Barts Genome Centre staff for their assistance with this project. The ASCOT study and the collection of the ASCOT DNA repository was supported by Pfizer, New York, NY, USA, Servier Research Group, Paris, France; and by Leo Laboratories, Copenhagen, Denmark. Genotyping of the Exome Chip in ASCOT-SC and ASCOT-UK was funded by the National Institutes of Health Research (NIHR). Anna F. Dominiczak was supported by the British Heart Foundation (Grant Numbers RG/07/005/23633, SP/08/005/25115); and by the European Union Ingenious HyperCare Consortium: Integrated Genomics, Clinical Research, and Care in Hypertension (grant number LSHM-C7-2006-037093). Nilesh J. Samani is supported by the British Heart Foundation and is a Senior National Institute for Health Research Investigator. Panos Deloukas is supported by the British Heart Foundation (RG/14/5/30893), and NIHR, where his work forms part of the research themes contributing to the translational research portfolio of Barts Cardiovascular Biomedical Research Centre which is funded by the National Institute for Health Research (NIHR). The LOLIPOP study is supported by the National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre Imperial College Healthcare NHS Trust, the British Heart Foundation (SP/04/002), the Medical Research Council (G0601966, G0700931), the Wellcome Trust (084723/Z/08/Z, 090532 & 098381) the NIHR (RP-PG-0407-10371), the NIHR Official Development Assistance (ODA, award 16/136/68), the European Union FP7 (EpiMigrant, 279143) and H2020 programs (iHealth-T2D, 643774). We acknowledge support of the MRC-PHE Centre for Environment and Health, and the NIHR Health Protection Research Unit on Health Impact of Environmental Hazards. The work was carried out in part at the NIHR/Wellcome Trust Imperial Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the Imperial College Healthcare NHS Trust, the NHS, the NIHR or the Department of Health. We thank the participants and research staff who made the study possible. JC is supported by the Singapore Ministry of Health's National Medical Research Council under its Singapore Translational Research Investigator (STaR) Award (NMRC/STaR/0028/2017). The research was supported by the National Institute for Health Research (NIHR) Exeter Clinical Research Facility and ERC grant 323195; SZ-245 50371-GLUCOSEGENES-FP7-IDEAS-ERC to T.M. Frayling. Hanieh Yaghootkar is funded by Diabetes UK RD Lawrence fellowship (grant:17/0005594) Anna Dominiczak was funded by a BHF Centre of Research Excellence Award (RE/13/5/30177) GSCAN participating cohorts: The Collaborative Study on the Genetics of Alcoholism (COGA), Principal Investigators: B. Porjesz, V. Hesselbrock, H. Edenberg, L. Bierut. The study includes eleven different centers: University of Connecticut (V. Hesselbrock); Indiana University (H.J. Edenberg, J. Nurnberger Jr., T. Foroud); University of Iowa (S. Kuperman, J. Kramer); SUNY Downstate (B. Porjesz); Washington University in St. Louis (L. Bierut, J. Rice, K. Bucholz, A. Agrawal); University of California at San Diego (M. Schuckit); Rutgers University (J. Tischfield, A. Brooks); Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA (L. Almasy), Virginia Commonwealth University (D. Dick), Icahn School of Medicine at Mount Sinai (A. Goate), and Howard University (R. Taylor). Other COGA collaborators include: L. Bauer (University of Connecticut); J. McClintick, L. Wetherill, X. Xuei, Y. Liu, D. Lai, S. O'Connor, M. Plawecki, S. Lourens (Indiana University); G. Chan (University of Iowa; University of Connecticut); J. Meyers, D. Chorlian, C. Kamarajan, A. Pandey, J. Zhang (SUNY Downstate); J.-C. Wang, M. Kapoor, S. Bertelsen (Icahn School of Medicine at Mount Sinai); A. Anokhin, V. McCutcheon, S. Saccone (Washington University); J. Salvatore, F. Aliev, B. Cho (Virginia Commonwealth University); and Mark Kos (University of Texas Rio Grande Valley). A. Parsian and M. Reilly are the NIAAA Staff Collaborators. COGA investigators continue to be inspired by their memories of Henri Begleiter and Theodore Reich, founding PI and Co-PI of COGA, and also owe a debt of gratitude to other past organizers of COGA, including Ting-Kai Li, P. Michael Conneally, Raymond Crowe, and Wendy Reich, for their critical contributions. COGA investigators are very grateful to Dr. Bruno Buecher without whom this project would not have existed. The authors also thank all those at the GECCO Coordinating Center for helping bring together the data and people that made this project possible. ASTERISK, a GECCO sub-study, also thanks all those who agreed to participate in this study, including the patients and the healthy control persons, as well as all the physicians, technicians and students. As part of the GECCO sub-studies, CPS-II authors thank the CPS-II participants and Study Management Group for their invaluable contributions to this research. The authors would also like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention National Program of Cancer Registries, and cancer registries supported by the National Cancer Institute Surveillance Epidemiology and End Results program. Another GECCO sub-study, HPFS and NHS investigators would like to acknowledge Patrice Soule and Hardeep Ranu of the Dana Farber Harvard Cancer Center High-Throughput Polymorphism Core who assisted in the genotyping for NHS, HPFS under the supervision of Dr. Immaculata Devivo and Dr. David Hunter, Qin (Carolyn) Guo and Lixue Zhu who assisted in programming for NHS and HPFS. HPFS and NHS investigators also thank the participants and staff of the Nurses' Health Study and the Health Professionals Follow-Up Study, for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyses and interpretation of these data. PLCO, a substudy within GECCO, was supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, and additionally supported by contracts from the Division of Cancer Prevention, National Cancer Institute, NIH, DHHS. Additionally, a subset of control samples were genotyped as part of the Cancer Genetic Markers of Susceptibility (CGEMS) Prostate Cancer GWAS1, CGEMS pancreatic cancer scan (PanScan)2, 3, and the Lung Cancer and Smoking study4. The prostate and PanScan study datasets were accessed with appropriate approval through the dbGaP online resource (http://cgems.cancer.gov/data/) accession numbers phs000207.v1.p1 and phs000206.v3.p2, respectively, and the lung datasets were accessed from the dbGaP website (http://www.ncbi.nlm.nih.gov/gap) through accession number phs000093.v2.p2. For the lung study, the GENEVA Coordinating Center provided assistance with genotype cleaning and general study coordination, and the Johns Hopkins University Center for Inherited Disease Research conducted genotyping. The authors thank Drs. Christine Berg and Philip Prorok, Division of Cancer Prevention, National Cancer Institute, the Screening Center investigators and staff or the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, Mr. Tom Riley and staff, Information Management Services, Inc., Ms. Barbara O'Brien and staff, Westat, Inc., and Drs. Bill Kopp and staff, SAIC-Frederick. Most importantly, we acknowledge the study participants for their contributions to making this study possible. We also thank all participants and staff of the André and France Desmarais Montreal Heart Institute's (MHI) Biobank. The genotyping of the MHI Biobank was done at the MHI Pharmacogenomic Centre and funded by the MHI Foundation. HRS is supported by the National Institute on Aging (NIA U01AG009740). The genotyping was funded separately by the National Institute on Aging (RC2 AG036495, RC4 AG039029). Our genotyping was conducted by the NIH Center for Inherited Disease Research (CIDR) at Johns Hopkins University. Genotyping quality control and final preparation of the data were performed by the University of Michigan School of Public Health. CHDExome+ participating cohorts: BRAVE: The BRAVE study genetic epidemiology working group is a collaboration between the Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK, the Centre for Control of Chronic Diseases, icddr,b, Dhaka, Bangladesh and the National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. CCHS, CIHDS, and CGPS collaborators thank participants and staff of the Copenhagen City Heart Study, Copenhagen Ischemic Heart Disease Study, and the Copenhagen General Population Study for their important contributions. EPIC-CVD: CHD case ascertainment and validation, genotyping, and clinical chemistry assays in EPIC-CVD were principally supported by grants awarded to the University of Cambridge from the EU Framework Programme 7 (HEALTH-F2-2012-279233), the UK Medical Research Council (G0800270) and British Heart Foundation (SP/09/002), and the European Research Council (268834). We thank all EPIC participants and staff for their contribution to the study, the laboratory teams at the Medical Research Council Epidemiology Unit for sample management and Cambridge Genomic Services for genotyping, Sarah Spackman for data management, and the team at the EPIC-CVD Coordinating Centre for study coordination and administration. MORGAM: The work by MORGAM collaborators has been sustained by the MORGAM Project's recent funding: European Union FP 7 projects ENGAGE (HEALTH-F4-2007-201413), CHANCES (HEALTH-F3-2010-242244) and BiomarCaRE (278913). This has supported central coordination, workshops and part of the activities of the The MORGAM Data Centre, at THL in Helsinki, Finland. MORGAM Participating Centres are funded by regional and national governments, research councils, charities, and other local sources. PROSPER: collaborators have received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° HEALTH-F2-2009-223004 PROMIS: The PROMIS collaborators are are thankful to all the study participants in Pakistan. Recruitment in PROMIS was funded through grants available to investigators at the Center for Non-Communicable Diseases, Pakistan (Danish Saleheen and Philippe Frossard) and investigators at the University of Cambridge, UK (Danish Saleheen and John Danesh). Field-work, genotyping, and standard clinical chemistry assays in PROMIS were principally supported by grants awarded to the University of Cambridge from the British Heart Foundation, UK Medical Research Council, Wellcome Trust, EU Framework 6-funded Bloodomics Integrated Project, Pfizer. We would like to acknowledge the contributions made by the following individuals who were involved in the field work and other administrative aspects of the study: Mohammad Zeeshan Ozair, Usman Ahmed, Abdul Hakeem, Hamza Khalid, Kamran Shahid, Fahad Shuja, Ali Kazmi, Mustafa Qadir Hameed, Naeem Khan, Sadiq Khan, Ayaz Ali, Madad Ali, Saeed Ahmed, Muhammad Waqar Khan, Muhammad Razaq Khan, Abdul Ghafoor, Mir Alam, Riazuddin, Muhammad Irshad Javed, Abdul Ghaffar, Tanveer Baig Mirza, Muhammad Shahid, Jabir Furqan, Muhammad Iqbal Abbasi, Tanveer Abbas, Rana Zulfiqar, Muhammad Wajid, Irfan Ali, Muhammad Ikhlaq, Danish Sheikh and Muhammad Imran. INTERVAL: Participants in the INTERVAL randomised controlled trial were recruited with the active collaboration of NHS Blood and Transplant England (www.nhsbt.nhs.uk), which has supported field work and other elements of the trial. DNA extraction and genotyping was funded by the National Institute of Health Research (NIHR), the NIHR BioResource (http://bioresource.nihr.ac.uk/) and the NIHR Cambridge Biomedical Research Centre (www.cambridge-brc.org.uk). The academic coordinating centre for INTERVAL was supported by core funding from: NIHR Blood and Transplant Research Unit in Donor Health and Genomics, UK Medical Research Council (MR/L003120/1), British Heart Foundation (RG/13/13/30194), and NIHR Research Cambridge Biomedical Research Centre. A complete list of the investigators and contributors to the INTERVAL trial is provided in reference.

Brazil grew 2.4 percent per year on average in the last 25 years-somewhat less than Latin America, a good deal less than the world, far less than the emerging countries of Asia in the same period, and indeed far less than Brazil itself in previous decades. If anything stands out favorably in recent Brazilian experience, it is not growth but stabilization and the successful opening of the economy. The purpose of this paper is more modest. It is limited to setting out the authors' particular view of recent efforts to consolidate democracy in Brazil while controlling inflation and resuming economic growth. At the same time the paper presents, as objectively as possible, some thoughts on the limits but also the relevance of action by political leaders to set a course and circumvent obstacles to that process. Here and there, the paper refers to the experiences of other Latin American countries, especially Argentina, Chile, and Mexico, not to offer a full fledged comparative analysis but merely to note contrasts and similarities that may shed light on the peculiarities of the Brazilian case and suggest themes for a more wide-ranging exchange of views.

