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Selected AbstractsGMO Food Labelling in the EU: Tracing ,the Seeds of Dispute'EUROCHOICES, Issue 1 2003Maria L. Loureiro Summary GMO Food Labelling in the EU: Tracinq ,the Seeds of Dispute' Genetically modified (GM) food labelling has become a critical issue in the international trade arena. Policymakers and consumers in the European Union (EU) seem to agree on the need to control the use of biotechnology in the food industry. As a consequence, recently the EU Commission approved a measure that establishes strict rules on genetically modified organisms (GMOs), but which lifts the moratorium on GMO production and marketing. This new Directive deals with mandatory labelling of GM foods and their traceability along the food chain. In spite of the substantial effort made to reconcile the different opinions in the escalating debate about biotechnology, the new GMO regulation seems to be unsatisfactory for too many interest groups. A system of total traceability from ,farm to fork' and mandatory labelling for genetically modified products may be considered too complex and too expensive to implement, particularly by those countries or industries that have produced GMO foods for many years. Yet, giving European consumers the freedom to choose GMOs may be the only option that there is until Europeans restore their confidence in the food system and food regulators. A market or consumer-driven solution may eventually terminate the GMO dispute between the two transatlantic trading blocks. , Assurance , Revenud a ns , Agriculture Européenne ,étiquetage des aliments contenant des organismes génétiquement modifyés (OGM) est devenu une question cruciale sur la scène du commerce international. Tant les décideurs politiques que les citoyens de , Union européenne semblent s'accorder sur la nécessité de soumettre à contrôle , utilisation des biotechnologies dans , industrie alimentaire. En conséquence, la Commission européenne a récemment approuvé une mesure qui établit des règies strictes sur les OGM, mais qui lève le moratoire sur leur production et leur commercialisation. Cette nouvelle directive concerne ,étiquetage obligatoire des aliments contenant des OGM et la façon ? en assurer le suivi dans les filières alimentaires. Ce nouveau règlement OGM, en dépit des efforts réels effectués pour réconcilier les différents points de vue dans la montée du débat sur les biotechnologies, semble inconciliable avec trop de groupes ? intérêts pour être satisfaisant. Un système assurant une traçabilité totale, ,du champ à la fourchette' et un étiquetage obligatoire pour tout produit contenant des OGM, paraît bien trop complexe et coûteux à mettre en ,uvre, en particulier pour les pays ou les industries qui produisent des aliments génétiquement modifyés depuis des années. Et pourtant, il se pourrait bien que la seule façpn de restaurer la confiance perdue des Européens dans le système alimentaire et ses institutions soit justement de leur donner le droit de choisir. La fin de la querelle des OGM entre les blocs commerciaux des deux rives de , Atlantique peut venir de solutions apportées par le marché et issues des consommateurs. Einkommenversicherung in der Europäischen Landwirtschaft Die Kennzeichnung von genetisch veränderten Lebensmitteln ist zu einer der bedeutendsten Streitfragen auf dem Gebiet des internationalen Handels geworden. Politische Entscheidungsträger und Verbraucher in der Europäischen Union scheinen dahingehend überein zu stimmen, dass der Einsatz von Biotechnologie in der Nahrungsmittel-industrie kontrolliert werden sollte. Als Reaktion darauf hat die EU-Kommission kürzlich einer Maßnahme zugestimmt, welche ein strenges Regelwerk für genetisch veränderte Organismen (GVO) festschreibt, mit der aber gleichzeitig das Moratorium für die Produktion und Vermarktung von GVO aufgehoben wird. Die neue Richtlinie beschäftigt sich mit der Pflichtkennzeichnung von genetisch veränderten Nahrungsmitteln und mit ihrer Rückverfolgbarkeit entlang der Nahrungsmittelkette. Trotz der erheblichen Anstrengungen, die verschiedenen Standpunkte in der eskalierenden Debatte um Biotechnologie zu berücksichtigen, scheint die neue GVO Richtlinie in den Augen (zu) vieler Interessengruppen unbefriedigend zu sein. Ein System der vollständigen Rückverfolgbarkeit vom Stall bis zum Teller und die Pflichtkennzeichnung von genetisch veränderten Nahrungsmitteln mag in der Umsetzung als zu komplex und zu teuer betrachtet werden, insbesondere von den Ländern oder Industriezweigen, welche seit vielen Jahren GVO-Nahrungsmittel hergestellt haben. Dennoch könnte der Ansatz, den europäischen Verbrauchern die freie Wahl für oder gegen GVO zu gewähren, der einzig gangbare Weg sein, bis die Europäer ihr Vertrauen in das Produktions- und Kontrollsystem für Nahrungsmittel