A Mindful Environmental Jurisprudence?: Speculations on the Application of Gandhi’s Thought to MCWC v. Nestlé

We attempt to engage modern legal reasoning with Gandhi’s thought. We hope to speculate on what jurisprudence would look like if it were more mindful of the concepts central to Gandhi’s thought. By using Gandhi as an intellectual anchor, we hope to take a step toward creating a more “mindful jurisprudence” that implicitly incorporates into its reasoning the needs of environmental stewardship, disempowered populations, and the poverty-stricken. Because Gandhi’s thought has been discussed at length in environmental justice campaigns, we begin this effort by examining the relationship between environmental law and Gandhi’s thought. Given Gandhi’s commentaries on exploitative and oppressive social relationships, we focus on the intersections of law, environment, and economy. We use the recent suit, Michigan Citizens for Water Conservation v. Nestlé Waters North America, Inc. (MCWC), as a case study to which we apply themes from Gandhi’s thought. Applying Gandhi’s thought to MCWC is useful for two reasons. First, MCWC contains several core legal doctrines that appear regularly in environmental cases (and in case law more broadly). As a result, our applications of Gandhi’s thought directly apply to other environmental cases. Second, the case involves a defendant-corporation’s encroachment onto a stream used by local plaintiff-civilians. Environmental justice campaigns often involve similar factual circumstances in which local people resist large outsider organizations. Therefore, using Gandhi’s thought, we examine the legal reasoning in MCWC to identify taken-for-granted assumptions about environment and society that favor outside parties over local residents

Two Concepts of Religious Freedom in the European Court of Human Rights

This paper considers the way in which recent historical work on the history of freedom of religion and freedom of conscience opens up a new interpretation of the decisions of the European Court of Human Rights in the headscarf cases. These decisions have been widely criticized as adopting a militantly secularist approach to the presence of Islamic religious symbols in the public sphere, an approach that seems inconsistent or even overtly discriminatory in light of the court’s recent decision in Lautsi that the compulsory display of crucifixes in the classroom did not breach Italy’s convention obligations. I argue that the headscarf cases turn less on the balance between state neutrality and religious belief, than on an understanding of certain religious symbols as a threat to public order and as harbingers of sectarian strife which undermine democracy

Decentralisation and school autonomy impact on the quality of education: the case of two MENA countries

An effective institutional structure is a crucial tool for having a highly functioning education system and consequently, economic growth and development. We analyse the effects of decentralisation and school autonomy on the quality of education in two MENA countries (Jordan and Tunisia), by using the OECD PISA 2009 database. Results reveal that decentralisation has a positive impact on the quality of education in some decision-making areas, whereas most autonomy related variables are not significant. Accordingly, schools with more autonomy management and facing more competition do not lead to different results than others, while (public) ownership is positively significant only in Tunisia. However, private funding and accountability measures are positively associated with student achievement

Old disease, new targets. Part-II, haematological malignancies

In last two decades newer therapies in cancer treatment have emerged and have opened new horizons. New term of targeted therapy has emerged and for certain malignancies the paradigm has really changed after the introduction of these agents. We have learnt and have seen the outcome of some diseases after the addition of these monoclonal antibodies (MoABs) and tyrosine kinase inhibitors (TKIs). Rituximab a MoAB against CD-20 has really paved its role in the treatment of B-cell lymphomas and become the sort of standard therapy. The TKIs are newer agents available in a pill form and have inhibited many pathways at cellular level which are necessary for cancer development. Imatinib has really changed the prognosis and outcome of chronic myeloid leukemia (CML) remarkably. For those patients who develope intolerance to imatinib or their disease became resistant to the imatinib the newer agents like dasatinib and nilotinib are second line options. The major edge of these newer agents is more potency with low side-effect profile. The major concern remains the cost

Knowledge, attitude and preventive practices for breast cancer among health care professionals at Aga Khan Hospital Karachi

OBJECTIVE: To assess the knowledge and practice of risk factors, symptoms and screening for breast cancer among health care professionals. METHODS: A cross sectional study was carried out at The Aga Khan University Hospital from January 2008 to March 2008. A total of 336 health care workers including consultants (48), fellows (17), residents (76), medical officers (14), interns (37), nurses (94) and fourth and final year medical students (50) were requested to fill a questionnaire designed to assess the knowledge about the risk factors, signs and symptoms, screening tools, breast self examination (BSE) and treatment. RESULTS: More than two third participants had good knowledge about the risk factors and signs of breast cancer except some dissociation regarding association of menarche status and smoking. Majority was aware of the benefits of mammography. More than 80% had the consensus that breast cancer is curable if detected early and more than 50% thought that a surgeon should be consulted first if lump is palpable. CONCLUSIONS: This study reveals that health care professionals have fairly good awareness regarding the risk factors, symptoms and role of mammography. But some are still deficient in their knowledge regarding screening modalities and BSE method and time and role of chemotherapy. And this can be improved with further education

Current management of advanced and metastatic renal cell carcinoma.