At less than three weeks away from the national election, an Obama victory, even if not inevitable, seems today quite likely. Political scientist Larry Sabato of the University of Virginia, in his on-line publication Crystal Ball, has now put Obama over the magic number of 270 electoral votes (50% plus 1 of all electoral votes), with potentially many more votes to be added from close races in several states. Barack Obama leads John McCain in the polls by ten points, and the McCain campaign is in disarray. It has stopped campaigning in some states (i.e. Michigan) and is trying to hold on to other states that traditionally vote Republican but are about to be lost for the first time in decades (Virginia, North Carolina). Barring a huge end-of-October surprise, this trend will firm up and determine the result in favor of Obama. Democrats are also poised to win a majority of seats in the Senate and House of Representatives. The so-called "coattails effect" of the presidential race on the congressional election is starting to worry Republicans, who are becoming very critical of John McCain's campaign. Considering that the electoral race was at a continuous dead heat in the last two months, it is worth discussing what has determined the steady rise of Obama in the polls. First and foremost, of course, was the financial crisis. The astounding institutional banking crisis that originated from the meltdown of the real estate market, the resulting credit crunch, have created an anxiety not seen since the Great Depression of 1930. Historically, the Democratic Party has a better reputation for salvaging the economy in times of crisis. In addition to the historical record, several political scientists, Alan Abramowitz from Emory and Larry Bartels from Princeton among others, have developed models based on the correlation between economic growth and presidential election results, and have found that when the economy is not growing in the second quarter of the election year, the party in power almost without exception loses the election. But just as important as the economic disarray has been the reaction of each candidate to that crisis, and the style of leadership that emerged from it. One week before the Wall Street debacle, McCain had said that" the fundamentals of the economy were strong". That unfortunate statement immediately gave an unequivocal ring of truth to Obama's claim that his opponent was "out of touch" with the realities of the country, and it will probably be remembered in history books as the critical turning point of this election. In the first debate, both candidates were cautious about the rescue plan (which had not yet been fully developed by the Treasury) and answered the questions on the economy as if little had changed. However, two days earlier, McCain had suspended his campaign and announced he was needed in Washington to "help solve the crisis". He had also demanded that the debate be cancelled because "times were too serious for that type of exchange". This was a gamble taken by his campaign and it backfired badly, as Obama (who also flew to Washington and attended the same meeting at the invitation of Bush) insisted that because times were difficult, the debate had become even more important and should take place: Americans were now paying attention to who should be the one to lead them out of this mess. Ultimately, McCain backed down and attended the debate, after no agreement on the Rescue Plan came out of that White House meeting. Although he did very well, was energetic and on message, his erratic pre-debate behavior worked against him by providing ammunition to the opposition, who were thereby able to portray him as unpredictable and over excitable, not the steady hand you would want at the helm of a nation in turmoil. Still, most experts and observers considered the first debate a draw, with both candidates passing their respective tests: Obama proving he was presidential enough to hold the office, and McCain reminding the public of his experience and dedication to the country. However, the polls showed most voters had chosen Obama as the winner. The second debate was in a town-hall meeting format, but with strict control of time and of the questioning. Veteran journalist Tom Brockaw moderated it with a strong hand, but the questions were lame and it was a lackluster performance on the part of everybody involved. However, the body language proved an asset to Obama, who listened respectfully, did not take any notes, and when needed, moved comfortably around the set to approach the public. On the other hand, McCain had a nervous restlessness about him that put him at a disadvantage; he kept going back to his corner to make notes on his opponent's comments and at a certain point referred to Obama as "that one" in what was perceived by many to be an expression of slight contempt. This was compounded by his aimless wondering around the set, at times having to be called on by Brockaw for blocking the moderator's teleprompter. In comparison, Obama looked very relaxed and cool, exuding that kind of calm and self-confidence that most people seem to be yearning for during these difficult times. It paid off, and his numbers started mounting dramatically on the next day. Even before that debate, the McCain campaign had thrown all self-restraint overboard and was using every trick in the book of negative campaigning. Thus, the name of William Ayres has become very widely known across the country, as a "domestic terrorist" who organized a bombing campaign of the Pentagon in the 60s, and as a "close associate to Barack Obama". Ayres was the founder of the Weather Underground movement, which protested against the Vietnam War four decades ago. Today he is a university professor and an educational reformer who has worked with many politicians (both Republican and Democrat) to change the educational system in Chicago. The more McCain slips in the poll numbers, the more we hear allusions to Obama's radical "associate", even if their contacts have been sporadic, that they met only a few years ago, and that Obama was eight years old when Ayres was a radical anti-war activist. McCain, however, did not bring this up in the face-to-face debate, perhaps for fear of opening the door to his own connection to Charles Keating, the convicted Savings and Loan scandal figure of the 1980s, whose investigation by regulators McCain had tried to suppress. McCain's vice-presidential candidate, Sarah Palin, on the other hand, has at every opportunity mentioned Ayres' name at her rallies, working her base up to frenzy to the point of violent threats, with some yelling "off with his (Obama's) head". For good measure, she added underhanded allusions to his "foreignness" (read: race) by saying for example: "He is not a man who sees America the way you and I see it." This decision to play the "guilt by association" game and to associate Obama with terrorism (of any kind) has led to a violent escalation in the rhetoric and has roused the base, but does not seem to be working with the independent voters, as poll after poll continues to show. On the contrary, it seems to have hurt McCain: at last weekend rallies he had to "correct" several of his own supporters who in their questions to him claimed Obama was an "Arab", a terrorist, a criminal. After one of such claims, McCain very determinedly took the microphone away from a woman and told her: "No, Ma'm, that is not true. He is a decent family man with whom I just happen to have disagreements on policy." Surely this disappointed the base, which has been led to believe differently. In all fairness to Senator McCain, he is not a racist; in fact, he is a very moderate, middle of the road Republican who has taken on his own party on matters of campaign finance reform and immigration. Why, then, is he playing this self-destructive game? The only logical answer is: out of desperation, as his numbers slip and several senior Republicans have turned against him. The constant chasing of the headlines, the constant spewing of "rapid responses and frantic emails" has resulted in an incoherent message to the detriment of his own personal appeal. Yesterday Bill Kristol, political analyst and commentator of impeccable conservative credentials, and editor of the Weekly Standard, in an op-ed column in the New York Times, called for McCain to fire his campaign staff, "set himself free" and run as the "cheerful, open and accessible candidate" he was in the past. He said it is the "strategic incoherence and operational incompetence of his staff that has made his campaign dysfunctional…and toxic." To this, McCain retorted that "even Bill Kristol had bought into the Obama line" and that he himself was "exactly where he wanted to be, with the whole media establishment against him." However, Republicans are starting to distance themselves from McCain, who they think is dragging the whole party down and will be responsible for loss of Senate and House Republican races, too. To compound his plight even more, yesterday a bipartisan ethics report by the state legislature of Alaska found Sarah Palin abused her power when she fired the Police Commissioner over a family vendetta against a state trooper (an affair already nicknamed "Troopergate" by the media). Voters seem to have tuned McCain out; it is no longer a question of message. It is a question of leadership, of calm amid the turmoil, of whom Americans want to answer the proverbial three-in-the-morning phone call that rings in the White House. Confronted with the angst and fury of John McCain, his impulsive change of course and mixed messages at a time of enormous economic uncertainty, voters are turning in larger numbers to Obama, who has remained unflustered in the face of nasty accusations. Composed, focused on the economy, he dismisses the violent rhetoric of his opponents, and prefers to focus on the difficulty of the times and on the specifics of his policy solutions. He has sharpened his message, spoken directly to the issues and remained a sea of calm amidst the turmoil, a source of optimism amidst the gloom and doom of the headlines. In the meantime, his campaign has registered hundreds of thousands of voters in many states that have traditionally voted Republican, and that today are surprisingly in play for the Democrats (namely Virginia, North Carolina). The McCain campaign is financially weaker and had to pull out of Michigan, where he was down eight points, in order to concentrate more resources in Florida, where the race is still tight, but where the economy has been severely hit by the real estate bust and by the reduction in tourism due to the credit crunch, all of which may favor Obama. In spite of the 270 electoral votes that put him over the top, with potentially many more votes to be added from close races in several states, an Obama win is still not assured. McCain is defending states that went for Bush in the last two elections and which he absolutely must win in order to have a slim chance at the whole, and therefore he can't be on the offense as much in other states. If Obama wins Indiana, Virginia and North Carolina, he will be the first non-Southerner Democrat to carry these states since John F. Kennedy. That explains the frustration of Republican Party stalwarts with McCain, his irresponsible choice of running mate and the unraveling of his campaign. Ironically, in the first debate McCain accused Obama of not knowing the difference between a tactic and a strategy. It actually seems it is McCain who has confused the two. Populism as a political tactic is common, but as the main strategy it is ineffective and harmful for the country. At times like this, when people are worried about their jobs, their pensions and their health care, the populist message of anger and division is not what the average voter is looking for. They are looking instead for some measure of optimism and reassurance. That is why they have turned to Obama. To win, the McCain campaign should stop playing the race–and-terrorism card, and instead bring up a concept which surprisingly has been all but ignored in this election: that of Washington being swept up by a "one-party rule", with Democrats controlling not only the White House but also Congress. No checks and balances, no limits on government in this country of Lockean traditions? That is a scenario that few Americans would look forward too, even in difficult times. It may win McCain more votes than destructive insinuations about his opponent. Senior Lecturer, Department of Political Science and Geography Director, ODU Model United Nations Program Old Dominion University, Norfolk, Virginia

For the purposes of this project, the East African countries included in the study were Kenya, Rwanda, Tanzania, and Uganda. The focus for this project was Small and Medium-sized Enterprises (SMEs) as for-profit or nonprofit organizations with less than 50 employees and not exceeding USD 1,000,000 in annual revenues/turnover. The main output of this project was a proposed program of interventions to drive transformational change. To succeed in this ambitious endeavor, the project articulated clear objectives and designed a blueprint for implementation including levels of resourcing, budget and monitoring metrics. Over the course of the project the team conducted brief surveys with over 90 entrepreneurs, over 50 percent of who had 3-10 years of experience in the Information and Communication Technology (ICT) sector and primarily worked at companies with 5 employees or less.

Frente a un escenario de creciente competencia por los recursos hídricos entre el riego y otros sectores, como el urbano o el industrial, el riego enfrenta el desafío de diseñar e implementar estrategias para aumentar el aprovechamiento del agua, garantizando la equidad de su uso y evitando la degradación de su calidad o el agotamiento de sus fuentes no renovables. Esto implica cambios de conciencia e institucionales necesarios para que los agricultores se vuelvan más activos y asuman responsabilidades compartidas de la gestión del agua en su región. La transferencia de la gestión del riego (IMT, sus siglas en inglés) implica delegar responsabilidades o transferir la autoridad de gestión para algunas o todas las funciones de desvío y/o distribución de agua, mantenimiento y rehabilitación de la infraestructura, gestión de disputas relacionadas con el agua, asignación de derechos de agua o planificación de calendarios de cultivos a asociaciones de usuarios del agua (WUA, su acrónimo en inglés) u otros tipos de organizaciones no gubernamentales. Las experiencias sobre la IMT en diferentes partes del mundo han sido muy variadas, al igual que los enfoques adoptados en su implementación y los impactos de las reformas sobre el desempeño de los sistemas de riego. Para la evaluación del desempeño de un sistema de riego es recomendable utilizar indicadores simples, efectivos y universalmente aplicables. Su estimación con herramientas vinculadas a las tecnologías de la información y comunicación sobre grandes áreas irrigadas han tomado relevancia y en especial sobre aquellos indicadores relacionados con el balance hídrico que requieren de una estimación precisa. Estos se relacionan directamente con una mejora en la estimación de la evapotranspiración (ET), principal fuente de consumo de agua en un sistema de riego. En la región noroeste de la República Argentina, en la provincia de Santiago del Estero, se encuentra ubicado el sistema de riego del Río Dulce (SRRD). A pesar de no contar con un programa de gobierno vinculado a la IMT, desde el año 2006 al 2011 se formalizaron convenios de transferencia de la operación y mantenimiento (O&M) de los canales secundarios hasta nivel de derivaciones de riego (último nivel del sistema colectivo de riego) con siete WUAs. En el SRRD se ha evaluado su desempeño en varias ocasiones, pero en ningún caso se han relacionado los resultados con el tipo de gestión, posiblemente porque la gestión del riego no había sido transferida a los agricultores o no tenía un período suficientemente largo como para ser evaluado. Esta tesis doctoral presenta una comparación del desempeño de dos subsistemas del SRRD donde en uno la O&M se ha transferido a las WUAs y en el otro la gestión permanece bajo responsabilidad del gobierno. Para evaluar el desempeño se emplearon indicadores comúnmente utilizados y validados y utilizando técnicas de evaluación social se contrastó la actitud de los usuarios en relación a sus sistemas productivos, percepción sobre el servicio de suministro de agua y su participación e involucramiento en las WUAs. En el subsistema donde se transfirió la gestión a los usuarios la gestión permitió horarios de entrega flexibles que facilitaron un patrón de cultivo diversificado, una mayor intensidad de riego y dieron como resultado un mayor uso de agua, aunque no implicó un aumento en el suministro relativo de riego, lo que denotó en general una subirrigación. Los agricultores del subsistema transferido estaban más conscientes de los problemas del servicio de riego que los agricultores del subsistema no transferido. La percepción de problemas en el subsistema no transferido aumentó con el nivel de profesionalismo y conocimiento técnico del agricultor. La transmisión de solicitudes y quejas de los agricultores a los administradores fue más transparente en el subsistema transferido que en aquel donde no se había transferido su gestión. Con la necesidad de información precisa y disgregada, clave para el cálculo de indicadores de desempeño de un sistema de riego, se incluyó una evaluación comparativa de los dos enfoques basados en teledetección para la estimación de la evapotranspiración de los cultivos (ETc), componente clave del consumo de agua de la agricultura. Los enfoques evaluados fueron el balance de energía superficial y el enfoque basado en FAO56, que utiliza la capacidad de los índices de vegetación (VI, por sus siglas en inglés) para rastrear el coeficiente de cultivo. En un primer análisis se utilizaron coeficientes de cultivo basales derivados de VI específicos de campo obtenidos para 1743 campos utilizando series de 9 a 29 imágenes satelitales a lo largo de la campaña de riego 2014-2015. En un segundo análisis se utilizaron 30 campos (cultivados con algodón y maíz) donde se conocían los programas de riego reales de la campaña de riego 2014-2015. En estos campos se calculó un balance hídrico del suelo en la zona de la raíz utilizando el enfoque dual de FAO56 con coeficientes de cultivo basales derivados del VI específicos de campo. La ETc obtenida del balance hídrico se comparó con la ETc estimada usando un enfoque de coeficiente de cultivo único que usa VI específico de campo y tiene en cuenta la evaporación del suelo (enfoque sintético), y con la ETc obtenida del balance de energía superficial con el modelo de mapeo de la evapotranspiración a alta resolución con calibración internalizada (METRIC, por sus siglas en inglés) facilitado por la aplicación Earth Engine Evapotranspiration Flux (EEFlux) de Google, Inc. En un tercer análisis de simulación analizó los errores en la estimación de la ETc debido a la interpolación a valores diarios de coeficientes de cultivo y coeficientes de cultivo basales determinados en intervalos hipotéticos de paso de satélites de más de un día. Las curvas de coeficiente de cultivo basales derivadas de VI obtenidas para los 1743 campos del primer análisis estaban por debajo del coeficiente de cultivo basal estándar adoptado localmente (no específico del campo). La ETc en las 8005 ha cubiertas por este análisis fue aproximadamente un 20% mayor cuando se aplicaron curvas estándar no específicas de campo que cuando se aplicaron curvas derivadas de VI. Esta diferencia señaló la importancia de utilizar estimaciones específicas de campo de ETc. En el análisis realizado en los 30 campos seleccionados, la ETc estimada utilizando el enfoque basado en VI coincidió bien con la ETc obtenida del balance hídrico del suelo excepto en condiciones de déficit hídrico. Los coeficientes de cultivo obtenidos para estos campos utilizando el modelo METRIC se correlacionaron con los obtenidos aplicando el método basado en el VI, aunque los primeros tendieron a ser más altos que los segundos en el rango de valores más bajos. El análisis de errores de interpolación mostró que cuando la frecuencia de paso elevado del satélite es superior a una semana y el déficit hídrico es leve o inexistente, la interpolación de los coeficientes de cultivo (por ejemplo, de los derivados de un balance energético) arroja errores de estimaciones de ETc superiores a los resultantes del enfoque basado en VI. En condiciones de déficit de agua, el enfoque basado en VI sobreestima sistemáticamente la evapotranspiración. ; In a scenario of growing competition for water resources between irrigation and other sectors, such as urban or industrial, irrigation has the challenge of designing and implementing strategies to increase the use of water, guaranteeing equity and avoiding the loss of quality or the depletion of its non-renewable sources. This implies changes in consciousness and institutional necessary for users to become more active and assume shared responsibilities for water management in their region. Irrigation management transfer (IMT) involves delegating responsibilities or transferring management authority for some or all functions of diversion and / or distribution of water, maintenance and rehabilitation of infrastructure, management of disputes related to water, allocation water rights or planning crop schedules to water users associations (WUA) or other types of non-governmental organizations. The experiences of IMT in different parts of the world have been very varied, as have the approaches adopted in its implementation and the impacts of the reforms on the performance of irrigation schemes. To performance assessment of an irrigation scheme, it is advisable to use simple, effective and universally applicable indicators. Its estimation with tools related to information and communication technologies on large irrigated areas have become relevant and especially on those indicators related to the water balance that require a precise estimation. These are directly related to an improvement in the estimation of evapotranspiration (ET), the main source of water consumption in an irrigation scheme. The Río Dulce irrigation scheme (SRRD, acronym in Spanish) is located in the northwestern region of Argentine, in the province of Santiago del Estero. Despite not having a government program linked to the IMT, from 2006 to 2011 agreements were formalized for the transfer of operation and maintenance (O&M) of the secondary canals up to the level of farm block (last level of the collective system irrigation) with seven WUAs. In the SRRD, performance assessment has been on several occasions, but in no case have the results been related to the type of management, possibly because irrigation management had not been transferred to farmers or did not have a long enough period to be evaluated. This thesis presents a comparative performance assessment of two SRRD subsystems, one where O&M has been transferred to the WUAs with another where management remains under the responsibility of the government. To performance assessment, conventional and validated indicators were used. Using technical evaluations and social inquiry, the attitude of users in relation to their production systems, perception of the water supply service, and their participation and involvement in the WUAs were contrasted. In the subsystem where management was transferred to users, management allowed flexible delivery schedules that facilitated a diversified cropping pattern, greater irrigation intensity, and resulted in greater use of water, although it did not imply an increase in the relative irrigation supply, which denoted overall under-irrigation. Farmers in the transferred subsystem were more aware of irrigation service problems than farmers in the nontransferred subsystem. The perception of problems in the non-transferred subsystem increased with the level of professionalism and technical knowledge of the farmer. The transmission of requests and complaints from farmers to managements was more transparent in the subsystem transferred than in the non-transferred one. With the need for precise and disaggregated information, key to the estimation of performance indicators of an irrigation scheme, a comparative evaluation of the two main remote sensing approaches for the estimation of crop evapotranspiration (ETc), an important component of the water consumption from agriculture, was carried out. The approaches evaluated were the surface energy balance and the approach based on FAO56, which uses the ability of multispectral vegetation indices (VI) to trace the crop's growth and estimate the crop coefficient. The first analysis used field-specific, VI-derived basal crop coefficients obtained for 1743 fields using series of 9 to 29 satellite images along the 2014-15 irrigation campaign. The second analysis used 30 fields (grown with cotton and maize) where the actual irrigation schedules in the 2014-15 irrigation campaign were known. A root zone soil water balance was computed in these fields using the FAO56 dual approach with field-specific, VI-derived basal crop coefficients. The ETc obtained from the water balance was compared with the ETc estimated using a single crop coefficient approach that uses field-specific VI and takes into account soil evaporation (herein called synthetic approach), and with the ETc obtained with the METRIC surface energy balance model as facilitated by the EEFlux application. The third analysis was a simulation analysis of errors in the estimation of the ETc due to the interpolation to daily values of single crop coefficients and basal crop coefficients determined at hypothetical satellite overpass intervals of longer than one day. The VIderived basal crop coefficient curves obtained for the 1743 fields of the first analysis were below the locally adopted standard (not field-specific) basal crop coefficient. Crop evapotranspiration in the 8005 ha covered by this analysis was about 20 % higher when applying standard non-field specific curves than when applying VI-derived curves. This difference pointed to the importance of using field-specific estimations of ETc. In the analysis carried out on the 30 selected fields, the ETc estimated using the VI-based approach agreed well with the ETc obtained from the water balance except under water deficit conditions. The crop coefficients obtained for these fields using the METRIC model correlated with those obtained by applying the VI-based method, although the former tended to be higher than the latter in the lower value range. The analysis of interpolation errors showed that when satellite overpass frequency is greater than one week and water deficit is mild or inexistent, the interpolation of crop coefficients (for instance, of those derived from an energy balance) gives errors of ETc estimations that are greater than those resulting from the VI-based approach. Under water deficit conditions, the VI-based approach systematically overestimates evapotranspiration.

