The Trump Presidency : what consequences will this have on Europe?

The election of Donald Trump as the 45th President of the United States may represent one of the greatest challenge to transatlantic relations since the end of WWII. Throughout the Cold War and since then, all US Presidents have based their foreign policy on a core set of beliefs that America’s closest partners in world affairs are democracies, that US prosperity is dependent on global free trade, and that its own security is unquestionably linked to the international context, especially its ties with Europe. Thus, American commitment to European prosperity and security has never been questioned. During his electoral campaign, however, Donald Trump made many statements that called into question every one of these core sets of beliefs that have formed the backbone of transatlantic relations for the last seventy years. From his strident criticism of free trade and his admiration of strong authoritarian leaders such as Russian President Vladimir Putin, to his questioning of Article 5 of the NATO Treaty, Donald Trump’s rhetoric has shaken the very foundations of the Atlantic alliance. This paper aims to analyze the full extent of the challenge that Donald Trump’s presidency represents for Europe. The second objective is to offer policy recommendations on how the European Union can manage Trump’s presidency, turning adversity into opportunity in order to make the next four years a success for the Atlantic alliance. The goal of this paper is to highlight a strategy for the EU to remain visibly present on the world stage, making the most of the potential opportunities that could open-up in the next four years. While isolationism is certainly a risk that must be taken into consideration, closer inspection reveals that Donald Trump has developed a core consistency in his understanding of world politics that can be divided into three main pillars. First, Trump has been clear that he is against free trade in its current form, which he blames for impoverishing American workers and weakening the US while serving the interests of a cosmopolitan elite. Second, Trump has been consistent in his belief that the US is getting a “bad deal” from its allies, who stand accused of taking advantage of American largesse. Third, Trump appears to have a fascination for strong leadership, and seems to believe he can obtain “better deals” by negotiating bilaterally with authoritarian strong men such as Russian President Putin than by working cooperatively with democratic allies and multilateral organizations such as NATO or the EU. These views represent a potential threat to the Atlantic alliance. Thus, it is essential for the EU and its Member States to respond intelligently and assertively in order to avoid a worst-case scenario. This paper will focus on several issues where Trump’s presidency is likely to have the most impact on transatlantic relations: trade, NATO, Russia, Iran and China. In each case, the aim will be to outline possible scenarios, and then provide policy recommendations on how the EU can turn challenges into opportunities.L'élection de Donald Trump, 45e Président des États-Unis, peut constituer l'un des plus grands défis pour les relations transatlantiques depuis la fin de la Seconde Guerre mondiale. Tout au long de la Guerre froide et depuis sa fin, tous les présidents des États-Unis ont fondé leur politique étrangère sur un ensemble de convictions essentielles : les partenaires les plus proches sont les démocraties, la prospérité des États-Unis dépend du libre-échange mondial et leur propre sécurité est incontestablement liée au contexte international, en particulier à leurs liens avec l'Europe. Aussi, l'engagement américain pour la prospérité et la sécurité européenne n'a-t-il jamais été remis en question. Toutefois, au cours de sa campagne électorale, Donald Trump a fait de nombreuses déclarations qui remettent en cause toutes les convictions fondamentales qui ont constitué la colonne vertébrale des relations transatlantiques pendant les soixante-dix dernières années. Depuis ses critiques sévères à l’égard du libre-échange et son admiration pour des dirigeants autoritaires tels que le président russe Vladimir Poutine, jusqu’à sa remise en question de l'article 5 du Traité de l'OTAN, la rhétorique de Donald Trump a ébranlé les fondements de l'Alliance atlantique. Cet article a pour premier but d’analyser l'ampleur du défi que la présidence de Donald Trump représente pour l'Europe. Son deuxième objectif est de suggérer des recommandations politiques sur la façon dont l'Union européenne peut gérer la présidence de M. Trump afin de transformer l'adversité en un succès pour l'Alliance atlantique durant les quatre prochaines années. Ce document se propose donc de dégager une stratégie pour que l'Union européenne reste visiblement présente sur la scène mondiale, en tirant le meilleur parti des opportunités qui pourraient s'ouvrir dans les quatre années qui viennent. Bien que l'isolationnisme soit sans doute un risque qui doit être pris en considération, une analyse plus approfondie révèle que Donald Trump a développé une cohérence au cœur de sa vision de la politique mondiale qui peut être divisée en trois axes principaux. Tout d'abord, Trump a clairement manifesté qu'il est contre le libre-échange sous sa forme actuelle, accusé d’appauvrir les travailleurs américains et d’affaiblir les États-Unis tout en servant les intérêts d'une élite cosmopolite. Deuxièmement, Trump n’a pas cessé d’exprimer sa conviction que les États-Unis concluaient de « mauvais accords » avec leurs alliés, accusés de profiter de la générosité américaine. En troisième lieu, Trump paraît fasciné par un leadership fort, et semble croire qu'il peut obtenir de « meilleurs accords » par des négociations bilatérales auprès des personnalités autoritaires, comme le président russe Poutine, plutôt que par la coopération avec des alliés démocratiques ou des organisations multilatérales, telles que l'OTAN ou l’Union européenne. Ces positions constituent potentiellement une menace pour l'Alliance atlantique. C'est pourquoi il est essentiel que l'Union européenne et ses États membres réagissent intelligemment et fermement afin d'éviter le scénario du pire. Ce document se centrera sur plusieurs questions où la présidence de Trump serait le plus susceptible d’affecter les relations transatlantiques : le commerce, l'OTAN, la Russie, l'Iran et la Chine. Pour chacune de ces questions, nous exposerons différents scénarios et nous proposerons ensuite des recommandations politiques sur la manière dont l'Union européenne peut transformer les défis en succès