zurückgewonnen haben. Eine markt- oder verbraucherorientierte Lösung könnte letztlich den Streit um GVO zwischen den beiden transatlantischen Handelsblöcken beenden. [source] European Union Constitution-Making, Political Identity and Central European ReflectionsEUROPEAN LAW JOURNAL, Issue 2 2005It analyses both the temporal and spatial dimensions of constitution-making and addresses the problems of political identity related to ethnic divisions and civic demos. It starts by summarising the major arguments supporting the Union's constitution-making project and emphasises the Union's symbolic power as a polity built on the principles of civil society and parliamentary democracy. The EU's official rejection of ethnically based political identity played an important symbolic role in post-Communist constitutional and legal transformations in Central Europe in the 1990s. In the following part, the text analyses the temporal dimension of the EU's identity-building and constitution-making and emphasises its profoundly future-oriented structure. The concept of identity as the ,future in process' is the only option of how to deal with the absence of the European demos. Furthermore, it initiates the politically much-needed constitution-making process. The following spatial analysis of this process emphasises positive aspects of the horizontal model of constitution-making, its elements in the Convention's deliberation and their positive effect on the Central European accession states. The article concludes by understanding the emerging European identity as a multi-level identity of civil political virtues surrounded by old loyalties and traditions, which supports the conversational model of liberal democratic politics, reflects the continent's heterogeneity and leads to the beneficial combination of universal principles and political realism. [source] Suppression of testosterone stimulates recovery of spermatogenesis after cancer treatmentINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 3 2003Marvin L. Meistrich Summary It is important to develop methods to prevent or reverse the infertility caused by chemotherapy or radiation therapy for cancer in men. Radiation and some chemotherapeutic agents kill spermatogonial stem cells, but we have shown that these cells survive in rats, although they are unable to differentiate. There is evidence that this phenomenon also occurs in men. The block to spermatogonial differentiation in rats is caused by some unknown change, either in the spermatogonia or the somatic elements of the testis, such that testosterone inhibits spermatogonial differentiation. In the rat, the spermatogenesis and fertility lost following treatment with radiation or some chemotherapeutic agents can be restored by suppressing testosterone with gonadotropin releasing hormone (GnRH) agonists or antagonists, either before or after the cytotoxic insult. The applicability of this procedure to humans is still unknown. Some anticancer regimens may kill all the stem cells, in which case the only option would be spermatogonial transplantation. However, in some cases stem cells survive and there is one report of stimulation of recovery of spermatogenesis with hormonal treatment. Clinical trials should focus on treating patients with hormones during or soon after anticancer treatment. The hormone regimen should involve suppression of testosterone production with minimum androgen supplementation used to improve the diminished libido. [source] Harvesting of the Radial Artery: Subfasciotomy or Full Skeletonization: A Comparative StudyJOURNAL OF CARDIAC SURGERY, Issue 4 2008Nezihi Kucukarslan M.D. We compared the early results of this technique with those of the RA graft harvested as a pedicle in the conventional fashion. Methods: The study patients have been selected from the patients who underwent coronary artery bypass grafting (CABG) using the RA graft harvested either with a long posterior fasciotomy (group 1) or as a whole with a pedicle in the classical manner (group 2). Only the patients with a flow study have been included. The flow index was described as the bleeding amount of the RA in a minute per body surface area (mL/m2 min). The flow index has been performed before and after fasciotomy in group 1, and after full skeletonization in group 2. The clinical and demographic parameters and flow indices were measured and compared between the groups, and in group 1, before and after fasciotomy. Results: From 218 patients with CABG using the RA between January 1998 and August 2005, a total of 57 patients were recruited into the study. Group 1 consisted of 25 patients. Thirty-two patients constituted group 2. Subfascial dissection of the RA increased the blood flow index from 48 ± 20 mL/m2 min to 51 ± 19 mL/m2 min (p < 0.001). The comparison of the