In Italy, Protection System for Asylum Seekers and Refugees (SPRAR) manages the second reception of forced migrants. This organization was founded by the Bossi-Fini law n. 189/2002 and is composed by the network of local governments, which uses the available resources of National Fund for Asylum Policies and Services provided by Government finance law and managed by the Ministry of Interior. Its principal goal is to realize integrated reception projects for refugees, asylum seekers, subsidiary and humanitarian protection holders in order to ensure their socio-economic inclusion within local contexts in cooperation with voluntary and third sector organizations. On 10th July 2014, local governments were signed an agreement between national and regional executive to create a national reception system to face the growing number of people who have arrived on the Italian coasts. The main goal of this system is to overcome only a material reception (food and lodging), in order to offer a "widespread reception" within urban areas. The strategy is to create an individual project and an accompaniment to ensure the integration of each person in the local community. The services provided consist in inclusion of migrants in the national health and scholastic system, orientation and access to other local services, professional training, job placement, legal assistance and social and housing integration . Indeed, it is crucial to emphasize that the Italian reception system is characterized by extreme fragmentation. Only SPRAR provides these services with the goal of enabling social and economic inclusion of hosted people in local context, which is why we talk about second reception centres. In Italy, there are, however, many different types of first and extraordinary reception centres for migrants . They are managed by the prefectures and differ in terms of goals, structural characteristics, services and receptive capacity. Only 18.7% of migrants are hosted in the SPRAR structures, while the remainder incurs the possibility of carrying out the entire procedure of the asylum application in the centres of first and extraordinary reception (IDOS, 2017). In recent years, the Italian reception structures have undergone a reorganization and redenomination phase, in which the SPRAR should have become a reference standard. In fact, this system has positively distinguished itself for its objectives, the structuring of his interventions and many best practices. This did not prevent bad reception occurrences even within SPRAR structures, as well as a large number of violent and verbal conflicts, some of which carried out by Italian citizens to the detriment of asylum seekers and owners of a status of international protection. These episodes, exacerbated by a political and media discourse that represents migrants as a threat (Battistelli et al., 2016), are the consequence and symbol of the fragmentary and contradictory reception policies adopted at a European level, in the individual countries and at a local level (IDOS, 2016). Instability and political, economic and social uncertainty, rulers in this historical period, are manifested in an emergency approach that is characterized by insufficient planning and a lack of coordination between the reception agencies. This orientation, supported by many and incongruent legislative changes, deprives the system of a strong structure and facilitates the overturning of the same principles of "widespread reception" of migrants in local communities. Moreover, this facilitates the affirmation of nationalist, xenophobic and localist drifts, as well as reception situations in which human rights are violated and which do not provide real opportunities for inclusion in the territories in a safe and dignified manner. Therefore, the conceptual distinction of the terms danger, risk and threat, used as the interpretative line of this work, appears fundamental to understand why subjective responses, in terms of perception and actions, differ according to the situations, as well as to manage the effects that derive in a consistent manner (Battistelli e Galantino, 2018). In order to realize the analysis, I decided to use an ethnographic approach that is traced back to the constructivist philosophical paradigm, where the vision of facts is investigated locally. Ethnographers, indeed, study subjects, artefacts and actions in their interactions, from an interpretative-dialectical point of view, without the claim of absolute objectivity of the results (Piccardo and Benozzo, 1996). Then, I have chosen to use focused narrative interviews because they turn to individuals, they aim for their "understanding", and this is part of the renewed interest in the subject's centrality and in the "deliberately intentional" social action (Weber, 1922). It is also an approach that allows investigating deeply the phenomena. It is very interactive, flexible and able to empathize in the perspective of the subject being studied. This makes it easier to interview marginal subjects neglected by "official knowledge" and to rediscover the social function of research, which is "giving voice to those who do not have it" (Crespi, 1985, pp. 351) In addition, observation and fieldwork are supported by a strong theoretical basis that offers its help to the researcher for the understanding of the social world, providing an order that supports they in their critical analysis of the facts. So, empirical work and theory support each other (Silverman, 2002). Then, narrative approach is highly adaptable to the study of organizations and to analyse the collected data. In fact, this approach is characterized for attention given to concrete situations and not to general theorizations (Czarniawska, 2000). Hence, the empirical research carried out in 2016-2018 can be summarized in the following phases: 1- Analysis of secondary data and documents produced by European and national statistical institutes, private associations, protection bodies and by SPRAR itself. 2- Participant observation in: - a political protest demonstration against the opening of a SPRAR centre in XIII Town Hall, on the north-western suburb of Rome; - nine meetings of social operators working in SPRAR network of Rome and in the national CARA and CAS reception centres; - a SPRAR centre (20 reception places increased to 40 in the south-eastern suburbs of Rome, VII Town Hall). One year of observation and shadowing of operators: 16th January 2017 – 22th January 2018; - a SPRAR apartment (14 reception places for families in the residential area of Monte Sacro neighbourhood, Town Hall III). Five days of observation and shadowing of operators in January 2018; - a seminar of reflection organized by SPRAR and ANCI on the reception system in Lazio, focused on the role of the Regions and Municipalities. 3- Forty-one narrative focused interviews: - Twenty-four SPRAR operators working in SPRAR centres of Rome; - Seventeen asylum seekers and refugees from SPRAR centre observed in Town Hall VII of Rome. The intent behind this ethnographic research started in a restructuring phase aimed to make the SPRAR a reference standard of reception for all asylum seekers who came to our country. But it was characterized, as still today, by speculative situations, the high presence on the territory of large collective reception centres and managing bodies without the necessary experience (Olivieri, 2011; Lunaria 2016). Therefore, the analysis of the risk management and the operators perception of the SPRAR of Rome has the objective to unveil and analyse the contradictions and weaknesses that may arise within this model due to a reckless management that produces specific factors of risk. The hypothesis underlying the case study is that, although the SPRAR has been recognized as an ordinary model, it can also be reproduced in a distorted manner, not respecting the reference guidelines. The alteration between SPRAR in books, the theoretical expression of a principle, and SPRAR in action, its implementation (Pound, 1910), is caused by specific factors that can cause significant effects from several points of view. To bring to light these aspects, closely related to the risk management and the perception that its operators have, I achieve a classification of the risks that I applied to three different types of SPRAR structures (large, medium and single apartment). Then, I identified a series of outcomes involving the people hosted, the operators, the local community and the SPRAR organization itself. The decision to draw the case study at the SPRAR of the city of Rome is driven by the complexity that distinguishes this territory on a social, cultural and political level. In fact, I believe it can bring out the contradictions of the model as new forms of confinement compared to territories with reduced complexity. However, allowing a glimpse of a reception of asylum seekers and holders of a protection status also possible within urban and metropolitan areas. The empirical survey shows that an increase in the distortion compared to the assumptions of an integrated and widespread reception in the territories corresponds to a greater possibility that specific risk factors are produced. Which in their turn, crystallizing into unhealthy forms, can involve the people hosted, the operators, the local community and the SPRAR organization itself. The case study and the application of the risk classification, which I achieved based on the evidence revealed from the field, reveal how the identified risk areas (socio-spatial context, production of the service, recipients) and the corresponding categories, do not produce in itself a negative result. However, this can occur if a short-sighted management acts on these aspects and does not align with the proposed guidelines. Therefore, this classification appears to be a useful tool to identify problems and to develop preventive measures, aimed to improve the management of SPRAR centres in metropolitan cities such as Rome (and other contexts), by intervening on the identified risk categories and reducing the factors that eventually emerge. The analysis, focused on three different types of SPRAR structure (large, medium, single apartment) of the Capital, shows how this alteration occurs in a disruptive way in the large collective centres, the most represented in Rome. Meanwhile, greater adherence to the model is shown, with a modality proportional to the size, in the medium-sized structure and in the apartment. The distortion detected in the large SPRAR collective centres of Rome and partly also in the medium-sized centre, reflects the ambivalence of the general reception system. It promotes on the one hand the principles of a good reception that respects human rights and the autonomy of people and by another implements foreclosure practices and new forms of borders (Vacchiano, 2011; Van Haken, 2008). The field research shows that this happens on different levels due to specific material factors (location and capacity of the centres, management of internal spaces, activation of the services provided, etc.) and through the daily practices of the operators who, in a more or less assenting, controlling and disciplining the people hosted, shape their conduct. Therefore, in the daily life of the structures in which the situations described are involved, the principles of freedom, inclusion and autonomy supported by the rhetoric of reception system are governed by a neoliberal logic of citizenship that suggests the criteria to distinguish, in the same integration paths, who is more worthy than other beneficiaries (Van Haken, 2008). Although the case study highlights strong contradictions and weaknesses that come to life in the implementation of the SPRAR model, it also shows the realization of a good reception. That which, despite being included in an extremely complex context such as Rome, attempts to oppose the "logic of large numbers and profits" of large cooperatives and which implements functional inclusion paths to achieve the objectives. Alignment and consistency with the guidelines and the SPRAR operating manual, in fact, allow the construction of a real project of individualized socio-economic integration for the person hosted. Only by acting in a widespread manner on the territory, in apartments or small centres, the genesis of new forms of borders beyond those already present is avoided. In fact, through this management most of the risks identified are eliminated or at least reduced, precisely because the "trajectory of opportunities" of risk (Reason, 1997) towards unfavourable outcomes generally develops within large collective centres. References Battistelli Fabrizio, Farruggia Francesca, Galantino Maria Grazia and Ricotta Giuseppe. 2016. "Affrontarsi o Confrontarsi? Il "Rischio" Immigrati sulla Stampa Italiana e nella Periferia di Tor Sapienza a Roma". Sicurezza e Scienze Sociali 1:86-112. Battistelli Fabrizio e Galantino Maria Grazia. 2018. "Dangers, Risks and Threats: An Alternative Conceptualization to the Catch-All Concept of Risk". Current Sociology 1-15. Czarniawska Barbara. 2000. Narrare l'organizzazione. La costruzione dell'identità istituzionale. Tr.it. Torino: Edizioni di Comunità. Crespi Franco. 1985. Le vie della sociologia. Bologna: Il Mulino. IDOS in partnership with Confronti. 2017. Dossier Statistico Immigrazione 2017. Roma: Inprinting srl. IDOS. 2016. "INTRA MOENIA. Il Sistema di Accoglienza per Rifugiati e Richiedenti Asilo in Italia nei Rapporti di Monitoraggio Indipendenti". Affari Sociali Internazionali IV (1-4). Lunaria. 2016. Il mondo di dentro. Il sistema di protezione per richiedenti asilo e rifugiati a Roma. (https://www.lunaria.org/wp-content/uploads/2016/10/Il_mondo_di_dentro.pdf). Olivieri Maria Silvia. 2011. "L'accoglienza frantumata sotto il peso dell'«emergenza»", pp. 35-44 in Lunaria. 2011. Cronache di ordinario razzismo. Secondo libro bianco sul razzismo in Italia. Roma: Edizioni dell'Asino. Piccardo Claudia and Benozzo Angelo. 1996. Etnografia organizzativa. Una proposta di metodo per l'analisi delle organizzazioni come culture. Milano: Raffaello Cortina Editore. Reason James. 1997. Managing the Risks of Organisational Accidents. London: Ashgate Publishing Company. Vacchiano Francesco. 2011. "Discipline della Scarsità e del Sospetto: Rifugiati e Accoglienza nel Regime di Frontiera". Lares LXXVII (1): 181-198. Van Aken Mauro. 2008. Rifugio Milano. Vie di fuga e vita quotidiana dei richiedenti asilo. Roma: Carta. Weber Max. 1922. Economia e Società. Tr.it. Milano: Edizioni di Comunità.