Europe's Asia pivot : a new balancing act?

The year 2017 poses a number of existential dilemmas for Europe. On the regional front, several key domestic elections will likely determine the future direction of the European Union. The international situation also presents many equally significant challenges. As the Asia Pacific region spearheads the global recovery from the 2008 financial crisis, the European pivot to Asia stands poised to accelerate. A series of economic and security issues throughout the region present both opportunities and challenges for European member states; items on the agenda include persistent trade imbalances, climate change, maritime security and the law of the sea. With the rise in authoritarian governance worldwide and the push for regime neutrality within international institutions, how should the EU and its democratic member states respond to a potentially volatile realignment of geopolitics in Asia? China’s continuing economic rise, coupled with its uneven human rights record and territorial push into the South China Sea, poses a particular challenge for the European Union. This paper will examine the advantages and disadvantages of a heightened interdependence with Asian markets, as well as the security dimension of Europe’s presence in the region, including its longstanding commitment to free navigation and fair allocation of resources according to international law.Au cours de l’année 2017, l’Europe sera confrontée à des choix essentiels. Plusieurs élections nationales seront déterminantes pour l'avenir de l'Union européenne. La situation internationale suscite également de nombreux défis, tout aussi importants. Alors que la région de l’Asie-Pacifique mène la reprise économique mondiale depuis la crise financière de 2008, le pivot européen vers l’Asie est en passe de s’accélérer. Une série d’enjeux économiques et sécuritaires au sein de la région présentent tout à la fois des opportunités et des défis pour les États membres de l’Union européenne. Les sujets à l’ordre du jour incluent les déséquilibres commerciaux persistants, le changement climatique, la sécurité maritime, ainsi que le droit de la mer. Comment l’Union européenne devra-t-elle réagir face à la montée d’une certaine gouvernance autoritaire dans le monde, à la propagation du concept de « neutralité du régime » dans les institutions internationales, ainsi qu’à un réalignement instable de la géopolitique en Asie ? La croissance économique continue de la Chine, son bilan inégal en matière de droits de l’Homme, ainsi que son expansion territoriale en mer de Chine méridionale, représentent un défi particulier. Cette étude analysera les avantages et les désavantages d’une interdépendance renforcée avec les marchés asiatiques, ainsi que la dimension sécuritaire du pivot européen vers l’Asie. Cela inclut l’engagement de l’Union européenne sur le long terme pour défendre le principe de la liberté de navigation et la répartition équitable des ressources selon le droit international

How Europe can and should become the guardian of the Paris Agreement on climate change

