The (Non-)Normative Power EU and the European Neighbourhood Policy: An Exceptional Policy for an Exceptional Actor?

The ENPÕs strong rhetoric in terms of the promotion of normative values, or Òmilieu goalsÓ, has stimulated an interest in the academic community for the argument that the EU is somehow a Ònormative powerÓ. This brief article will, however, sustain that the many contradictions inherent in the multifaceted EUÕs foreign policy conducted in the UnionÕs relations with neighbouring countries makes it difficult, for the time being, to fully concur with the assertion that the Union is a normative power.Normative power EU, civilian power EU, European Neighborhood Policy, ENP, EU foreign policy, exceptionalism

Is the EU's Foreign Policy Identity an Obstacle? The European Union, the Northern Dimension and the Union for the Mediterranean

The impact of the EU policies on its borderlands has been highly varied. We will argue that a valuable addendum on Rationalist explananda for such varied impact, can be found be exploring how the EU constructs its international identity vis-à-vis neighboring countries. We will use the Northern Dimension and the Union for the Mediterranean to verify how the EU identitarian projection creates contradictions and/or dissonance with neighboring countries to illustrate the uneven impact of EU policies.European foreign policy, Union for the Mediterranean, Northern Dimension, Baltic Sea, Identity

The Voting Practice of the Fifteen in the UN General Assembly : Convergence and Divergence

The EU has, since the early days of the Community, had the ambition to speak with 'a single voice' in international fora, in particular in the United Nations' General Assembly. This aspiration, which has become more pronounced since the inauguration of the CFSP, has not always been easy to achieve due to domestic or international level factors affecting the EU member states. However, in the last decade there has been a dramatic increase in convergence in the Fifteen's voting record. This paper contemplates the underlying reasons for such a convergenceLa UE, des dels primers dies de la Comunitat, tenia l'ambició de parlar amb "una sola veu" en els fòrums internacionals, en particular a l'Assemblea General de Nacions Unides. Aquesta aspiració, que s'ha accentuat des de la inauguració de la PESC, no sempre ha estat fàcil d'aconseguir a causa dels factors a nivell nacional o internacional que afecten els estats membres de la UE. No obstant això, en l'última dècada s'ha produït un augment espectacular de la convergència en l'historial de votació de Quinze. Aquest document contempla les raons subjacents d'aquesta convergènci

Atomic Layer Deposited Catalysts for Fuel Cell Applications

The micro direct methanol fuel cell (µDMFC) has been proposed as a candidate to power portable applications. The device can operate at room temperature on inexpensive, energy-dense methanol fuel, and it can be easily "recharged" by fuel refilling. Microfabrication techniques could be one route for the realization of such tiny devices. It is a mature technology, suitable for mass production, where versatile structuring is available at the micro and nano regime. Carbon black supported catalysts synthesized by wet chemistry methods are not readily applicable for standard microfabrication techniques. Atomic layer deposition (ALD), on the other hand, is a highly suitable and still relatively unexplored approach for the synthesis of noble metal catalysts. It is a vapor phase growth method, primarily used to deposit thin lms. ALD is based on self-limiting chemical reactions of alternately injected precursors on the sample surface. Its unique growth characteristic enables conformal and uniform lms of controlled thickness and composition. In certain conditions ALD commences by island growth, resulting in discrete nanoparticle formation, which is generally preferred for catalytic applications. Pt-Ru is the best catalyst toward the methanol oxidation reaction (MOR). In the work described in this PhD dissertation, two series of Pt-Ru ALD catalysts supported on nitrogen-doped multi-walled carbon nanotubes (N-CNTs) have been evaluated toward the CO oxidation and MOR at room temperature in a three-electrode electrochemical cell. The first series was comprised of Pt-Ru ALD catalysts of various Ru compositions, between 0 and 100 at.%. For the compositions investigated, the best catalyst had a Ru composition of 29 at.%. In the second series Ru-decorated Pt catalysts of various Ru loadings, i.e., various Ru ALD cycles (1, 2, 5, 10 and 20), were investigated. The Pt nanoparticles decorated with 2 Ru ALD cycles exhibited highest catalytic activity, which also outperformed the best catalyst of the first series. In addition, a Si-based fuel cell design with ALD catalysts is presented, and its anode was evaluated toward the MOR