L"olivicultura de la comarca del Priorat es basa en la varietat "Arbequina" i està inclosa dins la DOP "Siurana" (Tarragona) on ocupa unes 2.900 ha que produeixen 4.700 t d"olives i 900 t d"oli, que ha de competir amb unes 100.000 t d"oli d"aquesta varietat produïdes a tot el mon, més de la meitat fora de Catalunya i amb tecnologies de producció modernes que permeten reduir costos i millorar la rendibilitat. Per aquest motiu els productors de la zona van fundar l"Associació d"Oleïcultors del Priorat (AOP) amb la finalitat de crear una estructura comercial que permetés accedir a mercats d"alt preu, semblants als que utilitzen els vins de qualitat de la comarca. La AOP signà el 2002 un conveni amb l"IRTA i el DAAM per a desenvolupar un programa científico-tècnic que permetés la caracterització i tipificació dels olis de la comarca, establint criteris objectius de selecció d"aquells olis de qualitat superior i diferenciable de la resta d"olis de "Arbequina" de Catalunya, per a facilitar la seva comercialització. Aquesta tesis doctoral inclou tots els aspectes científics sobre els que està fonamentada l"aplicació comercial d"aquest programa. Els objectius fixats són: (1) caracteritzar els olis produïts a la comarca, a nivell fisicoquímic i sensorial; (2) constatar si aquests olis són objectivament diferents dels d"altres zones, produïts amb la mateixa varietat "Arbequina"; (3) identificar en què consisteix la seva tipicitat, relacionant-la amb factors propis del clima i sòls de la comarca; i (4) caracteritzar l"olivicultura i elaiotècnia de la comarca. Els treballs s"han desenvolupat durant sis campanyes successives (2002-03 a 2008-09) i es basen en l"anàlisi sistemàtica de pràcticament el 100% dels olis produïts a la comarca durant aquests anys (6.308.124 litres), la descripció de l"olivicultura de la zona (mitjançant enquesta) i dels processos d"extracció (descripció de les instal·lacions i anotació de les condicions de procés en campanya) i l"estudi de la relació existent entre l"oli i els factors de producció, edàfics i climàtics. Als olis s"han analitzat les característiques sensorials, paràmetres fisicoquímics de qualitat, àcids grassos, esterols, polifenols totals, índex d"amargor, estabilitat i, en alguns casos, ceres i compostos volàtils. La metodologia utilitzada és similar a la dels nombrosos treballs de tipificació i caracterització d"olis d"oliva verge, normalment associats a DOP espanyoles i d"Itàlia, la qual fiabilitat està relacionada amb la representativitat de les mostres d"oli analitzades i que apliquen tècniques estadístiques univariants i multivariants diverses. Els resultats demostren que fins un 54% dels olis de la zona Priorat, elaborats majoritàriament amb "Arbequina", es poden diferenciar objectivament dels d"altres zones productores del mon que utilitzen la mateixa varietat, inclús de les veïnes Garrigues i Siurana-Camp. Aquestes diferències ho són tant a nivell sensorial (principalment els atributs picant, aromes secundàries, fruitat, astringència i dols), como a nivell d"àcids grassos (principalment palmitoleic, oleic, palmític i esteàric). Existeix una variabilitat intrazonal (inferior al 20% en tots els paràmetres, excepte els esterols) que sembla aleatòria en el cas d"atributs sensorials i, en el cas de la composició química, està relacionada amb factors geogràfics, de tècniques de cultiu i de clima de cada municipi. Les diferències respecte d"altres zones veïnes on es cultiva la mateixa varietat estan relacionades amb l"orografia i geologia particular de la comarca (més del 50% de plantacions estan a més de 400 m d"altitud i sobre sòls del Paleozoic de baixa fertilitat i amb zones de transició cap a sòls sedimentaris del quaternari cap al Camp de Tarragona i del terciari cap a Les Garrigues) i amb el clima particular i bastant homogeni a tota la zona (règim termo-pluviomètric de tipus "mediterrani prelitoral sud", amb transició cap a "mediterrani continental sec" a Les Garrigues i "mediterrani litoral sud" al Camp de Tarragona). S"ha definit un model matemàtic per a predir si una partida d"olives té possibilitats de produir olis de qualitat suficient per a la seva diferenciació, així com funcions discriminants de Fischer per a determinar si el perfil sensorial o la composició en àcids grassos d"un oli són típics de la comarca del Priorat i, per tant, diferenciables de les zones veïnes. Actualment, els resultats d"aquests treballs serveixen de base per a establir les estratègies comercials de venda dels olis del Priorat. Els moliners i envasadores trien aquells olis considerats com típics de la zona per a ser envasats (s"ha passat del 20% al inici del programa fins al 65% actual), dedicant la resta de la producció a l"autoconsum i al mercat a doll ; El olivar de la comarca del Priorat se basa en el cultivo de la variedad "Arbequina" y está incluido en la DOP "Siurana" (Tarragona), ocupando unas 2.900 ha que producen 4.700 t de aceitunas y 900 t de aceite, que debe competir con unas 100.000 t de aceite de esta variedad producidas en todo el mundo, más de la mitad fuera de Cataluña y con tecnologías de producción modernas que permiten reducir los costes y mejorar la rentabilidad. Por este motivo, los productores de la zona fundaron la Asociación de Oleicultores del Priorat (AOP) con el fin de crear una estructura comercial que permitiera acceder a mercados de alto precio, parecidos a los que utilizan los vinos de calidad de la comarca. La AOP firmó, en 2002, un convenio con el IRTA y el DAAM para desarrollar un programa científico-técnico que permitiera la caracterización y tipificación de los aceites de la comarca, estableciendo criterios objetivos de selección de aquellos aceites de calidad superior y diferenciable del resto de aceites de "Arbequina" de Cataluña, para facilitar su comercialización. La presente tesis doctoral incluye todos los aspectos científicos sobre los que se fundamenta la aplicación comercial de este programa. Los objetivos que se plantean son: (1) caracterizar los aceites producidos en la comarca, a nivel físico-químico y sensorial; (2) constatar si estos aceites son objetivamente diferentes de los de otras zonas producidos con la misma variedad "Arbequina"; (3) identificar en qué consiste su tipicidad, relacionándola con factores propios del clima y suelos de la comarca; y (4) caracterizar la olivicultura y elaiotecnia de la comarca. Los trabajos se han desarrollado durante seis campañas (2002-03 a 2008-09) y se basan en el análisis sistemático de prácticamente el 100% de los aceites producidos en la comarca durante esos años (6.308.124 litros), la descripción de la olivicultura de la zona (mediante encuesta) y de los procesos extractivos (descripción de las instalaciones y anotación de las condiciones de proceso en campaña) y el estudio de la relación existente entre el aceite y los factores tanto de producción como edáficos y climáticos. En los aceites se han analizado las características sensoriales, parámetros físico-químicos de calidad, ácidos grasos, esteroles, polifenoles totales, índice de amargor, estabilidad y, en algunos casos, ceras y compuestos volátiles. La metodología utilizada se basa en los numerosos trabajos de tipificación y caracterización de aceites de oliva virgen, normalmente asociados a DOP españolas e italianas, cuya fiabilidad está relacionada con la representatividad de las muestras de aceite analizadas y que aplican técnicas estadísticas univariantes y multivariantes diversas. Los resultados demuestran que hasta un 54% de los aceites de la zona Priorat, elaborados mayoritariamente con "Arbequina", pueden diferenciarse objetivamente de los de otras zonas productoras del mundo que utilizan la misma variedad, incluso de las vecinas Garrigues y Siurana-Camp. Dichas diferencias lo son tanto a nivel sensorial (principalmente los atributos picante, aromas secundarios, frutado, astringencia y dulzor), como a nivel de ácidos grasos (principalmente palmitoleico, oleico, palmítico y esteárico). Existe una variabilidad intrazonal (inferior al 20% en todos los parámetros, excepto los esteroles) que parece aleatoria en el caso de atributos sensoriales y que, en el caso de la composición química, está relacionada con factores geográficos, de técnicas de cultivo y de clima de cada municipio. Las diferencias respecto de otras zonas vecinas, donde se cultiva la misma variedad, están relacionadas con la orografía y geología particular de la comarca (más del 50% de plantaciones están a más de 400 m de altitud y sobre suelos del Paleozoico de baja fertilidad y con zonas de transición hacia suelos sedimentarios del cuaternario hacia el Camp de Tarragona y del terciario hacia Les Garrigues) y con el clima particular y bastante homogéneo en toda la zona (régimen termopluviométrico de tipo "mediterráneo prelitoral sur", con transición hacia el "mediterráneo continental seco" de Les Garrigues y el "mediterráneo litoral sur" del Camp de Tarragona). Se ha definido un modelo matemático para predecir si una partida de aceitunas tiene posibilidades de producir aceites de calidad suficiente para su diferenciación, así como funciones discriminantes de Fischer para determinar si el perfil sensorial o la composición en ácidos grasos de un aceite son típicos de la comarca del Priorat y, por tanto, diferenciables de las zonas vecinas. Actualmente, estos resultados sirven de base para establecer las estrategias comerciales de venta de los aceites del Priorat. Los almazareros y envasadores escogen aquellos aceites considerados como típicos de la zona para su envasado (se ha pasado desde un 20% al inicio del programa hasta el 65% actual), dedicando el resto de la producción al autoconsumo y al mercado de graneles. ; Olive production in the Priorat area raws on "Arbequina" cultivar and is included into PDO "Siurana" (Tarragona), with 2.900 ha and yielding 4.700 t fruits in average, equivalent to 900 t of virgin oil. This oil competes with 100.000 t of oil from the same cultivar produced worldwide (more than a half out of Catalonia and using new technologies to reduce costs and enhance profitability). This was the reason to promote the Priorat"s Producer Association (PPA) in order to build a commercial structure to gain high value markets, similar to those used by high quality wines of this area. PPA proposed in 2002 an agreement with IRTA and the Agricultural Services from the Catalan Government with the aim to develop a scientific and technical program to characterize and differentiate virgin oils from Priorat and setting objective criteria to select high quality oils different from others "Arbequina". This ought to improve current commercialization. This thesis includes all scientific aspects supporting the commercial application of the program. Research goals were: (1) to characterize oils from Priorat using physic, chemical and sensorial parameters; (2) to assess if these oils can be differentiated from others produced with the same cultivar "Arbequina" in other regions; (3) to test their "typicality", related to Priorats" climate and soil characteristics; and (4) to characterize olive production and mill technology in Priorat. The study was carried out during a six years period (2002-03 to 2008-09 harvests) with systematic analysis of almost 100% virgin oil produced in the area (6.308.124 liters). Olive crop production was studied using a questioner, while mill technology was assessed by registering processing conditions along harvest every year. The relationship between oil quality and climate, soils and cultural practices was studied. Chemical parameters analyzed were: sensory profile, physic and chemical quality parameters, fatty acids, sterols, total polyphenols, bitterness index, stability and, sometimes, waxes and volatiles. Methodology was similar to that applied in many scientific studies on virgin oil characterization in wide areas, usually linked to PDO in Spain and Italy. Results reliability depends on oil sampling representativeness. Both univariate and multivariate statistics were used. Results show that up to 54% of Priorat virgin oils made with "Arbequina" can be classified to be typical and different from other producing regions, even the neighboring areas of Garrigues and Siurana-Camp. Such differences are both sensorial (mainly pungency, secondary aromas, fruity, astringency and sweet) and chemical (fatty acids palmitoleic, oleic, pamitic, and stearic). Variability between Priorat areas, is lower than 20% (except for sterols) and seems to be random for sensory profile while is related to geography, cultural practices and climate, for chemical composition. Differences to other regions with the same cultivar are related to the Priorat"s geography and geology (more than 50% orchards are placed higher than 400 m and over soils from Paleozoic with low fertility with transitions to quaternary sedimentary soils towards Camp of Tarragona and transitions to tertiary sedimentary soils towards Garrigues) and climate (Priorat"s climate belongs to "south pre-littoral Mediterranean" with transitions to "dry continental Mediterranean" towards Garrigues and transitions to "south littoral Mediterranean" towards Camp of Tarragona). A mathematic model was fitted which makes possible to decide if an olive lot is able to produce virgin oil of enough quality to be classified as typical of Priorat. Fischers" discriminate functions were fitted that make possible to decide if a virgin oil sample has a fatty acid composition or a sensory profile characteristics from Priorat and different to other regions. Currently, these results are used to establish commercial strategies to sell Priorat virgin oils. The oil producers from this area select those more characteristics oils to be retailed (this increased from 20% at the beginning of the program to currently 65%) while the standard oils are used to self consumption or for bulk market.

Improvements in infrastructure in all parts of Sudan in recent years have had a strong impact on per capita growth, contributing 1.7 percentage points. Consistent with trends in other countries, the information and communication (ICT) revolution that swept Africa contributed the most to Sudan. Raising the infrastructure endowment of all parts of Sudan to that of the region's best performer, Mauritius, could boosts annual growth by about 3.5 percentage points. Sudan has invested heavily in infrastructure in recent years, with some notable achievements. Power generation capacity tripled in just a few years, rising from around 800 megawatts (MW) in 2005 to 2,687MW in 2007, with a shift toward hydropower. Nevertheless, service reliability remains an issue. In ICT, Sudan has made enormous strides in liberalizing the sector and as a result has attracted significant private capital. Mobile penetration soared from less than 1 percent in 2000 to 33 percent in 2009. Recent connectivity to an undersea fiber-optic cable has led to expansions in access, improvements in quality, and reduction in prices. Looking ahead, Sudan's most pressing infrastructure challenges lie in the water and transport sectors. Sudan's infrastructure development has so far had a national focus, and there is much that remains to be done to achieve greater regional integration. While internal road corridors are developed, connectivity with neighbors is largely absent. Sudan has a natural gateway to the sea through Port Sudan but the port's performance is severely hindered by long dwell times, high costs, and capacity constraints. Looking further ahead, Sudan has the potential to be a major hydropower exporter if additional capacity could be developed and transmission links with neighboring Nile Basin countries strengthened.

Nicholas Anthony


An interesting issue with central bank digital currencies (CBDCs) is their status as a direct liability of the central bank. This distinction rarely gets the attention of the broader public, but it's an important distinction because it could lead to a complete destabilization of the financial system as we know it. For example, a CBDC would likely worsen bank runs, lead people to leave the banking system, and increase the cost of loans. Broadly speaking, this direct liability feature is one of the main reasons that a CBDC represents a radical departure from the existing financial system.
What Is a Liability?
For those that might not be familiar, the term "liability" is used in finance to describe something that person A owes to person B. In contrast, an "asset" is something that person A owns outright. From here, we can see that something—such as a loan or a deposit—can simultaneously be a liability for one person and an asset for another person. The difference between what is owned (assets) and what is owed (liabilities) is referred to as "equity." Generally, equity is the residual value that belongs to the owners of the bank.
If we step back to accounting 101, we can model the relationship between assets, liabilities, and equities in a simplified balance sheet for a bank (see Figure 1). There might be different items in each category, but, ultimately, assets should equal liabilities plus equities. This relationship is often referred to as "the accounting equation."












Whose Liability Is It?
When people spend money digitally today with a debit card, the money in the corresponding checking account is a liability of the bank (e.g., Bank of America or Capital One). Similarly, when people spend money digitally today with a prepaid card, the balance is a liability of the private company that issued the card (e.g., Visa or Mastercard). In either case, the financial institution owes the customer the funds that are deposited in the account. When a customer transfers that money to make a payment, the financial institution that has the liability is responsible for transferring the money.
In the case of a CBDC, however, the digital money would be a liability of the central bank itself. That is, it would be the government that has the direct responsibility to hold, transfer, or otherwise remit those funds to the ostensible owner. This feature creates a direct link between citizens and the central bank.
Why Does a CBDC's Liability Status Matter?
As mentioned in the initial accounting primer, something can be a liability to one person and an asset to another. However, something cannot be a liability owned by two separate parties (Note: the word "separate" is used here to exclude agreements like joint partnerships). In the context of a CBDC, this distinction means that a CBDC cannot be a liability on both the Federal Reserve's balance sheet and a bank's balance sheet. That condition matters because the basic business model for banks has long involved a strategy of using deposits (i.e., their liabilities) to fund loans (i.e., their assets).
If the number of deposits is cut down as people put their money in CBDC wallets instead of bank accounts, then the number of loans will be cut down, too (see Figure 2). As the supply of private loans decreases (Q1 to Q2), the price of those loans will start to increase (P1 to P2). In other words, this issue is about more than just bank profits. Yes, some banks would likely go out of business or merge with larger banks as the price of loans increases and cuts into profit lines, but this disruption would also make loans more expensive for everyone.