Environmental issues have become one of the most salient topics on the political agenda. This is due to near-unanimous consensus amongst the scientific community that all types of environmental degradation, particularly the release of greenhouse gases (GHG) into the atmosphere leading to climate change, represent a threat to life on Earth. Nonetheless, until recently, progress on finding political solutions to environmental problems has been remarkably slow. This is often linked to fears that environmental regulation may hamper economic development. Europe has always been an exception in this regard, as from the 1960s onward, it has gradually succeeded in enacting some of the most comprehensive environmental legislation in the world. All the while, Europe has maintained steady economic development, demonstrating that the two can be reconciled and are in fact mutually reinforcing. Since the 1990s, Europe has relied on this solid base to play a leading role in the emerging global climate regime. This has been critical in shaping the European Union’s identity and incipient foreign policy as a normative power engaged in multilateral diplomacy to shape the international agenda. Following decades of laborious negotiations, the international community finally reached a new accord to tackle climate change during the 21st Conference of the Parties (COP) held in Paris in 2015. The so-called ‘Paris Agreement’, signed by 195 countries, represents the most comprehensive and far-reaching climate accord ever achieved. Consequently, President Trump’s decision to withdraw the United States from the Paris Agreement in June 2017 sent shockwaves through the international community. How should the EU respond to this setback? This paper will provide recommendations on how Europe can and should become the guardian of the Paris Agreement. The first part of the paper will focus on the historical context of Europe’s role in climate diplomacy up to the Paris Agreement. The second section will analyze the strengths and weaknesses of EU and member state environmental policies, demonstrating how Europe is committed to lead by example, inciting further international climate action. The last section will examine how leading by example will provide Europe with the authority to position itself at the heart of the global climate regime, building a network of robust partnerships with countries around the world to compensate for US disengagement.Les questions environnementales sont devenues l'un des sujets les plus marquants de l'agenda politique. Cela est dû à un consensus quasi unanime parmi la communauté scientifique, selon lequel les atteintes à l'environnement représentent une menace pour la vie sur Terre, en particulier les gaz à effet de serre (GES) rejetés dans l'atmosphère, qui provoquent un dérèglement climatique. Néanmoins, jusqu'à récemment, les progrès vers des solutions politiques aux problèmes environnementaux ont été lents à se mettre en place. Cela est souvent lié aux craintes que la réglementation environnementale devienne un frein au développement économique. L'Europe a toujours constitué une exception de ce point de vue. En effet, à partir des années 1960, elle a progressivement réussi à adopter une législation environnementale parmi les plus ambitieuses au monde. Or, dans le même temps, elle a connu un développement économique stable, démontrant ainsi que les deux aspects sont compatibles et peuvent se renforcer mutuellement. Depuis les années 1990, l'Europe s'est appuyée sur cette base solide pour jouer un rôle de premier plan dans l’émergence du régime climatique mondial. Cela a contribué à façonner l'identité et la politique étrangère naissante de l'Union européenne (UE) en la positionnant comme puissance normative, utilisant une diplomatie multilatérale capable d’influer sur la politique internationale. Après des décennies de négociations laborieuses, la communauté internationale est finalement parvenue à un accord mondial pour lutter contre le changement climatique lors de la 21e Conférence des Parties (COP) qui s'est tenue à Paris en 2015. L'Accord de Paris, signé par 195 pays, constitue le traité climatique le plus complet et le plus ambitieux jamais conclu. Dès lors, la décision du président Trump d’en retirer les États-Unis en juin 2017 a provoqué des ondes de choc à travers la communauté internationale. De quelle manière l'Union européenne devrait-elle réagir face à ce recul? La première partie de cette étude présentera le contexte historique du rôle de l’Europe dans les négociations climatiques jusqu’à l’Accord de Paris. La seconde partie analysera les forces et les faiblesses des politiques climatiques de l’UE et de ses États membres, soulignant de quelle façon l’Europe doit montrer l’exemple dans ce domaine. La troisième partie abordera comment l’UE a le potentiel de se positionner au cœur du régime climatique mondial en construisant un réseau de partenariats avec des pays du monde entier pour compenser le retrait américain

Awareness and knowledge about weight status and management: results from the 1 d sensitization campaign 'Obesity Day' in northern Italy.