Introduction:Unresectable renal cell carcinoma (RCC) is a technically incurable condition. Historically, RCC is resistant to chemotherapy and radiotherapy. Cytokine therapy was until recently considered the mainstay of treatment. However, responses are modest. Improvement in the understanding of the biology of RCC, particularly the hereditary types, is providing the basis for novel therapeutic targets. Our aim was to review the clinical utility of various systemic agents and surgery in the management of advanced RCC and suggest practice guidelines in the light of current literature. Materials and Methods: Evidence was collected by review of current literature, guidelines of the American and European associations and the national comprehensive cancer network. Results: Treatment of advanced RCC has recently undergone a major change with the development of targeted agents and potent angiogenesis inhibitors. Small-molecule multikinase inhibitors that target vascular endothelial growth factor receptors have a favorable toxicity profile and can prolong time to progression and preserve quality of life when used in newly diagnosed or previously treated Patients, bevacizumab enhances the response rate and prolongs disease control when added to interferon-alpha. Temsirolimus, a mammalian target of rapamycin inhibitor, prolongs the survival duration of Patients with poor-risk disease. All currently available agents have variable toxicity profile and they, at best, improve survival by a few months. Surgery still has a significant role in the management of stage IV RCC. Conclusions: Supportive care and surgery remain the mainstay of treatment even in the management of advanced and metastatic RCC. Systemic therapeutic agents are showing promising results

Old disease, new targets--part-I, solid malignancies

Targeted agents are now an integral part of treatment regimens for some cancers. Trastuzumab is established in treatment of human epidermal receptor 2 (Her2) positive breast cancers, with improvements in both, the disease free and over all survival. Monoclonal antibody (MoAB) against vascular growth factor receptor (VEGF), bevacizumab and cetuximab a MoAB against epidermal growth factor receptor (EGFR) are establishing their role in a many cancers after making their mark in colorectal cancer. Sorafenib and sunitinib have success stories in renal carcinoma. The Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol (SHARP) trial has established sorafenib role in advanced hepatocellular carcinoma, while in gastrointestinal tumors; imatinib and sunitinib have proven role. At this point in time side effect profile of all these agents appears relatively safe however cost for developing countries remains an issue

Determination of complication rate of PICC lines in oncological patients

OBJECTIVE: To determine the complication rate of (PICCs) peripherally inserted central catheters in cancer patients with a 1 year prospective cohort study. METHODS: All PICCs inserted in adult cancer patients in Radiology Department of The Aga Khan University Hospital were followed prospectively till removed or patient expired and pattern of complications noted. RESULTS: One hundred and fourty six PICCs were inserted over a period of 1 year and followed for a total of 3329 catheter-days; median placement, 14 days: range 3-218 days. Of these 67 (32.8%) PICCs were complicated and removed earlier, for a rate of 14.4/1000 PICC-days. Patients with haematologic malignancies were more likely to have complications as compared to those with solid tissue malignancies. CONCLUSIONS: Despite a significant complication rate, PICCs are a relatively safe and cost effective method of establishing central venous access

Effects of hypoxic-ischemic encephalopathy and whole-body hypothermia on neonatal auditory function: a pilot study.

We assessed the effects of hypoxic-ischemic encephalopathy (HIE) and whole-body hypothermia therapy on auditory brain stem evoked responses (ABRs) and distortion product otoacoustic emissions (DPOAEs). We performed serial assessments of ABRs and DPOAEs in newborns with moderate or severe HIE, randomized to hypothermia ( N = 4) or usual care ( N = 5). Participants were five boys and four girls with mean gestational age (standard deviation) of 38.9 (1.8) weeks. During the first week of life, peripheral auditory function, as measured by the DPOAEs, was disrupted in all nine subjects. ABRs were delayed but central transmission was intact, suggesting a peripheral rather than a central neural insult. By 3 weeks of age, peripheral auditory function normalized. Hypothermia temporarily prolonged the ABR, more so for waves generated higher in the brain stem but the effects reversed quickly on rewarming. Neonatal audiometric testing is feasible, noninvasive, and capable of enhancing our understanding of the effects of HIE and hypothermia on auditory function