Why Would People Choose a CBDC Over a Bank Account?
There are many civil liberty concerns that might make people hesitant to adopt a CBDC. However, setting those concerns aside, there are reasons people may still be swayed to use a CBDC. Consider two situations that people may face in financial markets: a time of panic during a bank run and a time of peaceful planning during a period of financial stability.
Bank runs are instances when customers lose faith in their bank for one reason or another (often due to bad news about the bank's finances) and, as the name suggests, run to the bank to withdraw all their money. In the past, that primarily meant people ran to get their money out in cash. Yet, as far as a run for cash is considered, the time waiting in line, the amount of cash available in the vault, the difficulty in carrying cash, and the security risk of storing cash all act as frictions that slow down runs. In contrast, as explained by the Federal Reserve itself, "The ability to quickly convert other forms of money—including deposits at commercial banks—into CBDC could make runs on financial firms more likely or more severe." In other words, rather than run to the bank to get physical cash, a person could instead choose to transfer their balances into a CBDC without leaving their home. Not only that, but the money might be kept as a CBDC for prolonged periods because it would essentially be digital money that is "100 percent insured" and, unlike cash, people would not need to worry about storing, securing, or carrying a large sack of money.
While running for cash was more common in the past, technological advances have since led to digital runs where people instead wired or otherwise transferred their money directly to another bank instead of withdrawing cash (see Panel A in Figure 3). To be clear, the speed of these digital runs does pose a challenge. Yet, there is a silver lining with this development: this type of run is largely limited to the initial institution in question and does not affect the larger supply of deposits. Rather than leave the system, the money transferred flows into other institutions and stays within the financial system. The problem posed by a CBDC in this scenario is that people would instead transfer their money out of the financial system and into their digital wallets and purses—the digital equivalent of placing one's money under a mattress (see Panel B in Figure 3).











It is also likely that incentives could be used—even without a crisis or failure to spark a bank run—to encourage people to leave the existing financial system. For example, some CBDC proponents have called for CBDCs to offer things like "high interest compared with ordinary bank accounts and full government backing with no need for deposit insurance." For many people, the allure of above-market interest rates would likely make transferring to a CBDC a quick decision. In fact, proponents have specifically recognized that these offerings would crowd out alternatives in the private sector. When weighing the costs and benefits, one proponent went so far as to say that disrupting the banking system is the number one advantage of creating a CBDC even though doing so would lead to "profound systemic changes that threaten entire lines of business within banks and credit card companies."
Theory is not the only source for concern when considering how government incentives might lead people to leave the banking system. For those that might not recall, the U.S. Postal Savings System operated from 1911 to 1966 on the premise of offering "safe and convenient places for the deposit of savings at a comparatively low rate of interest." That low rate of interest, however, was set in stone by bureaucrats and later became comparatively high when market rates fell during the Great Depression—a period that coincided with a significant number of bank failures. So in addition to people leaving banks in pursuit of a higher return, studies have shown that other people moved their money to the Postal Savings System directly in response to the announcement of local bank suspensions. From 1929 to 1933, the amount of money deposited in the Postal Savings System had increased nearly eightfold from $154 million to $1.2 billion.
So both in times of panic and times of peace, a CBDC could destabilize the financial system.
Can't You Just Store CBDC at the Bank?
With a general understanding of both liabilities and bank runs in hand, let's dive deeper and explore how a CBDC might be used by the public. A common question that comes up when discussing CBDC risks is: Why can't people just keep their CBDC at the bank? There are really three options for a consumer looking to store their CBDC—partially depending on what CBDC model is ultimately used.
With a retail CBDC provided directly by the central bank, people would store their CBDC in accounts directly managed by the Federal Reserve. That means every dollar held as a CBDC is a dollar that has either been taken out of the banking system or converted from cash. Any dollar stored as a CBDC here would be off-limits to banks. This arrangement sort of turns the Federal Reserve into a payments processor like PayPal or Cash App. However, rather than solely handling money like those services do today, the Federal Reserve would also be providing money directly to the public—another deviation from the current system.
With an intermediated CBDC supported by private intermediaries, people would store their CBDC in a digital wallet that banks (or other private institutions) maintain on behalf of the Federal Reserve. Although the bank would incur costs for things like processing payments, cybersecurity, and regulatory compliance, putting a CBDC into this wallet does not mean that the CBDC becomes the bank's liability. Rather, storing a CBDC in this wallet is more akin to storing valuables in a safety deposit box. Banks will maintain the account, but they can't touch what is inside or have ownership of it—as ultimately, those accounts are being maintained on behalf of the Federal Reserve.
With either of those two CBDC designs, people could instead exchange their CBDC for bank deposits—though, it's a bit of a roundabout process. Behind the scenes, the bank would send the customer's CBDC to the Federal Reserve in exchange for a credit that would then be used to balance a newly created deposit of equal value. This method would allow banks to use deposit accounts to fund loans and consumers to continue using the financial system like they already do, but the owner of the account would no longer be using a CBDC. A payment from that account would be a regular debit transaction like what already happens—without a CBDC—over 240 million times a day in the United States.
This last option is akin to what happens with cash, or paper money, that is deposited at a bank. When someone deposits cash, they no longer get to use an anonymous, physical money. Instead, they spend money by initiating transfers to and from a deposit account. Exchanging a CBDC for a deposit account would resemble this process as people would no longer have access to the features of the CBDC.
Hold On, Isn't Cash a Direct Liability of the Central Bank?
At this point, some people might still be wondering how a CBDC poses a unique threat when cash is also a direct liability of the central bank and involves a similar exchange process when deposited at banks. It's a good question to consider.
First, the existence of cash does facilitate disruptions to the financial system considering it gives consumers a final means of payments that they can run to. In fact, similar arguments could be made about physical gold during the gold standard era. Yet, a CBDC poses a unique threat because consumers would likely be able to pull out their money faster than ever before and store the funds easily without significant storage or security costs. It's for this reason that the Federal Reserve said a CBDC would make bank runs "more likely" and "more severe." The digital nature of a CBDC would increase the impact of a run and delay the return to normal relative to cash (see Figure 4).











The CBDC Tradeoff
Many others have also recognized that the risk of destabilizing the financial system is a serious threat posed by CBDCs. George Selgin (Cato Institute), Andrea Maechler (Swiss National Bank), Greg Baer (Bank Policy Institute), Rob Morgan (American Bankers Association), and researchers at the European Central Bank, Massachusetts Institute of Technology, and University of Michigan have all described similar concerns about CBDCs destabilizing the financial system. In fact, the Federal Reserve has acknowledged that the introduction of a CBDC, "could reduce the aggregate amount of deposits in the banking system, which could in turn increase bank funding expenses, and reduce credit availability or raise credit costs for households and businesses."
Not ready to throw in the towel, some CBDC proponents have proposed making CBDCs intentionally bad to discourage and limit their use. For instance, the Federal Reserve and the European Central Bank have proposed not paying interest on CBDCs, limiting the amount of CBDC a person can hold, or limiting the amount of CBDC a person can accumulate over time. In other words, there won't be interest payments, total CBDC holdings will be limited, and the amount that can be transferred over time will be limited.
William Luther, director of AIER's Sound Money Project, has described this issue as the "CBDC Tradeoff." Consider two extremes. On the one hand, a CBDC could pay interest, offer subsidized payments, and even tax discounts. These offerings would lead people to leave the banking system, but it would mean that the CBDC gains enough users to maintain a stable network. On the other hand, a CBDC could pay no interest, have some low cap like $10,000, and restrict how many transactions people can make. In this case, people probably wouldn't leave their bank any time soon, but then the CBDC probably would not have enough users to be considered a worthwhile effort. In short, the tradeoff becomes a question between making something people will want at the expense of the larger financial system or making something no one will want at the expense of taxpayer resources.
Faced with this tradeoff, the best choice is to not introduce a CBDC at all.
Conclusion
Let's quickly recap the ground that has been covered here.
Introducing a CBDC risks destabilizing the banking system and worsening panics. The Federal Reserve tried to lessen that risk by "including" banks in the process by proposing an intermediated CBDC. Yet, with an intermediated CBDC, banks would have to cover regulatory and overhead costs to maintain CBDC accounts even though they would have no loan revenue from those funds since the CBDC is still a liability of the central bank. Moreover, shrinking the supply of deposits would likely lead to costlier credit. That means loans will be more expensive for everyone.
Today's financial system is not perfect, but it usually works so well that people rarely stop to ask: "Whose liability is it anyway?" Yet, being a direct liability of the central bank is a defining feature of a CBDC. In practice, that trait means destabilizing the financial system is a defining feature of a CBDC. Consequently, the risk posed to financial markets is just another reason why Congress should prohibit the Federal Reserve and Treasury from issuing a CBDC.

For countries as diverse as China and Mauritius, Special Economic Zones (SEZs) have been a powerful tool to attract foreign investment, promote export-oriented growth, and generate employment; for many others, the results have been less than encouraging. While the benefits and limitations of zones will no doubt continue to be debated, what is clear is that policymakers are increasingly attracted to them as an instrument of trade, investment, industrial, and spatial policy. Since the mid 1980s, the number of newly-established zones has grown rapidly in almost all regions, with dramatic growth i

This study is a product of the Africa Infrastructure Country Diagnostic (AICD), a project designed to expand the world's knowledge of physical infrastructure in Africa. The AICD provides a baseline against which future improvements in infrastructure services can be measured, making it possible to monitor the results achieved from donor support. It also offers a solid empirical foundation for prioritizing investments and designing policy reforms in Africa's infrastructure sectors. The AICD is based on an unprecedented effort to collect detailed economic and technical data on African infrastructure. The project has produced a series of original reports on public expenditure, spending needs, and sector performance in each of the main infrastructure sectors, including energy, information and communication technologies, irrigation, transport, and water and sanitation. This report presents the key AICD findings for Mozambique, allowing the country's infrastructure situation to be benchmarked against that of its African peers. Given that Mozambique is poor but stable country, two sets of African benchmarks will be used to evaluate its situation: those for non fragile Low Income Countries (LICs) and those for Middle-Income Countries (MICs). Detailed comparisons will also be made with immediate regional neighbors in the Economic Community of West African States (ECOWAS).

