Europe’s first and last field trial of gene-edited plants?

On 5 June this year the first field trial of a CRISPR-Cas-9 gene-edited crop began at Rothamsted Research in the UK, having been approved by the UK Department for Environment, Food & Rural Affairs. However, in late July 2018, after the trial had started, the European Court of Justice ruled that techniques such as gene editing fall within the European Union's 2001 GMO directive, meaning that our gene-edited Camelina plants should be considered as genetically modified (GM). Here we describe our experience of running this trial and the legal transformation of our plants. We also consider the future of European plant research using gene-editing techniques, which now fall under the burden of GM regulation, and how this will likely impede translation of publicly funded basic researc

La médiation humaniste, pour ‘faire société’ dans la prise en charge des différends

This paper is the work of a collective, and contains multidisciplinary reflexions on a humanistic practice of mediation that was pioneered in France in 1984, and refined over 30 years of practical experience and thousands of completed mediations. This kind of mediation focuses its efforts less on the specific area of dispute, and more on the transformation of human and social relationships, thereby justifying the qualifier ‘humanistic’. The exchanges established between the mediants, made possible and facilitated by the mediator, have the core objective of rebuilding a lasting and peaceable relationship.Humanistic mediation is shown to be a tool for personal, ontological transformation – a way of supporting the deep aspirations and values which everyone needs in order to live. In social interaction it enables common ground (‘commons’) to emerge which forms the basis of a new mode of sharing; it introduces a process that is humanizing and mutually nurturing while still respecting differences. Humanistic mediation is rooted in the trans-modern beginnings of our ongoing societal transformation. By reintroducing a sense of existential solidarity which is founded more on sharing than on exchange, it offers itself as an educational tool for peace, using a civilizing pedagogy to create a humanism for our times.The process is laid out in three sequential phases, which take into account the emotions of the mediants. With often spectacular results, the process leads to a pivotal moment that allows the energy of the conflict to be redirected. The role and attitude of the mediator are precisely defined. The relationship between mediation and institutions such as justice and education is discussed. Humanistic mediation takes its place in the evolution of a justice that both repairs and restores.Cet article est la réflexion pluridisciplinaire d’un collectif sur une pratique humaniste de la médiation, introduite de façon pionnière en 1984 et affinée au cours de 30 ans d’expérience et de milliers de médiations réalisées. Ce type de médiation concentre ses efforts moins sur le différend que sur la transformation des rapports humains et sociaux, justifiant ainsi le qualificatif humaniste. Les échanges instaurés entre les médiants, rendus possibles et facilités par le médiateur, ont pour objectif essentiel de reconstruire une relation pacifiée et durable.La médiation humaniste se révèle un outil ontologique de transformation personnelle prenant appui sur les aspirations profondes et les valeurs dont chacun a besoin pour vivre. Socialement, elle permet l’émergence de communs sur lesquels fonder un nouveau mode de partage, introduisant un processus de fécondation mutuelle et d’humanisation réciproque, dans le respect des différences. La médiation humaniste s’inscrit dans les prémices trans-modernes de la transformation sociétale en cours. Réintroduisant le sens d’une solidarité existentielle, fondée plus sur le partage que sur l’échange, elle se présente comme un outil d’éducation à la paix, pédagogique et civilisateur, pour un humanisme de notre temps.Le déroulement en est explicité en trois phases successives prenant en compte les émotions des médiants et aboutissant à un retournement souvent spectaculaire qui permet de réorienter l’énergie du conflit. Le rôle et la posture du médiateur sont précisés.Le rapport aux institutions Justice et Education est discuté. La médiation humaniste s’inscrit dans une démarche de justice réparatrice et restauratrice

Large-scale STI services in Avahan improve utilization and treatment seeking behaviour amongst high-risk groups in India: an analysis of clinical records from six states

<p>Abstract</p> <p>Background</p> <p>Avahan, the India AIDS Initiative, implemented a large HIV prevention programme across six high HIV prevalence states amongst high risk groups consisting of female sex workers, high risk men who have sex with men, transgenders and injecting drug users in India. Utilization of the clinical services, health seeking behaviour and trends in syndromic diagnosis of sexually transmitted infections amongst these populations were measured using the individual tracking data.</p> <p>Methods</p> <p>The Avahan clinical monitoring system included individual tracking data pertaining to clinical services amongst high risk groups. All clinic visits were recorded in the routine clinical monitoring system using unique identification numbers at the NGO-level. Visits by individual clinic attendees were tracked from January 2005 to December 2009. An analysis examining the limited variables over time, stratified by risk group, was performed.</p> <p>Results</p> <p>A total of 431,434 individuals including 331,533 female sex workers, 10,280 injecting drug users, 82,293 men who have sex with men, and 7,328 transgenders visited the clinics with a total of 2,700,192 visits. Individuals made an average of 6.2 visits to the clinics during the study period. The number of visits per person increased annually from 1.2 in 2005 to 8.3 in 2009. The proportion of attendees visiting clinics more than four times a year increased from 4% in 2005 to 26% in 2009 (p<0.001). The proportion of STI syndromes diagnosed amongst female sex workers decreased from 39% in 2005 to 11% in 2009 (p<0.001) while the proportion of STI syndromes diagnosed amongst high risk men who have sex with men decreased from 12% to 3 % (p<0.001). The proportion of attendees seeking regular STI check-ups increased from 12% to 48% (p<0.001). The proportion of high risk groups accessing clinics within two days of onset of STI-related symptoms and acceptability of speculum and proctoscope examination increased significantly during the programme implementation period.</p> <p>Conclusions</p> <p>The programme demonstrated that acceptable and accessible services with marginalised and often difficult–to-reach populations can be brought to a very large scale using standardized approaches. Utilization of these services can dramatically improve health seeking behaviour and reduce STI prevalence.</p