Stable unpredictability? An assessment of the Italian-Libyan relations

Since the end of the Cold War, Italy has sought to frame its relations with different southern Mediterranean countries inside various European multilateral initiatives. The Italian foreign policy objective to achieve stability and dependability in such relations has largely been met through the launch of different European Union (EU) framework policies, such as the 1995 Barcelona Process and more recently the 2008 Union for the Mediterranean (Aliboni 1999, Carbone 2008). The Italian diplomacy’s preferred approach, one can thus infer, has been to Europeanise its foreign policy in the Mediterranean area, whenever possible (Balfour 2005)

Symptoms and Well-Being in Older Hospitalized Patients with Cognitive Impairment, As Self-Reported and Reported in Patient Records: A Quantitative Exploratory Subgroup Analysis

Introduction: Given the aging population and the high prevalence of cognitive impairment in older hospitalized patients, it is essential to provide good fundamental care to these vulnerable patients, who easily might be affected by poor outcomes as delirium. Risk factors for delirium are, for example, cognitive impairment, old age, pain, and sleep deprivation. Different symptoms are often unidentified in hospitals, and associated with poor well-being, but this is rarely studied in older patients with cognitive impairment. The study aim was to examine symptoms and sense of well-being in older hospitalized patients with cognitive impairment, as self-reported and reported in patient records. Methods: Exploratory quantitative subgroup (n = 25) analysis of a point-prevalence study (n = 210). Inclusion criteria were age ≥65, and cognitive impairment. Data were collected through structured interviews, validated instruments, and patient records. Associations between well-being and symptoms, and concordance between the occurrence of self-reported symptoms and symptoms reported in patient records were analyzed. Results: The patients reported severe and distressing symptoms that were sparsely reported (14%) in their records. As well were cognitive impairment, and the patients’ own descriptions of their well-being. Some symptoms and the total symptom burden were associated with poor well-being. Discussion/Conclusion: To our knowledge, this hypothesis-generating study is one of few studies that describe both symptoms and well-being as self-reported and reported in patient records, in vulnerable patients due to old age, cognitive impairment, and hospitalization. Despite the limited sample size, the results indicate that symptoms were more insufficient alleviated in these patients compared to patients with normal cognitive function in other studies. To our knowledge, this has not been shown previously. Additionally, patients’ own experiences were sparsely reported in their records. A larger sample size and longitudinal design has the potential to determine if symptom alleviation differs between patients with and without cognitive impairment, and if a total symptom burden increases the risk of poor outcomes as delirium in vulnerable patients

Genetic diversity of Clostridium perfringens type A isolates from animals, food poisoning outbreaks and sludge

BACKGROUND: Clostridium perfringens, a serious pathogen, causes enteric diseases in domestic animals and food poisoning in humans. The epidemiological relationship between C. perfringens isolates from the same source has previously been investigated chiefly by pulsed-field gel electrophoresis (PFGE). In this study the genetic diversity of C. perfringens isolated from various animals, from food poisoning outbreaks and from sludge was investigated. RESULTS: We used PFGE to examine the genetic diversity of 95 C. perfringens type A isolates from eight different sources. The isolates were also examined for the presence of the beta2 toxin gene (cpb2) and the enterotoxin gene (cpe). The cpb2 gene from the 28 cpb2-positive isolates was also partially sequenced (519 bp, corresponding to positions 188 to 706 in the consensus cpb2 sequence). The results of PFGE revealed a wide genetic diversity among the C. perfringens type A isolates. The genetic relatedness of the isolates ranged from 58 to 100% and 56 distinct PFGE types were identified. Almost all clusters with similar patterns comprised isolates with a known epidemiological correlation. Most of the isolates from pig, horse and sheep carried the cpb2 gene. All isolates originating from food poisoning outbreaks carried the cpe gene and three of these also carried cpb2. Two evolutionary different populations were identified by sequence analysis of the partially sequenced cpb2 genes from our study and cpb2 sequences previously deposited in GenBank. CONCLUSION: As revealed by PFGE, there was a wide genetic diversity among C. perfringens isolates from different sources. Epidemiologically related isolates showed a high genetic similarity, as expected, while isolates with no obvious epidemiological relationship expressed a lesser degree of genetic similarity. The wide diversity revealed by PFGE was not reflected in the 16S rRNA sequences, which had a considerable degree of sequence similarity. Sequence comparison of the partially sequenced cpb2 gene revealed two genetically different populations. This is to our knowledge the first study in which the genetic diversity of C. perfringens isolates both from different animals species, from food poisoning outbreaks and from sludge has been investigated

Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting

Background: Delirium is common in older hospitalized patients. It has serious consequences e.g., poor health outcomes, mortality and increased costs. Despite that, many cases are undetected. Early detection of delirium is important in improving outcomes and use of assessment tools improves detection rates. The 4AT is a brief screening tool for delirium detection, which has not previously been translated into Swedish. The study aim was to evaluate diagnostic accuracy and clinical applicability of a Swedish version of the screening tool 4AT for delirium detection. Method: This diagnostic test accuracy study used a quantitative and a qualitative approach and evaluated the patients’ and the health care professionals’ experiences of the tool. Study included 200 patients ≥65 years from a university hospital and a county hospital in two Swedish regions. Medical specialties were geriatric stroke/neurology, geriatric multimorbidity, severe cognitive impairment, orthopaedic, and urology. The translated 4AT was tested against the reference standard DSM-IV-TR criteria, based on the Organic Brain Syndrome scale and patient records. The 4AT was assessed simultaneously and independently by two assessors. Additionally, data was collected through patient record reviews, and questions about applicability to the patients (n = 200) and the assessors (n = 37). Statistical analyses, and qualitative content analyses were conducted. Results: By reference standard 18% had delirium, and by 4AT 19%. The overall percent agreement was 88%, AUROC 0.808, sensitivity 0.70 (95% CI 0.51–0.84) and specificity 0.92 (95% CI 0.87–0.96). In the ward for severe cognitive impairment (n = 63) the 4AT was less sensitive and less specific. In the other wards (n = 132) sensitivity was 0.77 (95% CI 0.50–0.93), specificity 0.93 (95% CI 0.87–0.97), and AUROC 0.848. Interrater reliability (Kappa) was 0.918, p = \u3c 0.001 (n = 144). The 4AT was well tolerated by patients, easy to use for health care professionals, and took a few minutes to conduct. Conclusion: The Swedish version of 4AT is an accurate and applicable tool to use in clinical practice for detecting delirium in hospitalized patients across different medical specialities, and to use by different professionals and levels of seniority. To improve patient outcomes, we recommend the 4AT to be incorporated in clinical practice in health care settings in Sweden

Kommunikationsmetoder med intuberade patienter på en intensivvårdsavdelning.

Mekanisk ventilation utgör ett hinder för kommunikation, som är ett av intensivsjuksköterskans omvårdnadsansvar och en viktig del för den kritisk sjuke patienten. Syftet med studien var att beskriva vilka kommunikationsmetoder som används av personalen för att kommunicera med intuberade patienter på en allmän intensivvårdsavdelning. Under totalt 40 timmar observerades de olika kommunikationsmetoderna på intensivvårdssalar. Resultatet visade att de vanligaste kommunikationsmetoderna som användes på intensivvårdsavdelningen var ja/nej och envägskommunikation. Dessa två metoder utgjorde tillsammans för mer än hälften av all kommunikation på en intensivvårdsavdelning med 30% vardera av all registrerad kommunikation. Sjuksköterskor använde sig i genomsnitt av 3,5 olika kommunikationsmetoder under en och samma observation. Undersköterskor använde sig i genomsnitt av 2,25 olika metoder. Sjuksköterskor använde sig oftare av metoden kroppsspråk och hålla handen jämfört med undersköterskor

Per què és tan difícil la construcció de la identitat política i cultural europea?

La consolidació i l’extensió de la integració és lenta i atzarosa ateses les nombroses dificultats a les quals ha de fer front una Unió Europea en procés de canvi constant. Dins del context general d’ampliació a l’Europa central i oriental, és necessari que Europa articuli la seva identitat política i cultural; consolidi i racionalitzi una política exterior i de seguretat comuna; aporti solucions a la complexitat que suposa l’establiment d’una política social europea; resolgui l’encaix de les regions dins l’organigrama de les institucions i polítiques comunitàries; i, finalment, gestioni de manera eficaç i humana els nous fluxos migratoris