En mi formación de posgrado a finales de los años ochenta, teníamos cerca de treinta camas hospitalarias en un pabellón llamado "sépticas" (1). En Colombia, donde el aborto estaba totalmente penalizado, allí estaban mayoritariamente mujeres con abortos inseguros complicados. El enfoque que recibíamos era técnico: manejo de cuidados intensivos; realizar histerectomías, colostomías, resecciones intestinales, etc. En esa época algunas enfermeras eran monjas, y se limitaban a interrogar a las pacientes para que "confesaran" qué se habían hecho para abortar. Siempre me inquietó que las mujeres que salían vivas se iban sin ninguna asesoría, ni con un método anticonceptivo. Al preguntar alguna vez a uno de mis docentes me contestó con desdén: "este es un hospital de tercer nivel, esas cosas las hacen las enfermeras en primer nivel". Al ver tanto dolor y muerte, decidí hablar con las pacientes del servicio y empecé a entender sus decisiones. Recuerdo aún con tristeza tantas muertes, pero un caso en particular aún me duele: era una mujer cercana a los cincuenta años que llegó con una perforación uterina en estado de sepsis avanzada. A pesar de la cirugía y los cuidados intensivos, falleció. Alcancé a hablar con ella y me contó que era viuda, tenía dos hijos mayores y había abortado por "vergüenza con ellos", pues se iban a dar cuenta de que tenía vida sexual activa. A los pocos días de su fallecimiento, me llamó el profesor de patología, extrañado, para decirme que el útero que habíamos enviado para examen patológico no tenía embarazo. Era una mujer en estado perimenopáusico con una prueba de embarazo falsamente positiva, debido a los altos niveles de FSH/LH típicos de su edad. ¡¡¡NO ESTABA EMBARAZADA!!! No tenía menstruación porque estaba en premenopausia y una prueba falsamente positiva la llevó a un aborto inseguro. Claro, las lesiones causadas en las maniobras abortivas la llevaron al desenlace fatal, pero la real causa subyacente fue el tabú social respecto a la sexualidad. Tuve que ver muchas adolescentes y mujeres jóvenes salir del hospital vivas, pero sin útero, a veces sin ovarios y con colostomías, para ser despreciadas por una sociedad que les recriminaba el haber decidido no ser madres. Tuve que ver situaciones de mujeres que llegaban con sus intestinos protruyendo a través de sus vaginas por abortos inseguros. Vi mujeres que en su desespero se autoinfligieron lesiones tratando de abortar con elementos como palos, ramas, gajos de cebolla, barras de alumbre, ganchos, entre otros. Eran tantas las muertes que era difícil no tener por lo menos una mujer diariamente en la morgue a consecuencia de un aborto inseguro. En esa época no se abordaba la salud desde lo biopsicosocial sino solamente desde lo técnico (2); sin embargo, en las evaluaciones académicas que nos hacían, ante la pregunta de definición de salud, había que recitar el texto de la Organización Mundial de la Salud que involucraba estos tres aspectos, ¡qué contrasentido! Para dar respuesta a las necesidades de salud de las mujeres y garantizar sus derechos, cuando ya era docente, inicié el servicio de anticoncepción posevento obstétrico en ese hospital de tercer nivel. Hubo resistencia de las directivas, pero afortunadamente logré donaciones internacionales para la institución y esto facilitó su aceptación. Decidí concursar para carrera docente con el ánimo de poder sensibilizar a profesionales de la salud hacia un enfoque integral de la salud y la enfermedad. Cuando en 1994 se realizó la Conferencia Internacional de Población y Desarrollo (CIPD) en El Cairo ya llevaba varios años en la docencia, y cuando leí su Programa de Acción, encontré nombre para lo que estaba trabajando: derechos sexuales y derechos reproductivos. Empecé a incorporar en mi vida profesional y docente las herramientas que este documento me daba. Pude sensibilizar personas del Ministerio de Salud de mi país y trabajamos en conjunto recorriéndolo con un abordaje de derechos humanos en materia de salud sexual y reproductiva (SSR). Esta nueva mirada buscaba además de ser integral, dar respuesta a viejos problemas como la mortalidad materna, el embarazo en la adolescencia, la baja prevalencia anticonceptiva, el embarazo no planeado o no deseado o la violencia contra la mujer. Con otras personas sensibilizadas empezamos a permear con estos temas de SSR la Sociedad Colombiana de Obstetricia y Ginecología, algunas universidades y hospitales universitarios. Todavía seguimos dando la lucha en un país que a pesar de tantas dificultades ha mejorado muchos indicadores de SSR. Con la experiencia de haber trajinado en todas las esferas con estos temas, logramos con un puñado de colegas y amigas de la Universidad El Bosque crear la Maestría en Salud Sexual y Reproductiva, abierta a todas las profesiones, en la que rompimos varios paradigmas. Se inició un programa en el que la investigación cualitativa y cuantitativa tenían el mismo peso y algunos de los egresados del programa están ahora en posiciones de liderazgo en los entes gubernamentales e internacionales replicando modelos integrales. En la Federación Latinoamericana de Obstetricia y Ginecología (FLASOG) y en la Federación Internacional de Obstetricia y Ginecología (FIGO), pude por varios años aportar mi experiencia en los comités de SSR de esas asociaciones para beneficio de las mujeres y las niñas en los ámbitos regional y global. Cuando pienso en quienes me han inspirado en esta lucha, debo resaltar las grandes feministas que me han enseñado y acompañado en tantas batallas. No puedo mencionarlas a todas, pero he admirado la historia de vida de Margaret Sanger con su persistencia y mirada visionaria. Ella luchó durante toda su vida para ayudar a las mujeres del siglo XX para que obtuvieran el derecho a decidir si querían o no tener hijos o hijas y cuándo (3). De las feministas actuales he tenido el privilegio de compartir experiencias con Carmen Barroso, Giselle Carino, Debora Diniz y Alejandra Meglioli, lideresas de la Federación Internacional de Planificación de la Familia, Región del Hemisferio Occidental (IPPF-RHO, por su nombre en inglés). De mi país quiero resaltar a mi compatriota Florence Thomas, psicóloga, columnista, escritora y activista feminista colombo-francesa. Es una de las voces más influyentes e importantes del movimiento por los derechos de la mujer en Colombia y en la región. Arribó procedente de Francia en la década de 1960, en los años de la contracultura, los Beatles, los hippies, Simone de Beauvoir y Jean-Paul Sartre, época en la que se empezó a criticar el capitalismo y la cultura del consumo (4). Fue entonces cuando se comenzó a hablar del cuerpo femenino, la sexualidad femenina y cuando llegó la píldora anticonceptiva como una revolución total para las mujeres. A su llegada en 1967, ella experimentó un choque porque acababa de asistir a toda una revolución y solo encontró un país de madres, no de mujeres (5). Ese era el único destino de una mujer, ser callada y sumisa. Entonces se dio cuenta de que no se podía seguir así, hablando de "vanguardias revolucionarias" en un ambiente tan patriarcal. En 1986 con las olas del feminismo norteamericano y europeo, y con su equipo académico crearon el grupo Mujer y Sociedad de la Universidad Nacional de Colombia, semillero de grandes iniciativas y logros para el país (6). Ella ha liderado grandes cambios con su valentía, la fuerza de sus argumentos, y un discurso apasionado y agradable a la vez. Dentro de sus múltiples libros resalto Conversaciones con Violeta (7), motivado por el desdén hacia el feminismo de algunas mujeres jóvenes. Lo escribe a manera de diálogo con una hija imaginaria en el que, de una manera íntima, reconstruye la historia de las mujeres a través de los siglos y da nuevas luces sobre el papel fundamental del feminismo en la vida de la mujer moderna. Otro libro muestra de su valentía es Había que decirlo (8), en el que narra la experiencia de su propio aborto a sus 22 años en la Francia de los años sesenta. Mi experiencia de trabajo en la IPPF-RHO me ha permitido conocer líderes y lideresas de todas las edades en diversos países de la región, quienes con gran mística y dedicación, de manera voluntaria, trabajan por lograr una sociedad más equitativa y justa. Particularmente me ha impresionado la apropiación del concepto de derechos sexuales y reproductivos por parte de las personas más jóvenes, y esto me ha dado gran esperanza en el futuro del planeta. Seguimos con una agenda incompleta del Plan de acción de la CIPD de El Cairo, pero ver cómo la juventud enfrenta con valentía los retos, me motiva a seguir adelante y aportar mis años de experiencia en un trabajo intergeneracional. La IPPF-RHO evidencia un gran compromiso por los derechos y la SSR de adolescentes en sus políticas y programas, que son consistentes con lo que la Organización promueve; por ejemplo, el 20% de los puestos de toma de decisión están en manos de jóvenes. Las organizaciones miembros, que basan su labor en el voluntariado, son verdaderas incubadoras de jóvenes que harán ese recambio generacional inexpugnable y necesario. A diferencia de lo que nos tocó a muchos de nosotros, trabajar en esta complicada agenda de salud sexual y reproductiva sin bases teóricas, hoy vemos personas comprometidas y con una sólida formación para reemplazarnos. En la Facultad de Medicina de la Universidad Nacional de Colombia y en la Facultad de Enfermería de la Universidad El Bosque, las nuevas generaciones están más motivadas y empoderadas, con grandes deseos de cambiar las rígidas estructuras subyacentes. Nuestra gran preocupación son los embates de ultraderecha que soportan grupos antiderechos, muchas veces mejor organizados que nosotros, que sí apoyamos los derechos y somos verdaderos provida (9). Ante este escenario, debemos organizarnos mejor y seguir dando batallas para garantizar los derechos de las mujeres en el ámbito local, regional y global, aunando esfuerzos de todas las organizaciones proderechos. Estamos ahora comprometidos con los Objetivos de Desarrollo Sostenible (10), entendidos como aquellos que satisfacen las necesidades de la generación presente sin comprometer la capacidad de las generaciones futuras para satisfacer sus propias necesidades. Esta nueva agenda se basa en: - El trabajo no finalizado de los Objetivos de Desarrollo del Milenio - Los compromisos pendientes (convenciones ambientales internacionales) - Los temas emergentes en las tres dimensiones del desarrollo sostenible: social, económica y ambiental. Tenemos ahora 17 Objetivos de Desarrollo Sostenible y 169 metas (11). Entre estos objetivos se menciona en varias ocasiones el "acceso universal a la salud reproductiva". En el Objetivo 3 de esa lista se incluye garantizar, de aquí al año 2030, "el acceso universal a los servicios de salud sexual y reproductiva, incluidos los de planificación familiar, información y educación". De igual manera, el Objetivo 5, "Lograr la igualdad de género y empoderar a todas las mujeres y las niñas", establece que se deberá "asegurar el acceso universal a la salud sexual y reproductiva y los derechos reproductivos según lo acordado de conformidad con el Programa de Acción de la Conferencia Internacional sobre la Población y el Desarrollo, la Plataforma de Acción de Beijing". No se puede olvidar que el término acceso universal a la salud sexual y reproductiva incluye el acceso universal al aborto y la anticoncepción. Actualmente 830 mujeres mueren cada día por causas maternas prevenibles; de estos decesos, el 99% ocurre en países en desarrollo, más de la mitad en entornos frágiles y en contextos humanitarios (12). 216 millones de mujeres no pueden acceder a métodos de anticoncepción moderna y la mayoría vive en los nueve países más pobres del mundo y en un ambiente cultural propio de la década de los sesenta (13). Este número solo incluye las mujeres de 15 a 49 años en cualquier tipo de unión, es decir el número total es mucho mayor. Cumplir con los objetivos marcados supondría prevenir 67 millones de embarazos no deseados y reducir a un tercio las muertes maternas. Actualmente tenemos una alta demanda insatisfecha de anticoncepción moderna, con un bajísimo uso de los métodos de larga duración reversible (dispositivos intrauterinos e implantes subdérmicos) que son los más efectivos y de mayor adherencia (14). No hay uno solo de los 17 Objetivos de Desarrollo Sostenible donde la anticoncepción no tenga un papel preponderante: desde el primero que se refiere al fin de la pobreza, pasando por el quinto de igualdad de género, el décimo de reducción de la desigualdad, entre los países y en el mismo país, hasta el decimosexto relacionado con paz y justicia. Si queremos cambiar el mundo, debemos procurar acceso universal a la anticoncepción sin mitos ni barreras. Tenemos la obligación moral de lograr la erradicación de la pobreza extrema y avanzar en la construcción de sociedades más igualitarias, justas y felices. En anticoncepción de urgencia (AU), estamos muy lejos de alcanzar lo que esperamos. Si en métodos de larga duración reversible tenemos una baja prevalencia, en la AU la situación empeora. No en todas las facultades de medicina de la región se aborda este tema, y donde sí se hace, no hay homogeneidad de contenidos, ni siquiera dentro del mismo país. Hay aún mitos sobre su verdadero mecanismo de acción. Hay países como Honduras donde está prohibida y no hay un medicamento dedicado, como tampoco lo hay en Haití. Donde está disponible el acceso es ínfimo, particularmente entre las niñas, adolescentes, jóvenes, migrantes, afrodescendientes e indígenas. Hay que derrumbar las múltiples barreras para el uso eficaz de la anticoncepción de emergencia, y para eso necesitamos trabajar en romper mitos y percepciones erróneas, tabúes y normas culturales; lograr cambios en las leyes y normas restrictivas de los países; lograr acceso sin barreras a la AU; trabajar intersectorialmente; capacitar al personal de salud y la comunidad. Es necesario transformar la actitud del personal de salud en una de servicio por encima de sus propias opiniones. Reflexionando acerca de lo que ha pasado después de la CIPD realizada en El Cairo, su Programa de Acción cambió cómo miramos las dinámicas de población de un énfasis en la demografía a un enfoque en los derechos humanos y las personas. Los gobiernos acordaron que, en este nuevo enfoque, el éxito era el empoderamiento de las mujeres y la posibilidad de elegir a través de expandir el acceso a la educación, la salud, los servicios y el empleo, entre otros. Sin embargo, ha habido avances desiguales y persiste la inequidad en nuestra región, no se cumplieron todas las metas, los derechos sexuales y reproductivos continúan fuera del alcance de muchas mujeres (15). Aún queda un largo camino para recorrer, hasta que mujeres y niñas del mundo puedan reclamar sus derechos y la libertad de decidir. Globalmente la mortalidad materna se ha reducido, hay mayor asistencia calificada del parto, mayor prevalencia anticonceptiva, la educación integral en sexualidad y el acceso a servicios de SSR para adolescentes ya son derechos reconocidos y con grandes avances, además ha habido ganancias concretas en materia de marcos legales más favorables en particular en nuestra región; sin embargo, si bien las condiciones de acceso han mejorado, las legislaciones restrictivas de la región exponen a las mujeres más vulnerables a abortos inseguros. Hay aún grandes desafíos para que los gobiernos reconozcan la SSR y los DSR como parte integral de los sistemas de salud, existe una amplia agenda contra las mujeres. En ese sentido, el acceso a SSR está bajo amenaza y opresión, se requiere movilización intersectorial y litigios estratégicos, investigación y apoyo a los derechos de las mujeres como agenda intersectorial. Hacia adelante hay que esforzarnos más en el trabajo con jóvenes, para avanzar no solo en el Programa de Acción de la CIPD, sino en todos los movimientos sociales. Son uno de los grupos más vulnerables, y de los mayores catalizadores para el cambio. La población joven aún enfrentan muchos desafíos, especialmente las mujeres y niñas; las jóvenes están especialmente en alto riesgo debido a la falta de servicios y salud sexual y reproductiva amigables y confidenciales, la presencia de violencia basada en género y la falta de acceso a los servicios. Además hay que mejorar el acceso al aborto; es responsabilidad de los estados garantizar la calidad y seguridad en el acceso. Aún en nuestra región existen países con marcos totalmente restrictivos. Las nuevas tecnologías facilitan el autocuidado (16), lo que permitirá ampliar el acceso universal, pero los gobiernos no pueden desvincularse de su responsabilidad. El autocuidado se está expandiendo en el mundo y puede ser estratégico para llegar a las poblaciones más vulnerables. Hay nuevos desafíos para los mismos problemas, que requieren una reinterpretación de las medidas necesarias para garantizar los DSR de todas las personas, en particular mujeres, niñas y en general las poblaciones marginadas y vulnerables. Es necesario tener en cuenta aspectos como las migraciones, el cambio climático, el impacto de medios digitales, el resurgimiento de discursos de odio, la opresión, la violencia, la xenofobia, la homo/transfobia y otros problemas emergentes, pues la SSR debe verse en un marco de justicia, y no aislado. Debemos exigir rendición de cuentas a los 179 gobiernos que participaron en la CIPD hace 25 años y a los 193 países que firmaron los Objetivos de Desarrollo Sostenible. Deben reafirmarse en sus compromisos y expandir la agenda a los temas no considerados en ese momento. Nuestra región ha dado ejemplo al mundo con el Consenso de Montevideo, que se convierte en una hoja de ruta para el cumplimiento del plan de acción de la CIPD y no debe permitirnos retroceder. Este Consenso pone en el centro a las personas, en especial a las mujeres, e incluye el tema de aborto invitando a los estados a que consideren la posibilidad de legalizarlo, lo que abre la puerta para que los gobiernos de todo el mundo reconozcan que las mujeres tienen el derecho a decidir sobre la maternidad. Este Consenso es mucho más inclusivo: Considerando que las brechas en salud continúan sobresalientes en la región y las estadísticas promedio suelen ocultar los altos niveles de mortalidad materna, de infecciones de transmisión sexual, de infección por VIH/SIDA y de demanda insatisfecha de anticoncepción entre la población que vive en la pobreza y en áreas rurales, entre los pueblos indígenas y las personas afrodescendientes y grupos en condición de vulnerabilidad como mujeres, adolescentes y jóvenes y personas con discapacidad, acuerdan: 33-Promover, proteger y garantizar la salud y los derechos sexuales y los derechos reproductivos para contribuir a la plena realización de las personas y a la justicia social en una sociedad libre de toda forma de discriminación y violencia. 37-Garantizar el acceso universal a servicios de salud sexual y salud reproductiva de calidad, tomando en consideración las necesidades específicas de hombres y mujeres, adolescentes y jóvenes, personas LGBT, personas mayores y personas con discapacidad, prestando particular atención a personas en condición de vulnerabilidad y personas que viven en zonas rurales y remotas y promoviendo la participación ciudadana en el seguimiento de los compromisos. 