Validity of measures of pain and symptoms in HIV/AIDS infected households in resources poor settings: results from the Dominican Republic and Cambodia

BACKGROUND: HIV/AIDS treatment programs are currently being mounted in many developing nations that include palliative care services. While measures of palliative care have been developed and validated for resource rich settings, very little work exists to support an understanding of measurement for Africa, Latin America or Asia. METHODS: This study investigates the construct validity of measures of reported pain, pain control, symptoms and symptom control in areas with high HIV-infected prevalence in Dominican Republic and Cambodia Measures were adapted from the POS (Palliative Outcome Scale). Households were selected through purposive sampling from networks of people living with HIV/AIDS. Consistencies in patterns in the data were tested used Chi Square and Mantel Haenszel tests. RESULTS: The sample persons who reported chronic illness were much more likely to report pain and symptoms compared to those not chronically ill. When controlling for the degrees of pain, pain control did not differ between the chronically ill and non-chronically ill using a Mantel Haenszel test in both countries. Similar results were found for reported symptoms and symptom control for the Dominican Republic. These findings broadly support the construct validity of an adapted version of the POS in these two less developed countries. CONCLUSION: The results of the study suggest that the selected measures can usefully be incorporated into population-based surveys and evaluation tools needed to monitor palliative care and used in settings with high HIV/AIDS prevalence

A surveillance model for sexually transmitted infections in India

The strategy for prevention and control of sexually transmitted infections (STIs) in India is based on syndromic case management delivered through designated STI/reproductive tract infection (RTI) centers (DSRCs) situated in medical colleges, district hospitals, and STI-clinics of targeted interventions programs. Laboratory tests for enhanced syndromic management are available at some sites. To ensure country-level planning and effective local implementation of STI services, reliable and consistent epidemiologic information is required on the distribution of STI cases, rate and trends of newly acquired infections, and STI prevalence in specific population groups. The present STI management information system is inadequate to meet these requirements because it is based on syndromic data and limited laboratory investigations on STIs reported passively by DSRCs and laboratories. Geographically representative information on the etiology of STI syndromes and antimicrobial susceptibility of STI pathogens although essential for optimizing available treatment options, is deficient. Surveillance must provide high quality information on: (a) prevalence of STIs such as syphilis, trichomoniasis, gonorrhea, and chlamydia among high-risk groups; syphilis in the general population and pregnant antenatal women; (b) demographic characteristics such as age, sex, new/recurrent episode, and type of syndromically diagnosed STI cases; (c) proportion of acute infections such as urethral discharge (UD) in men and nonherpetic genital ulcer disease (GUD) in men and women; (d) etiology of STI syndromes; and (e) gonococcal antimicrobial susceptibility. We describe here a framework for an STI sentinel surveillance system in India, building on the existing STI reporting systems and infrastructure, an overview of the components of the proposed surveillance system, and operational challenges in its implementation

Quality control of antibiotics before the implementation of an STD program in Northern Myanmar.

BACKGROUND: The ready availability of poor-quality drugs in developing countries leads to treatment failure and, consequently, excess mortality and morbidity. Moreover, the widespread availability of substandard drugs plays a key role in increasing the resistance to antimicrobial drugs.GOAL As a prerequisite to the establishment of a sexually transmitted disease (STD) control program, this study aimed to evaluate the quality of antibiotics recommended for treatment of STDs that were locally available in the capital of a province of Northern Myanmar. STUDY DESIGN: In addition to the hospital pharmacy, we selected at random 5 of the 41 drug sellers and 5 of the 40 general practitioners who sell antibiotics in the city of Myitkyina. Twenty-one marketing products corresponding to nine different antibiotics used for STD treatment were purchased (benzathine benzylpenicillin, benzylpenicillin, ceftriaxone, chlortetracycline, ciprofloxacin, clotrimazole, co-trimoxazole, doxycycline, and erythromycin). Drugs were sent to France, where they were analyzed according to the WHO guidelines. Drugs were considered to be standard if their dosage remained in the 10% range of the expected value. RESULTS: Among the 21 different specialty products, only three displayed the official "registered" label. Three drugs were expired and the expiration date was not available for six others. One product did not contain the active drug declared (chlortetracycline; Lombisin, Unicorn, China) and did not show any in vitro activity against bacteria. Seven of 21 products (33%) did not contain the stated dosage (1, more than stated dosage; 6, less than stated dosage). The highest deficit observed was 48% in two products (co-trimoxazole, Yong Fong, Myanmar; benzylpenicillin, China [city and manufacturer unknown]). The dosage was not available for five drugs. As a result, only 8 of 21 products (38%) did not contain the stated dosage of active drug. CONCLUSION: These findings suggest that public health policies based on national treatment guidelines should rigorously include the monitoring of quality control of available antimicrobial products. In the absence of such measures, specific treatment strategies are likely to fail and to generate drug resistance