clinical, perioperative characteristics of the patients was not different between the groups. Conclusions: The necessity of total skeletonization of the RA should not be the only option when the aim is to reduce the spasm. While subfascial dissection (sympathectomy) of the pediculed RA alone provides a satisfactory increase in the blood flow index, it also reduces the manipulation time as well as the risk of injury to the graft. [source] Palliative management of cancer of the oesophagus , opportunities for dietetic interventionJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2003A. Holdoway Introduction: Cancer of the oesophagus develops insidiously and when patients present with symptoms such as dysphagia to solids/semi-solids and in some cases liquids, the disease is often advanced and patients are frequently poorly nourished and cachectic (Angorn, 1981; Larrea, 1992). In our own unit we were aware that patients were only referred to the dietitian once an oesophageal stent was inserted or radiotherapy commenced, thereby possibly missing opportunities to treat or prevent malnutrition earlier. We therefore evaluated the nutritional status and care pathways of patients diagnosed with cancer of the oesophagus in whom palliative treatment was the only option, with the aim of assessing the extent of malnutrition and identifying opportunities for earlier dietetic intervention to prevent or slow the development of malnutrition. Method: Data were collated on all patients referred to the hospital's dysphagia clinic and diagnosed with inoperable cancer of the oesophagus. Height, weight, body mass index, degree of dysphagia, period of dysphagia, percentage weight loss (data collected as standard practice in the dysphagia clinic) and time to stent insertion/radiotherapy and survival time was collected from the medical notes. Results: Data were available on 58 patients, 33 male, 25 female, mean age 75 years (range 49,92 years). The mean length of survival was 10.2 months (0,24 months). At diagnosis, 47% experienced dysphagia with solids, 33% with semi-solids and 16% experienced a degree of dysphagia with liquids. The period of dysphagia was 1 month to 2 years. Eighty-three per cent of patients had lost weight at diagnosis. Mean percentage weight loss per individual was 13% (range 0,45%). Thirty-five per cent had a BMI <20 kg/m2. Median time from diagnosis to radiotherapy (n = 8) was 2 months with range, 1,6 months. Median time from diagnosis to the placement of the oesophageal stent (n = 12) was 1 month with range, 0,7 months. Discussion: These data illustrate that malnutrition remains a significant problem in this patient group. These results demonstrate that dysphagia and malnutrition, as indicated by weight loss, is developing in the community before diagnosis. Opportunities for earlier dietetic intervention exist between diagnosis and date at which other treatments commence, i.e. stent insertion. Further opportunities exist to educate community health professionals on treating and preventing malnutrition when dysphagia presents. Survival times support the need for dietetic follow-up. In our unit the results of this audit helped to improve care pathways for patients with cancer of the oesophagus. In response to the above findings, a nutritional screening tool is now completed by a nurse specialist at the first clinic attended. This has enabled appropriate and timely advice to be given on modified texture and fortification of food to optimize nutritional intake at diagnosis. [source] Successful Organ Transplantation from Donors Poisoned with a Carbamate InsecticideAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010J. H. Garcia Currently, liver transplantation is the only option for patients with end-stage liver disease. In Brazil, the mortality rate on the waiting list is about 25%. Multiple strategies to expand the donor pool are being pursed, however, grafts from poisoned donors are rarely used. This report documents successful liver, kidney and heart transplantations from four female donors who suffered brain death by hypoxia despite cardiopulmonary resuscitation following Aldicarb exposure ([2-methyl-2-(methylthio)propionaldehyde O-(methylcarbamoyl)-oxime]). The success rate of 12 grafts from four donors poisoned by Aldicarb was 91% 6 months after transplantation. Poisoned patients are another pool of organ donors who at present are probably underused by transplantation services. More studies are necessary to confirm the safety for the recipients. [source] END-OF-LIFE CARE IN THE 21st CENTURY: ADVANCE DIRECTIVES IN UNIVERSAL RIGHTS DISCOURSEBIOETHICS, Issue 3 2010IREVI, VIOLETA BE ABSTRACT This article explores universal normative bases that could help to shape a workable legal construct that would facilitate a global use of advance directives. Although I believe