42-Asegurar, en los casos en que el aborto es legal o está despenalizado en la legislación nacional, la existencia de servicios de aborto seguros y de calidad para las mujeres que cursan embarazos no deseados y no aceptados e instar a los demás Estados a considerar la posibilidad de modificar las leyes, normativas, estrategias y políticas públicas sobre la interrupción voluntaria del embarazo para salvaguardar la vida y la salud de mujeres adolescentes, mejorando su calidad de vida y disminuyendo el número de abortos (17). ; In my postgraduate formation during the last years of the 80's, we had close to thirty hospital beds in a pavilion called "sépticas" (1). In Colombia, where abortion was completely penalized, the pavilion was mostly filled with women with insecure, complicated abortions. The focus we received was technical: management of intensive care; performance of hysterectomies, colostomies, bowel resection, etc. In those times, some nurses were nuns and limited themselves to interrogating the patients to get them to "confess" what they had done to themselves in order to abort. It always disturbed me that the women who left alive, left without any advice or contraceptive method. Having asked a professor of mine, he responded with disdain: "This is a third level hospital, those things are done by nurses of the first level". Seeing so much pain and death, I decided to talk to patients, and I began to understand their decision. I still remember so many deaths with sadness, but one case in particular pains me: it was a woman close to being fifty who arrived with a uterine perforation in a state of advanced sepsis. Despite the surgery and the intensive care, she passed away. I had talked to her, and she told me she was a widow, had two adult kids and had aborted because of "embarrassment towards them" because they were going to find out that she had an active sexual life. A few days after her passing, the pathology professor called me, surprised, to tell me that the uterus we had sent for pathological examination showed no pregnancy. She was a woman in a perimenopausal state with a pregnancy exam that gave a false positive due to the high levels of FSH/LH typical of her age. SHE WAS NOT PREGNANT!!! She didn't have menstruation because she was premenopausal and a false positive led her to an unsafe abortion. Of course, the injuries caused in the attempted abortion caused the fatal conclusion, but the real underlying cause was the social taboo in respect to sexuality. I had to watch many adolescents and young women leave the hospital alive, but without a uterus, sometime without ovaries and with colostomies, to be looked down on by a society that blamed them for deciding to not be mothers. I had to see situation of women that arrived with their intestines protruding from their vaginas because of unsafe abortions. I saw women, who in their despair, self-inflicted injuries attempting to abort with elements such as stick, branches, onion wedges, alum bars and clothing hooks among others. Among so many deaths, it was hard not having at least one woman per day in the morgue due to an unsafe abortion. During those time, healthcare was not handled from the biopsychosocial, but only from the technical (2); nonetheless, in the academic evaluations that were performed, when asked about the definition of health, we had to recite the text from the International Organization of Health that included these three aspects. How contradictory! To give response to the health need of women and guarantee their right when I was already a professor, I began an obstetric contraceptive service in that third level hospital. There was resistance from the directors, but fortunately I was able to acquire international donations for the institution, which facilitated its acceptance. I decided to undertake a teaching career with the hope of being able to sensitize health professionals towards an integral focus of health and illness. When the International Conference of Population and Development (ICPD) was held in Cairo in 1994, I had already spent various years in teaching, and when I read their Action Program, I found a name for what I was working on: Sexual and Reproductive Rights. I began to incorporate the tools given by this document into my professional and teaching life. I was able to sensitize people at my countries Health Ministry, and we worked together moving it to an approach of human rights in areas of sexual and reproductive health (SRH). This new viewpoint, in addition to being integral, sought to give answers to old problems like maternal mortality, adolescent pregnancy, low contraceptive prevalence, unplanned or unwanted pregnancy or violence against women. With other sensitized people, we began with these SRH issues to permeate the Colombian Society of Obstetrics and Gynecology, some universities, and university hospitals. We are still fighting in a country that despite many difficulties has improved its indicators of SRH. With the experience of having labored in all sphere of these topics, we manage to create, with a handful of colleagues and friend at the Universidad El Bosque, a Master's Program in Sexual and Reproductive Health, open to all professions, in which we broke several paradigms. A program was initiated in which the qualitative and quantitative investigation had the same weight, and some alumni of the program are now in positions of leadership in governmental and international institutions, replicating integral models. In the Latin American Federation of Obstetrics and Gynecology (FLASOG, English acronym) and in the International Federation of Obstetrics and Gynecology (FIGO), I was able to apply my experience for many years in the SRH committees of these association to benefit women and girls in the regional and global environments. When I think of who has inspired me in these fights, I should highlight the great feminist who have taught me and been with me in so many fights. I cannot mention them all, but I have admired the story of the life of Margaret Sanger with her persistence and visionary outlook. She fought throughout her whole life to help the women of the 20th century to be able to obtain the right to decide when and whether or not they wanted to have children (3). Of current feminist, I have had the privilege of sharing experiences with Carmen Barroso, Giselle Carino, Debora Diniz and Alejandra Meglioli, leaders of the International Planned Parenthood Federation – Western Hemisphere Region (IPPF-RHO). From my country, I want to mention my countrywoman Florence Thomas, psychologist, columnist, writer and Colombo-French feminist. She is one of the most influential and important voices in the movement for women rights in Colombia and the region. She arrived from France in the 1960's, in the years of counterculture, the Beatles, hippies, Simone de Beauvoir, and Jean-Paul Sartre, a time in which capitalism and consumer culture began to be criticized (4). It was then when they began to talk about the female body, female sexuality and when the contraceptive pill arrived like a total revolution for women. Upon its arrival in 1967, she experimented a shock because she had just assisted in a revolution and only found a country of mothers, not women (5). That was the only destiny for a woman, to be quiet and submissive. Then she realized that this could not continue, speaking of "revolutionary vanguards" in such a patriarchal environment. In 1986 with the North American and European feminism waves and with her academic team, they created the group "Mujer y Sociedad de la Universidad Nacional de Colombia", incubator of great initiatives and achievements for the country (6). She has led great changes with her courage, the strength of her arguments, and a simultaneously passionate and agreeable discourse. Among her multiple books, I highlight "Conversaciones con Violeta" (7), motivated by the disdain towards feminism of some young women. She writes it as a dialogue with an imaginary daughter in which, in an intimate manner, she reconstructs the history of women throughout the centuries and gives new light of the fundamental role of feminism in the life of modern women. Another book that shows her bravery is "Había que decirlo" (8), in which she narrates the experience of her own abortion at age twenty-two in sixty's France. My work experience in the IPPF-RHO has allowed me to meet leaders of all ages in diverse countries of the region, who with great mysticism and dedication, voluntarily, work to achieve a more equal and just society. I have been particularly impressed by the appropriation of the concept of sexual and reproductive rights by young people, and this has given me great hope for the future of the planet. We continue to have an incomplete agenda of the action plan of the ICPD of Cairo but seeing how the youth bravely confront the challenges motivates me to continue ahead and give my years of experience in an intergenerational work. In their policies and programs, the IPPF-RHO evidences great commitment for the rights and the SRH of adolescent, that are consistent with what the organization promotes, for example, 20% of the places for decision making are in hands of the young. Member organizations, that base their labor on volunteers, are true incubators of youth that will make that unassailable and necessary change of generations. In contrast to what many of us experienced, working in this complicated agenda of sexual and reproductive health without theoretical bases, today we see committed people with a solid formation to replace us. In the college of medicine at the Universidad Nacional de Colombia and the College of Nursing at the Universidad El Bosque, the new generations are more motivated and empowered, with great desire to change the strict underlying structures. Our great worry is the onslaught of the ultra-right, a lot of times better organized than us who do support rights, that supports anti-rights group and are truly pro-life (9). Faced with this scenario, we should organize ourselves better, giving battle to guarantee the rights of women in the local, regional, and global level, aggregating the efforts of all pro-right organizations. We are now committed to the Objectives of Sustainable Development (10), understood as those that satisfy the necessities of the current generation without jeopardizing the capacity of future generations to satisfy their own necessities. This new agenda is based on: - The unfinished work of the Millennium Development Goals - Pending commitments (international environmental conventions) - The emergent topics of the three dimensions of sustainable development: social, economic, and environmental. We now have 17 objectives of sustainable development and 169 goals (11). These goals mention "universal access to reproductive health" many times. In objective 3 of this list is included guaranteeing, before the year 2030, "universal access to sexual and reproductive health services, including those of family planning, information, and education." Likewise, objective 5, "obtain gender equality and empower all women and girls", establishes the goal of "assuring the universal access to sexual and reproductive health and reproductive rights in conformity with the action program of the International Conference on Population and Development, the Action Platform of Beijing". It cannot be forgotten that the term universal access to sexual and reproductive health includes universal access to abortion and contraception. Currently, 830 women die every day through preventable maternal causes; of these deaths, 99% occur in developing countries, more than half in fragile environments and in humanitarian contexts (12). 216 million women cannot access modern contraception methods and the majority live in the nine poorest countries in the world and in a cultural environment proper to the decades of the seventies (13). This number only includes women from 15 to 49 years in any marital state, that is to say, the number that takes all women into account is much greater. Achieving the proposed objectives would entail preventing 67 million unwanted pregnancies and reducing maternal deaths by two thirds. We currently have a high, unsatisfied demand for modern contraceptives, with extremely low use of reversible, long term methods (intrauterine devices and subdermal implants) which are the most effect ones with best adherence (14). There is not a single objective among the 17 Objectives of Sustainable Development where contraception does not have a prominent role: from the first one that refers to ending poverty, going through the fifth one about gender equality, the tenth of inequality reduction among countries and within the same country, until the sixteenth related with peace and justice. If we want to change the world, we should procure universal access to contraception without myths or barriers. We have the moral obligation of achieving the irradiation of extreme poverty and advancing the construction of more equal, just, and happy societies. In emergency contraception (EC), we are very far from reaching expectations. If in reversible, long-term methods we have low prevalence, in EC the situation gets worse. Not all faculties in the region look at this topic, and where it is looked at, there is no homogeneity in content, not even within the same country. There are still myths about their real action mechanisms. There are countries, like Honduras, where it is prohibited and there is no specific medicine, the same case as in Haiti. Where it is available, access is dismal, particularly among girls, adolescents, youth, migrants, afro-descendent, and indigenous. The multiple barriers for the effective use of emergency contraceptives must be knocked down, and to work toward that we have to destroy myths and erroneous perceptions, taboos and cultural norms; achieve changes in laws and restrictive rules within countries, achieve access without barriers to the EC; work in union with other sectors; train health personnel and the community. It is necessary to transform the attitude of health personal to a service above personal opinion. Reflecting on what has occurred after the ICPD in Cairo, their Action Program changed how we look at the dynamics of population from an emphasis on demographics to a focus on the people and human rights. The governments agreed that, in this new focus, success was the empowerment of women and the possibility of choice through expanded access to education, health, services, and employment among others. Nonetheless, there have been unequal advances and inequality persists in our region, all the goals were not met, the sexual and reproductive goals continue beyond the reach of many women (15). There is a long road ahead until women and girls of the world can claim their rights and liberty of deciding. Globally, maternal deaths have been reduced, there is more qualified assistance of births, more contraception prevalence, integral sexuality education, and access to SRH services for adolescents are now recognized rights with great advances, and additionally there have been concrete gains in terms of more favorable legal frameworks, particularly in our region; nonetheless, although it's true that the access condition have improved, the restrictive laws of the region expose the most vulnerable women to insecure abortions. There are great challenges for governments to recognize SRH and the DSR as integral parts of health systems, there is an ample agenda against women. In that sense, access to SRH is threatened and oppressed, it requires multi-sector mobilization and litigation strategies, investigation and support for the support of women's rights as a multi-sector agenda. Looking forward, we must make an effort to work more with youth to advance not only the Action Program of the ICPD, but also all social movements. They are one of the most vulnerable groups, and the biggest catalyzers for change. The young population still faces many challenges, especially women and girls; young girls are in particularly high risk due to lack of friendly and confidential services related with sexual and reproductive health, gender violence, and lack of access to services. In addition, access to abortion must be improved; it is the responsibility of states to guarantee the quality and security of this access. In our region there still exist countries with completely restrictive frameworks. New technologies facilitate self-care (16), which will allow expansion of universal access, but governments cannot detach themselves from their responsibility. Self-care is expanding in the world and can be strategic for reaching the most vulnerable populations. There are new challenges for the same problems, that require a re-interpretation of the measures necessary to guaranty the DSR of all people, in particular women, girls, and in general, marginalized and vulnerable populations. It is necessary to take into account migrations, climate change, the impact of digital media, the resurgence of hate discourse, oppression, violence, xenophobia, homo/transphobia, and other emergent problems, as SRH should be seen within a framework of justice, not isolated. We should demand accountability of the 179 governments that participate in the ICPD 25 years ago and the 193 countries that signed the Sustainable Development Objectives. They should reaffirm their commitments and expand their agenda to topics not considered at that time. Our region has given the world an example with the Agreement of Montevideo, that becomes a blueprint for achieving the action plan of the CIPD and we should not allow retreat. This agreement puts people at the center, especially women, and includes the topic of abortion, inviting the state to consider the possibility of legalizing it, which opens the doors for all governments of the world to recognize that women have the right to choose on maternity. This agreement is much more inclusive: Considering that the gaps in health continue to abound in the region and the average statistics hide the high levels of maternal mortality, of sexually transmitted diseases, of infection by HIV/AIDS, and the unsatisfied demand for contraception in the population that lives in poverty and rural areas, among indigenous communities, and afro-descendants and groups in conditions of vulnerability like women, adolescents and incapacitated people, it is agreed: 33- To promote, protect, and guarantee the health and the sexual and reproductive rights that contribute to the complete fulfillment of people and social justice in a society free of any form of discrimination and violence. 37- Guarantee universal access to quality sexual and reproductive health services, taking into consideration the specific needs of men and women, adolescents and young, LGBT people, older people and people with incapacity, paying particular attention to people in a condition of vulnerability and people who live in rural and remote zone, promoting citizen participation in the completing of these commitments. 42- To guarantee, in cases in which abortion is legal or decriminalized in the national legislation, the existence of safe and quality abortion for non-desired or non-accepted pregnancies and instigate the other States to consider the possibility of modifying public laws, norms, strategies, and public policy on the voluntary interruption of pregnancy to save the life and health of pregnant adolescent women, improving their quality of life and decreasing the number of abortions (17).

