Europe of patients, Europe for patients: The Europeanization of healthcare policies by European Patients' Organizations

CSI WORKING PAPERS 030The last two decades have witnessed an efflorescence of European lobbying organizations, including European civil society organizations (Lahusen 2004). Lobbying activity is mainly clustered around enterprise and environmental policy, domains in which the EU has greatest regulatory competencies. However, health has been identified as the fastest growing lobbying sector (Coen 2007). Patients' organizations have been part of the 'rush to Europe'. This domain is of particular significance because healthcare is a major area of the welfare state in which the EU has in the past had little involvement, but one which has in recent years witnessed an increasing Europeanization of policy (Greer et al. 2008). To date, very few studies have explored the species of organizations that European patients' organizations (EPOs) constitute, and the form of activism they develop. This article examines these two issues

The entanglement of scientific and political claims: towards a new form of patients' activism

Drawing on fieldwork in four condition areas (rare diseases, childbirth, Attention Deficit Hyperactivity Disorder, and Alzheimer's disease), this article shows that patients' organizations' (POs) engagement with knowledge is neither limited to a set of diseases nor restricted to biomedical knowledge. Their work on and with academic and experiential knowledge contributes to an understanding of their conditions and the problems they induce, and to the shaping of the causes they defend. This results in the production of new evidence for grounding research and health policies in their condition areas. The authors propose the notion of "evidence-­‐based activism" to capture the centrality of knowledge activities in contemporary POs

Effects of Feeding Bt Maize to Sows during Gestation and Lactation on Maternal and Offspring Immunity and Fate of Transgenic Material

peer-reviewedBackground: We aimed to determine the effect of feeding transgenic maize to sows during gestation and lactation on maternal and offspring immunity and to assess the fate of transgenic material. Methodology/Principal Findings: On the day of insemination, sows were assigned to one of two treatments (n = 12/treatment); 1) non-Bt control maize diet or 2) Bt-MON810 maize diet, which were fed for ~143 days throughout gestation and lactation. Immune function was assessed by leukocyte phenotyping, haematology and Cry1Ab-specific antibody presence in blood on days 0, 28 and 110 of gestation and at the end of lactation. Peripheral-blood mononuclear cell cytokine production was investigated on days 28 and 110 of gestation. Haematological analysis was performed on offspring at birth (n = 12/treatment). Presence of the cry1Ab transgene was assessed in sows' blood and faeces on day 110 of gestation and in blood and tissues of offspring at birth. Cry1Ab protein presence was assessed in sows' blood during gestation and lactation and in tissues of offspring at birth. Blood monocyte count and percentage were higher (P<0.05), while granulocyte percentage was lower (P<0.05) in Bt maize-fed sows on day 110 of gestation. Leukocyte count and granulocyte count and percentage were lower (P<0.05), while lymphocyte percentage was higher (P<0.05) in offspring of Bt maize-fed sows. Bt maize-fed sows had a lower percentage of monocytes on day 28 of lactation and of CD4+CD8+ lymphocytes on day 110 of gestation, day 28 of lactation and overall (P<0.05). Cytokine production was similar between treatments. Transgenic material or Cry1Ab-specific antibodies were not detected in sows or offspring. Conclusions/Significance: Treatment differences observed following feeding of Bt maize to sows did not indicate inflammation or allergy and are unlikely to be of major importance. These results provide additional data for Bt maize safety assessment.The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007–2013) under grant agreement number 211820 and the Teagasc Walsh Fellowship Programme

Evaluation of the Efficacy and Safety of a Marine-Derived Bacillus Strain for Use as an In-Feed Probiotic for Newly Weaned Pigs

peer-reviewedForty eight individual pigs (8.7±0.26 kg) weaned at 28±1 d of age were used in a 22-d study to evaluate the effect of oral administration of a Bacillus pumilus spore suspension on growth performance and health indicators. Treatments (n = 16) were: (1) non-medicated diet; (2) medicated diet with apramycin (200 mg/kg) and pharmacological levels of zinc oxide (2,500 mg zinc/kg) and (3) B. pumilus diet (non-medicated diet + 1010 spores/day B. pumilus). Final body weight and average daily gain tended to be lower (P = 0.07) and feed conversion ratio was worsened (P<0.05) for the medicated treatment compared to the B. pumilus treatment. Ileal E. coli counts were lower for the B. pumilus and medicated treatments compared to the non-medicated treatment (P<0.05), perhaps as a result of increased ileal propionic acid concentrations (P<0.001). However, the medicated treatment reduced fecal (P<0.001) and cecal (P<0.05) Lactobacillus counts and tended to reduce the total cecal short chain fatty acid (SCFA) concentration (P = 0.10). Liver weights were lighter and concentrations of liver enzymes higher (P<0.05) in pigs on the medicated treatment compared to those on the non-medicated or B. pumilus treatments. Pigs on the B. pumilus treatment had lower overall lymphocyte and higher granulocyte percentages (P<0.001) and higher numbers of jejunal goblet cells (P<0.01) than pigs on either of the other two treatments or the non-medicated treatment, respectively. However, histopathological examination of the small intestine, kidneys and liver revealed no abnormalities. Overall, the B. pumilus treatment decreased ileal E. coli counts in a manner similar to the medicated treatment but without the adverse effects on growth performance, Lactobacillus counts, cecal SCFA concentration and possible liver toxicity experienced with the medicated treatment.The study was funded by the Higher Education Authority/Institutes of Technology Ireland Technological Sector Research Strand III Programme