that advance directives are of universal character, my primary aim in approaching this issue is to remain realistic. I will make three claims. First, I will argue that the principles of autonomy, dignity and informed consent, embodied in the Oviedo Convention and the UNESCO Declaration on Bioethics and Human Rights, could arguably be regarded as universal bases for the global use of advance directives. Second, I will demonstrate that, despite the apparent consensus of ethical authorities in support of their global use, it is unlikely, for the time being, that such consensus could lead to unqualified legal recognition of advance directives, because of different understandings of the nature of the international rules, meanings of autonomy and dignity which are context-specific and culture-specific, and existing imperfections that make advance directives either unworkable or hardly applicable in practice. The third claim suggests that the fact that the concept of the advance directive is not universally shared does not mean that it should not become so, but never as the only option in managing incompetent patients. A way to proceed is to prioritize work on developing higher standards in managing incompetent patients and on progressing towards the realization of universal human rights in the sphere of bioethics, by advocating a universal, legally binding international convention that would outlaw human rights violations in end-of-life decision-making. [source] ,Paper Clinics', a model for improving delivery of outpatient colorectal servicesCOLORECTAL DISEASE, Issue 4 2004T. R. C. Porrett Abstract Objectives The overburdening of colorectal out-patient clinics necessarily leads to delays in time from referral to consultation and subsequent clinic attendance. This study aimed to ascertain the feasibility of ,paper clinic' follow-up rather than all patients receiving a routine follow-up appointment following investigation. A more efficient outpatient follow-up process should reduce unnecessary follow-up, thereby facilitating the speedy investigation and diagnosis of patients through changes in clinic profiles. Methods From August 2001 all patients seen in the outpatient clinic of one (part time) Consultant colorectal surgeon, who required investigation, were prospectively recorded on a ,paper clinic' form. These patients were given the necessary test request forms but were not given a further outpatient appointment. The results of the investigations were reviewed, together with the patients' medical records at a formal fortnightly ,paper clinic' session carried out by the Consultant and Nurse Consultant, and a treatment plan derived. Patients then followed one of 5 follow-up pathways and were notified in writing with a copy to their GP. Results During a 24-month period a total of 897 patients were reviewed using the ,paper clinic' follow-up system. Of these, 285 (31.8%) patients were discharged without further follow-up. In a given 3-month period when the clinic was well established, 152 patients were reviewed, of whom 27% were discharged from follow-up, 17% received SOS appointments, 13% required further investigation (and consequently were returned to ,paper clinic' follow-up), and 7% received Nurse led follow-up. In this 3-month period 64% of patients reviewed by ,paper clinic' follow-up did not return to Surgical Outpatient's and 12% received a Surgical Outpatient appointment for review. Conclusion ,Paper clinic' follow-up is an effective and feasible follow-up alternative, resulting in a major decrease in outpatient follow-up burden. This has allowed the redesign of the outpatient clinic profile allowing for an increase in new urgent slots, and more rapid clinic follow up review of those patients who need it. Re-design and rationalization of existing services can result in considerable service improvement. Expanding clinics should not be considered the only option when faced with capacity and demand issues. [source] Luck, Evidence and WarJOURNAL OF APPLIED PHILOSOPHY, Issue 3 2006ROB LAWLOR abstract We seem to have conflicting intuitions regarding luck and war, and we seem to be faced with a dilemma. Either, we deny that a war can be made just or unjust as a result of luck, and we accept that we should not appeal to the outcome when claiming that the war was or was not justified. Or, alternatively, we allow that it is legitimate to base our judgements on the outcome, but as a result we must accept that luck can make a war just or unjust. Traditionally, these have been taken to be the two forks of the dilemma, but, in this paper, I argue that they are not the only options. Rather, we can appeal to the outcome of our actions without claiming that this is, in anyway, an appeal to moral luck. Rather, the outcome provides us with evidence. [source] | |||||||||||||