Denne PhD afhandling beskriver udviklingen af en matematisk model, der estimerer det kvantitative bidrag fra fire husdyrreservoirer til forekomsten af Salmonella infektioner hos mennesker i den Europæiske Union. Med henblik på at ekstrapolere resultaterne til lande, hvor datatilgængeligheden er mindre, præsenteres desuden en alternativ og mere udforskende metode baseret på ekspertvurderinger. Sidstnævnte skal ses som et første skridt på vejen til at kvantificere betydningen af forskellige smitteilder for human salmonellose i et mere globalt perspektiv. Human salmonellose i EU blev ved hjælp af en matematisk model tilskrevet udlandsrejse, fødevarebårne udbrud samt de fire husdyrreservoirer: svin, slagtekyllinger, kalkuner og konsumægsproducerende høner. Modellen inkluderede data fra 24 lande. Metoden kræver data vedr. Salmonella forekomst og serotypefordeling i husdyr, rapporterede infektioner hos mennesker, oplysninger om mulig erhvervelse af infektionen i udlandet (herfra benævnt "rejseinformation"), forekomst af fødevarebårne udbrud samt kilderne til disse, samt mængden af kød eller æg fra husdyrreservoirerne pr. land, som er til rådighed for forbrugerne i de enkelte lande. Datahåndtering, -analyse og -validering vurderedes at være af stor betydning for resultaternes kvalitet, og der blev derfor lagt vægt på at beskrive, hvad der kræves for at frembringe et datasæt med standardiserede oplysninger for alle lande (Manuskript I). Data om rapporterede Salmonella infektioner hos mennesker blev skaffet fra det Europæiske Center for Sygdomsforebyggelse og Kontrol (ECDC) via Den Europæiske Fødevaresikkerhedsautoritet (EFSA). Salmonella forekomsten i de fire husdyrarter blev indhentet fra de EU-dækkende baseline undersøgelser (BS) rapporteret af EFSA og blev, når det var nødvendigt, suppleret med oplysninger fra EU's Zoonoserapport (EUSR) ligeledes publiceret af EFSA. Oplysninger om fødevarebårne Salmonella udbrud blev også leveret af EFSA. Mængden af animalske fødevarer til rådighed til forbrug blev estimeret på baggrund af data om fødevareproduktion og samhandel indhentet fra det europæiske statistisk kontor, EUROSTAT. Disse data blev suppleret med oplysninger fra sammenslutningen af fjerkræslagterier i EU, AVEC. Der var visse begrænsninger i data, som for nogle lande inkluderede manglende deltagelse i en af baseline undersøgelserne, manglende indberetning af fødevarebårne udbrud eller rejseinformation, manglende indberetning af serotype specifikke data, manglende indberetning af case-baserede data og manglende tilgængelighed af data i EUROSTAT. For at standardisere de foreliggende oplysninger, blev det antaget, at human tilfælde uden rejseinformation var indenlandsk erhvervede, og human tilfælde uden specifik serotype information blev tildelt en serotype i forhold til serotypefordelinger observeret i det samme datasæt eller fra andre referencedata. Manglende EUROSTAT data blev estimeret baseret på tidligere år, og manglende baseline data blev, hvor det var muligt, erstattet af data fra EUSR. For nogle lande var datamængden og – kvaliteten for ringe til, at de kunne indgå i modellen uden at kompromittere validiteten af resultaterne. Det endelige datasæt omfattede Østrig, Belgien, Cypern, Tjekkiet, Danmark, Estland, Finland, Frankrig, Tyskland, Grækenland, Ungarn, Irland, Italien, Letland, Litauen, Luxembourg, Holland, Polen, Portugal, Slovakiet, Slovenien, Spanien, Sverige og Storbritannien. Tre lande blev inkluderet i den indledende analyse, men ikke i det endelige datasæt. Det var Bulgarien, hvor 100% af de humane tilfælde ikke havde oplysning om serotype; Rumænien, som kun deltog i én baseline undersøgelse og ikke havde andre relevante data, og desuden havde en stor andel human tilfælde uden serotypeoplysning; samt Norge, der ikke er en del af EU og ikke rapporterer til EUROSTAT (Manuskript I). Den Bayesiansk model, som blev anvendt til den matematiske analyse, sammenligner serotypefordelingen i mennesker med serotypefordelingen i husdyrreservoirerne. Modellen estimerer antallet af tilfælde af human salmonellose i de 24 lande fra hvert af disse reservoirer, samt fra rejser og udbrud baseret på de ovennævnte data (Manuskript II). Konsumægsproducerende høner (dvs. æg) blev anslået til at være den vigtigste kilde til salmonellose hos mennesker i EU med 48,1% (95% Credibility Interval (CI) 47,5 til 48,8%) af tilfældene, efterfulgt af svin (29,6%, 95% CI 28,9-30,3%). Kalkuner og slagtekyllinger blev estimeret til at være mindre betydningsfulde kilder og bidrog med hhv. 4,4% (95% CI 4,2-4,7%) og 3,7% (95% CI 3,4-4,0%) af tilfældene. I alt blev 10,2% af alle Salmonella tilfældene rapporteret som værende rejserelaterede, og 3,9% af tilfælde blev rapporteret som værende en del af et udbrud med ukendt kilde. S. Enteritidis var den hyppigste serotype og ansvarlig for 95,9% af de tilfælde som blev tilskrevet æg, 56,9% af tilfældene tilskrevet slagtekyllinger, 30,4% af de kalkunrelaterede tilfælde og 28,3% af de svinerelaterede tilfælde. Den vigtigste serotype i svin var S. Typhimurium, som udgjorde 63,1% af de svinerelaterede tilfælde. Landespecifikke resultater viste, at æg var den vigtigste kilde til salmonellose i 13 lande (Østrig, Tjekkiet, Estland, Tyskland, Grækenland, Ungarn, Letland, Litauen, Luxembourg, Slovenien, Slovakiet, Spanien og Storbritannien), mens svin var den store bidragyder i otte (Belgien, Cypern, Finland, Frankrig, Irland, Italien, Polen og Sverige). I Finland og Sverige kunne hovedparten af salmonellainfektionerne relateres til udlandsrejse. Rejse var også en vigtig kilde i Irland, Storbritannien og Danmark om end i lavere grad. I Holland var andelen af infektioner fra æg og svin omtrent det samme. I Danmark blev den vigtigste fødevarekilde estimeret at være kalkun, mens slagtekyllinger var den største kilde i Portugal (Manuskript II). Danske strategier for risikohåndtering af Salmonella i jord-til-bord kæden omfatter anvendelse af en såkaldt smittekilderegnskabsmodel, det estimerer bidraget fra de vigtigste animalske fødevarekilder til infektioner hos mennesker i Danmark. Det danske modelkoncept dannede grundlag for EU-modellen beskrevet i Manuskript II. Som en del af valideringsprocessen af EU-modellen, blev resultaterne for Danmark i EU-modellen sammenlignet med dem, der opnås under brug af den danske model i samme periode (Manuskript III). Den danske model pegede på svinekød (9,3% af tilfælde), som den vigtigste kilde til salmonellose i perioden, efterfulgt af æg (7,5% af tilfælde) og slagtekyllinger (4,7% af tilfælde), mens EU-modellen til sammenligning tilskrev 15,6% af tilfælde til svin, 15,1% til kalkuner, 10,5% til æg og 2,8% til slagtekyllinger. Andelen af rejserelaterede tilfælde var 30,6% i den danske model mod 18,2% i EU-modellen. Infektioner, der ikke kunne henføres til nogen bestemt kilde, svarede til 16,7% af tilfældene i den danske model og 14,1% i EU-modellen. De observerede uoverensstemmelser kan forklares ved forskelle i modellernes struktur og de grundlæggende antagelser: a) en andel af tilfældene uden rejseinformation tilskrives rejse i den danske model, hvilket baseres på proportionen af rejsetilfælde observeret for tilfælde med fuld rejseinformation; i EU-modellen antages det, at ingen rejseinformation er lig med ingen rejserelation, da mange lande ikke skelner mellem "nej til rejse" og "ingen rejseinformation", b) den danske model anvender Salmonella typefordelinger baseret på både serotypning, fagtypning og resistensbestemmelse, mens EU-modellen kun anvender serotypefordelinger, fordi mere detaljerede typningsdata ikke var til rådighed for de fleste lande og/eller kilder; dette giver en mere specifik fordeling af tilfælde til de rigtige kilder i den danske model; c) et større antal smittekilder i den danske model giver flere muligheder for specifik fordeling af tilfælde, hvilket formentlig resulterer i en mere korrekt fordeling af kilder; d) den danske model anvender officielle data om mængden af dansk producerede og importerede fødevarer til rådighed til forbrug, men tager i modsætning til EU-modellen ikke hensyn til den mængde, der importeres specifikt fra hvert land, hvilket resulterer i at bidrag fra lande med høje Salmonella forekomster underestimeres i den danske model (manuskript III). Alt taget betragtning, så rangerer de to modeller tre ud af de fire kilder i samme rækkefølge, og mens EU-modellen må anses for at være nyttig for lande, som ikke umiddelbart har den datadetaljeringsgrad som findes i Danmark, vil Danmark kunne drage større nytte af at anvende landespecifikke importdata frem for at anvende resultaterne fra EU-modellen. Det sidste kapitel beskriver en alternativ metode til at estimere kilder til human salmonellose for Tjekkiet, Bulgarien, Norge og Rumænien, hvoraf de tre sidstnævnte ikke var inkluderet i EU modellen pga. manglende data. Ved hjælp af clusteranalyser blev 28 lande grupperet efter nogle udvalgte variable, som karakteriserer landenes sociale og økonomiske status, den animalske husdyrproduktion samt kostvaner. Hvis data var tilgængelige, blev variable som afspejler forekomsten af Salmonella hos mennesker og husdyr også inddraget. Resultaterne af analyserne blev fremlagt et panel af eksperter med ekspertise indenfor fødevaresikkerhed, epidemiologi og risikomodellering. Disse blev bedt om at komme med estimater for den relative betydning af Salmonella smittekilder for de førnævnte lande, baseret på disses lighed med lande, for hvilke resultater allerede forelå dvs. på baggrund af resultater fra EU-modellen. Eksperterne blev også bedt om at evaluere metodens egnethed og anvendeligheden af resultaterne. Eksperternes individuelle estimater blev evalueret dels ved en sammenligning med de tjekkiske resultater, som var til rådighed fra EU-modellen, men også i forhold til estimaternes ensartethed og usikkerhedsintervallerne mellem de forskellige estimater fra samme ekspert og imellem eksperterne i panelet. Evalueringen resulterede i, at svarene fra fem ud af de syv respondenter blev bibeholdt i de endelige analyser. Selv om panelet angav estimater for Tjekkiet som ikke var identiske med dem fra EU-modellen, var der enighed om rækkefølgen af betydningen af de animalske kilder, og der var enighed i panelet om samme rækkefølge. Det vurderes derfor, at metoden med nogle justeringer, kan være nyttig til at prioritere målrettet Salmonella kontrol i lande uden tilstrækkelige data til en mere datadrevet fremgangsmåde. På sigt kan metoden måske bruges til at identificere "surrogatlande," hvorfra prævalensdata kan "lånes" og anvendes i en matematisk model baseret på sammenligning af Salmonella typer. Dette PhD projekt har fremlagt resultater for et Europæisk smittekilderegnskab for Salmonella, samt evalueret de anvendte metoder og fremkommet med løsninger til, hvordan man kan håndtere manglende eller utilstrækkelige data i lignende undersøgelser. Projektet har også opnået resultater, som kan lægge grunden for fremtidige forsøg på at udarbejde Salmonella smittekilderegnskaber i et mere globalt perspektiv. ; This thesis presents a mathematical modeling approach to estimate the contribution of four animal reservoirs of the food chain to the occurrence of salmonellosis cases in humans in the European Union. In addition, an alternative and more explorative approach based on expert elicitation is attempted in order to extrapolate results to countries with less data availability, as a first step to perform source attribution of Salmonella in a more global perspective. Cases of foodborne salmonellosis in humans were attributed to travel, outbreaks and four animal reservoirs, namely pigs, broilers, turkeys and laying hens, using a Bayesian model based on microbial subtyping in 24 countries of the European Union. The chosen approach is recognized as data intensive, requiring numbers for Salmonella occurrence in food-producing animals, reported human cases, information on possibility of infection abroad (from here on referred to as "travel information"), human cases originating from outbreaks with and without a confirmed source and amounts of the meat or eggs of each animal reservoir originating from each country and available for consumption in each country. Thus, special data management, analysis and validation was required to produce a dataset containing standardized information for all countries (Manuscript I). Data on reported human cases were provided by the European Centre for Disease Prevention and Control (ECDC) through the European Food Safety Authority (EFSA). Salmonella prevalences in animals were obtained from the EU-wide baseline studies (BS) conducted by EFSA and complemented where necessary with information found in the European Union Summary Report (EUSR), as published by EFSA. Information on outbreaks was also provided by EFSA. The amount of food available for consumption was calculated based on trade data obtained from the European Statistical Office (EUROSTAT) and complemented with information from the Association of Poultry Processors and Poultry Trade in the European Union Countries (AVEC). Common limitations included non-participation in all BS, non-reporting of outbreaks or travel information, non-reporting of serovar-specific information, non-reporting of case-based data and non-availability of trade data on EUROSTAT. In order to standardize the information available, cases without travel information were assumed to be domestic; cases without specific serovar information were redistributed according to serovar proportions observed in the same dataset or other reference documents; missing trade information was estimated based on previous years, and non-participation in a BS was supplied, where possible, with data from the EUSR. When the lack of original data was considered too extreme to the point of compromising the attribution results, countries were excluded. The resulting dataset comprised Austria, Belgium, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden and the United Kingdom. Three countries were included in the initial analysis, but were excluded from the final dataset. Those were: Bulgaria, which presented 100% of human cases without serovar detailing; Romania, which only participated in one BS and had not enough surrogate data to be retrieved from the EUSR, besides reporting a large parcel of cases without serovar information; and Norway, which is not part of the EU and does not report to EUROSTAT (Manuscript I). A Bayesian modeling approach which compares the occurrence of serovars in humans with the occurrence of the same serovars in animals of the food-chain was used to estimate the contribution of each of these reservoirs, travel and outbreaks to the number of human cases of salmonellosis in the 24 countries present in the dataset previously described (Manuscript II). Laying hens (i.e. eggs) were estimated to be the most important source of human salmonellosis at EU level, with 48.1% (95% Credibility Interval (CI) 47.5 – 48.8%) of cases, followed by pigs (29.6%, 95% CI 28.9-30.3%). Turkeys and broilers were estimated to be less important sources of Salmonella, contributing with 4.4% (95% CI 4.2-4.7%) and 3.7% (95% CI 3.4-4.0%), respectively. A total of 10.2% of all salmonellosis cases were reported as being travel-related, and 3.9% of cases were reported as being part of outbreaks with unknown source. S. Enteritidis was the most important serovar in the study, being responsible for 95.9% of cases attributed to laying hens, 56.9% of cases attributed to broilers, 30.4% of turkeys and 28.3% of cases attributed to pigs, for which the main serovar was S. Typhimurium (63.1% of cases attributed to this source). Country-specific results show laying hens as the most important source of salmonellosis in 13 countries (Austria, Czech Republic, Estonia, Germany, Greece, Hungary, Latvia, Lithuania, Luxembourg, Slovenia, Slovakia, Spain and the United Kingdom), whereas pigs were the larger animal contributor in eight (Belgium, Cyprus, Finland, France, Ireland, Italy, Poland and Sweden). In Finland and Sweden the majority of Salmonella infections were estimated to be travel-related. Travel was also an important source in Ireland, the UK and Denmark, although to a lower extent. In the Netherlands, the proportion of disease attributed to layers and pigs were similar. In Denmark, the most important food-animal source was estimated to be turkeys, and broilers were the major source in Portugal. (Manuscript II). Danish strategies for risk management of Salmonella in the farm-to-fork continuum include the routine application of a source attribution model to estimate the contribution of the major animal-food sources to human infections by Salmonella in Denmark. This model concept formed the basis for the model described in Manuscript II. As part of the validation process of the EU model, results for Denmark in the EU model were compared with the ones obtained using the Danish model in the same period (Manuscript III).The Danish model points to pork as the main animal source of human salmonellosis in the period (9.3% of cases), followed closely by table eggs (7.5% of cases) and broilers (4.7% of cases), while the EU model attributed 15.6% to pigs, 15.1% to turkeys, 10.5% to eggs and 2.8% to broilers. Travel-related cases constitute 30.6% in the Danish model and only 18.2% in the EU model. Cases that could not be attributed to any source corresponded to 16.7% in the Danish model and 14.1% in the European model. Discrepancies in numbers are explained by differences in model structure and basic assumptions: a) cases with no travel information in the Danish model are redistributed according to proportions observed in cases with full information; in the EU model, as some countries did not provide any information regarding travel prior to sickness, it had to be assumed that no information means no travel; b) the Danish model uses data subtyped to phage-type level, while the EU model only uses serovar level, as phage-type data in humans and animals was not sufficiently available; this allows the more specific allocation of cases to the right sources; c) the larger number of sources in the Danish model allows more options for specific allocation of cases, presumably resulting in a more correct distribution of cases among sources; d) the Danish model uses official data on amount of domestic and imported food items available for consumption in the country, but does not as opposed to the EU model take into account the amount imported from each country specifically, which results in an underestimation of the contribution from high prevalence countries as compared to the EU model (Manuscript III). All facts considered, the two models rank three out of the four sources in a similar order and, while the EU model is considered useful for countries which cannot readily attain the level of detailing found in Denmark for monitoring and surveillance data, Denmark would benefit more from applying country-specific data than to adopt the results of the EU model. The last chapter presents an alternative approach to obtain results for the Czech Republic, Bulgaria, Norway and Romania, the last three of which were excluded from the EU-model due to insufficient data. Using clustering techniques, 28 countries were grouped according to variables used to characterize them as to social and economic status, animal production characteristics and food consumption patterns. Where available, variables reflecting the occurrence of Salmonella enterica in humans and animals were also used. The results of the analyses were delivered to a panel of experts composed by foodborne disease epidemiologists and risk modelers, which were asked to provide attribution estimates for the aforementioned countries, based on their similarity to countries for which results were previously obtained. Experts were also asked to evaluate the method concerning its utility and applicability of results. Individual estimates were evaluated based on comparison with the Czech results, for which results based on the microbial subtyping model were available, but also in relation to uniformity of guesses and uncertainty intervals among different estimates from the same expert and among all experts in the panel. This evaluation resulted in five out of the seven respondents being maintained in the panel. Although the Czech Republic values obtained did not match the ones observed in the EU study, the order of importance of the animal sources was in agreement between the two studies and there was also a consensus in the panel concerning that order. It is, therefore, believed that with some adjustments, this method may be useful for prioritizing targeted actions for Salmonella control in countries without sufficient data for a traditional approach. Further on, this method may be used to identify "surrogate countries" from where animal prevalence data can be "borrowed" and applied in the traditional microbial subtyping approach in the aforementioned Member States. This PhD project has provided results for a European "source of infection account" for Salmonella, and has at the same time been evaluating the approaches attempted, raising questions and proposing solutions on how to deal with the lack of good-quality data for such studies. The project has also achieved results that may lay the groundwork for future attempts to develop Salmonella source attribution estimates in a more global perspective.