Effects of feeding Bt MON810 maize to sows during first gestation and lactation on maternal and offspring health indicators

A total of twenty-four sows and their offspring were used in a 20-week study to investigate the effects of feeding GM maize on maternal and offspring health. Sows were fed diets containing GM or non-GM maize from service to the end of lactation. GM maize-fed sows were heavier on day 56 of gestation (P< 0·05). Offspring from sows fed GM maize tended to be lighter at weaning (P= 0·08). Sows fed GM maize tended to have decreased serum total protein (P= 0·08), and increased serum creatinine (P< 0·05) and γ-glutamyltransferase activity (P= 0·07) on day 28 of lactation. Serum urea tended to be decreased on day 110 of gestation in GM maize-fed sows (P= 0·10) and in offspring at birth (P= 0·08). Both platelet count (P= 0·07) and mean cell Hb concentration (MCHC; P= 0·05) were decreased on day 110 of gestation in GM maize-fed sows; however, MCHC tended to be increased in offspring at birth (P= 0·08). There was a minimal effect of feeding GM maize to sows during gestation and lactation on maternal and offspring serum biochemistry and haematology at birth and body weight at weaning

Instances of altered gut microbiomes among Irish cricketers over periods of travel in the lead up to the 2016 World Cup: A sequencing analysis

peer-reviewedBackgroundChanges and stresses experienced during travel have the potential to impact the gut microbiome, with travel implicated in the spread of antibiotic resistance genes across continents. The possibility of gut microbiome-mediated negative impacts arising from travel, and consequences for peak performance, would be of particular concern for elite athletes. MethodsFaecal samples were collected from male (N = 14) and female (N = 7) cricket players during the build-up to the 2016 Cricket World Cup. Baseline and post-travel samples were collected from all participants and subjected to 16S rRNA amplicon sequencing. Samples from a subset of participants (N = 4) were also analysed by shotgun metagenomic sequencing. ResultsAnalysis revealed a single travel time point as having the potential to have an impact on the gut microbiome. Reductions in alpha diversity following travel were observed, accompanied by shifts in the taxonomic profile of the gut microbiome. Antibiotic resistance and virulence genes were also identified as undergoing changes following travel. ConclusionsThis study reveals that periods of travel, in particular following gastrointestinal distress, may result in gut microbiome disruption. While this analysis was completed in athletes, the findings are applicable to all travelling individuals and considerations should be made surrounding travel in an attempt to reduce these changes

Predicting Carotid Artery Disease and Plaque Instability from Cell-derived Microparticles

ObjectivesCell-derived microparticles (MPs) are small plasma membrane-derived vesicles shed from circulating blood cells and may act as novel biomarkers of vascular disease. We investigated the potential of circulating MPs to predict (a) carotid plaque instability and (b) the presence of advanced carotid disease.MethodsThis pilot study recruited carotid disease patients (aged 69.3 ± 1.2 years [mean ± SD], 69% male, 90% symptomatic) undergoing endarterectomy (n = 42) and age- and sex-matched controls (n = 73). Plaques were classified as stable (n = 25) or unstable (n = 16) post surgery using immunohistochemistry. Blood samples were analysed for MP subsets and molecular biomarkers. Odds ratios (OR) are expressed per standard deviation biomarker increase.ResultsEndothelial MP (EMP) subsets, but not any vascular, inflammatory, or proteolytic molecular biomarker, were higher (p < .05) in the unstable than the stable plaque patients. The area under the receiver operator characteristic curve for CD31+41− EMP in discriminating an unstable plaque was 0.73 (0.56–0.90, p < .05). CD31+41− EMP predicted plaque instability (OR = 2.19, 1.08–4.46, p < .05) and remained significant in a multivariable model that included transient ischaemic attack symptom status. Annexin V+ MP, platelet MP (PMP) subsets, and C-reactive protein were higher (p < .05) in cases than controls. Annexin V+ MP (OR = 3.15, 1.49–6.68), soluble vascular cell adhesion molecule-1 (OR = 1.64, 1.03–2.59), and previous smoking history (OR = 3.82, 1.38–10.60) independently (p < .05) predicted the presence of carotid disease in a multivariable model.ConclusionsEMP may have utility in predicting plaque instability in carotid patients and annexin V+ MPs may predict the presence of advanced carotid disease in aging populations, independent of established biomarkers

Choosing Short: An Explanation of the Similarities and Dissimilarities in the Distribution Patterns of Binding and Covaluation

Covaluation is the generalization of coreference introduced by Tanya Reinhart. Covaluation distributes in patterns that are very similar yet not entirely identical to those of binding. On a widespread view, covaluation and binding distribute similarly because binding is defined in terms of covaluation. Yet on Reinhart's view, binding and covaluation are not related that way: binding pertains to syntax, covaluation does not. Naturally, the widespread view can easily explain the similarities between binding and covaluation, whereas Reinhart can easily explain the dissimilarities. Reciprocally, the widespread view finds it harder to explain the dissimilarities, whereas Reinhart finds it harder to explain the similarities. Reinhart and others have proposed more than one explanation of the similarities, but as I argue, these explanations do not work. Hence although I adopt Reinhart's view, I propose a new explanation of the similarities and dissimilarities between binding and covaluation: While Reinhart has invoked semantic structure only to explain dissimilarities, I do so to explain both similarities and dissimilarities at once. Finally, I examine in light of this approach the topics of language acquisition, only-constructions, the identity predicate, the Partee/Bach/Higginbotham problem, the Dahl puzzle and its recent versions by Roelofsen