AbstractObjectiveTo evaluate the awareness and knowledge about weight status and its management.DesignA 1 d cross-sectional survey. Basic anthropometric assessments (weight, height, BMI and waist circumference) and a self-administered questionnaire were considered.SettingNineteen Clinical Nutrition or Endocrinology and Metabolic Disorders Units or Dietetics Services in the Italian region of Lombardy.SubjectsAll adults attending the 'Obesity Day' initiative.ResultsA total of 914 participants (605 female and 309 male) were recruited. Although most of the participants (83·5 %) considered obesity to be a disease, 38·5 % were likely to misperceive their weight status. In particular, 38·8 % of normal-weight adults believed themselves to be overweight, whereas 71·1 % and 37·5 % of classes I and II/III obese adults classified themselves as being overweight and mildly obese, respectively. However, most of the overweight (90·2 %), mildly (96·8 %) and moderately/severely obese adults (99·1 %) recognized the need to lose weight. In all, 37·8 % of the sample underestimated the role of physical activity in weight management. Interestingly, only 17·2 % of dieters (previous or current) declared being advised by their doctor to lose weight. Multivariate models revealed that higher age, low education and higher BMI were important determinants of poor weight control and management. In addition, previous dieting appeared not to provide better knowledge, whereas the role of physical activity was recognized mainly by those practising it.ConclusionsThe present study suggests that in Italy knowledge about weight management should be improved not only in the general population but also among health-care professionals. To confirm this finding, there is now the rationale for a nationally representative survey. New educational programmes can be designed on the basis of the information collected

Major nutritional issues in the management of Parkinson\u2019s disease

As with other neurodegenerative diseases, neurologic and nutritional elements may interact affecting each other in Parkinson's disease (PD). However, the long-term effects of such interactions on prognosis and outcome have not been given much attention and are poorly addressed by current research. Factors contributing to the clinical conditions of patients with PD are not only the basic features of PD, progression of disease, and the therapeutic approach but also fiber and nutrient intakes (in terms of both energy and protein content), fluid and micronutrient balance, and pharmaconutrient interactions (protein and levodopa). During the course of PD nutritional requirements frequently change. Accordingly, both body weight gain and loss may occur and, despite controversy, it seems that both changes in energy expenditure and food intake contribute. Nonmotor symptoms play a significant role and dysphagia may be responsible for the impairment of nutritional status and fluid balance. Constipation, gastroparesis, and gastro-oesophageal reflux significantly affect quality of life. Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). A balanced Mediterranean-like dietary regimen should be recommended before the introduction of levodopa; afterward, patients with advanced disease may benefit considerably from protein redistribution and low-protein regimens

Serum Adiponectin Levels in Advanced-Stage Parkinson's Disease Patients

Patients with advanced Parkinson's disease (PD) experience body weight loss and reductions in the most common cardiovascular risk factors. At present, the pathogenetic mechanisms involved have not been elucidated. Increased serum concentrations of adiponectin, which possesses antiatherogenic and anti-inflammatory properties, are associated with a reduction in cardiovascular risk. The objective of this study was to determine adiponectin serum concentrations in PD patients. Thirty PD patients underwent a full nutritional status assessment, including the determination of adiponectin serum concentrations. Mean ± SD adiponectin concentrations were 9.59 ± 5.9 μg/mL (interquartile range: 5.92–12.9 μg/mL). In PD patients, adiponectin serum levels were similar to those in normal-weight, healthy, young subjects and significantly higher than that in an aged-matched group of morbidly obese subjects. Further studies are warranted to establish the role of adiponectin in the management of PD patients

Nutrition and Inflammation in Older Individuals: Focus on Vitamin D, n-3 Polyunsaturated Fatty Acids and Whey Proteins

Chronic activation of the inflammatory response, defined as inflammaging, is the key physio-pathological substrate for anabolic resistance, sarcopenia and frailty in older individuals. Nutrients can theoretically modulate this phenomenon. The underlying molecular mechanisms reducing the synthesis of pro-inflammatory mediators have been elucidated, particularly for vitamin D, n-3 polyunsaturated fatty acids (PUFA) and whey proteins. In this paper, we review the current evidence emerging from observational and intervention studies, performed in older individuals, either community-dwelling or hospitalized with acute disease, and evaluating the effects of intake of vitamin D, n-3 PUFA and whey proteins on inflammatory markers, such as C-Reactive Protein (CRP), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor \u3b1 (TNF-\u3b1). After the analysis, we conclude that there is sufficient evidence for an anti-inflammatory effect in aging only for n-3 PUFA intake, while the few existing intervention studies do not support a similar activity for vitamin D and whey supplements. There is need in the future of large, high-quality studies testing the effects of combined dietary interventions including the above mentioned nutrients on inflammation and health-related outcomes

Weight Loss Improves Cardio-Metabolic and Inflammatory State in Subjects with Metabolic Syndrome

Metabolic syndrome (MetS) is a condition characterized by a constellation of reversible major risk factors for cardiovascular disease (CVD) and type 2 diabetes (T2DM). While it has been widely demonstrated that weight reduction by 5\u201310% decreases CVD and T2DM risk factors, including atherogenic dyslipidemia, on the other hand, its effects on comprehensive serum cytokine profile and endotoxemia are less investigated. Furthermore, the impact of weight loss on these parameters was studied especially in subjects with morbid obesity, often after bariatric surgery; while the studies on the effects of a physiological weight reduction with a balanced hypocaloric diet in overweight and moderately obese subjects showed contradictory results

Mucuna pruriens for Parkinson's disease: Low-cost preparation method, laboratory measures and pharmacokinetics profile

Abstract Background Parkinson's disease (PD) is a progressive neurological condition. Levodopa (LD) is the gold standard therapy for PD patients. Most PD patients in low-income areas cannot afford long-term daily Levodopa therapy. The aim of our study was to investigate if Mucuna pruriens (MP), a legume with high LD content that grows in tropical regions worldwide, might be potential alternative for poor PD patients. Methods We analyzed 25 samples of MP from Africa, Latin America and Asia. We measured the content in LD in various MP preparations (dried, roasted, boiled). LD pharmacokinetics and motor response were recorded in four PD patients, comparing MP vs. LD+Dopa-Decarboxylase Inhibitor (DDCI) formulations. Results Median LD concentration in dried MP seeds was 5.29%; similar results were obtained in roasted powder samples (5.3%), while boiling reduced LD content up to 70%. Compared to LD+DDCI, MP extract at similar LD dose provided less clinical benefit, with a 3.5-fold lower median AUC. Conclusion Considering the lack of a DDCI, MP therapy may provide clinical benefit only when content of LD is at least 3.5-fold the standard LD+DDCI. If long-term MP proves to be safe and effective in controlled clinical trials, it may be a sustainable alternative therapy for PD in low-income countries

A cross-sectional study of the nutritional status of community-dwelling people with idiopathic Parkinson's disease

<p>Abstract</p> <p>Background</p> <p>Parkinson's disease (PD) patients have an increased risk of under-nutrition, but we are unaware of any population based prevalence studies of under-nutrition in PD. The main objective of this study was to identify the prevalence, and nature, of under-nutrition in a representative population of people with PD.</p> <p>Methods</p> <p>People diagnosed with idiopathic PD from within two PD prevalence study sites in North-East England were asked to participate in this study. Those who participated (n = 136) were assessed using a number of standard rating scales including Hoehn & Yahr stage and Unified Parkinson's Disease Rating Scale (UPDRS). Body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (TSF) and grip strength were recorded together with social and demographic information.</p> <p>Results</p> <p>BMI < 20 identified over 15% of the study group to have under-nutrition. The Malnutritional Universal Screening Tool (MUST) scoring system identified 23.5% of participants at medium or high risk of malnutrition. Low BMI, indicating under-nutrition, was associated with greater age and disease duration, lower MAC, TSF, mid-arm muscle circumference (MAMC), reduced grip strength and a report of unintentional weight loss. Problems increased with increasing age and disease duration and were greater in females.</p> <p>Conclusions</p> <p>Under-nutrition is a problem for around 15% of community dwelling people with PD. All PD patients should be screened for under-nutrition; the MUST score is a useful early screening tool.</p