The common foreign and security policy of the European Union as a system of governance: The Euro-Mediterranean partnership

The Common Foreign and Security Policy (CFSP) of the European Union (EU) has often been characterised by legal scholars as an intergovernmental ‘pillar’ within the constitutional structure of the EU, distinct from the type of law and legal processes common to other dimensions of the European integration process. The perceived limitations caused by the intergovernmental nature of the CFSP have contributed to the widespread view that it is largely ineffective in meeting its goals. This thesis analyses the CFSP by characterising it as a system of governance. Building on the language and meanings of ‘governance’, an institutional constructivist framework of legal analysis is developed. Using this framework helps to show that characterising the CFSP in this way demonstrates how its (legal) effects go beyond the instruments provided for in the Treaty on European Union. The CFSP as a system of governance can be seen to influence other Union-level instruments, tools and policies in which the EU’s foreign policy goals are pursued. The case is made that the CFSP can be understood as an integral part of the constitutional order of the EU and legal analysis need not be limited to the competences and instruments found in the Treaty. The thesis uses the Euro-Mediterranean Partnership (EuroMed) to demonstrate how the EU’s foreign policy goals are pursued. Although EuroMed was not formally created by a CFSP instrument, analysis of its institutional framework and operation shows that it bears close affinity with the CFSP goals, both globally and towards the Mediterranean. EuroMed can also be seen as a system of governance, in which the EU institutions act as strong, central actors which enable foreign policy goals to be pursued within an institutionalised framework. As a policy area within EuroMed, the broad issues of migration are examined against the background of growing EU competence in migration law and policy. The analysis demonstrates that migration issues have come to the forefront in EuroMed, which is increasingly used as a means by which foreign policy and security goals can be pursued by the EU under the guise of a ‘partnership’ with Mediterranean states. Applying the institutional constructivist framework of legal analysis to the CFSP shows that, as a system of governance, it has strong effects on other policy-making spheres within the EU, and these effects can justifiably be termed as ‘legal’. As such, the CFSP should therefore not be regarded as a policy which is limited in its usefulness but one which can be seen to fulfil its goals through a wider set of means than previously thought

Sex differences in body anthropometry and composition in individuals with and without diabetes in the UK Biobank

OBJECTIVE: Type I and II diabetes are associated with a greater relative risk of cardiovascular diseases (CVD) in women than in men. Sex differences in adiposity storage may explain these findings. METHODS: A cross-sectional study of 480 813 participants from the UK Biobank without history of CVD was conducted to assess whether the difference in body size in people with and without diabetes was greater in women than in men. Age-adjusted linear regression analyses were used to obtain the mean difference in women minus men in the difference in body size measures, separately for type I and II diabetes. RESULTS: Body size was higher in individuals with diabetes than in individuals without diabetes, particularly in type II diabetes. Differences in body size between individuals with and without type II diabetes were more extreme in women than in men; compared to those without type II diabetes, body mass index and waist circumference were 1.94 (95% CI 1.82 to 2.07) and 4.84 (4.53 to 5.16) higher in women than in men, respectively. In type I diabetes, body size differed to a similar extent between those with and without diabetes in women as in men. This pattern was observed across all prespecified subgroups. CONCLUSIONS: Differences in body size associated with diabetes were significantly greater in women than in men in type II diabetes but not in type I diabetes. Prospective studies can determine whether sex differences in body size associated with diabetes underpin some of the excess risk for CVD in women with type II diabetes

Technologies for the diagnosis of angle closure glaucoma (ACE): protocol of a prospective, multicentre, cross-sectional diagnostic study

INTRODUCTION: Angle-closure is responsible for half of all glaucoma blindness globally. Patients with suspected glaucoma require assessment of the drainage angle by an experienced clinician. The goal of this study is to evaluate the diagnostic performance and cost-effectiveness of two non-contact tests, anterior segment OCT (Optical Coherence Tomography) (AS-OCT) and limbal anterior chamber depth for patients referred to hospital with suspected angle closure compared with gonioscopy by ophthalmologist. METHODS AND ANALYSIS: Study design: prospective, multicentre, cross-sectional diagnostic accuracy study. INCLUSION CRITERIA: adults referred from community optometry to hospital with suspected angle closure. PRIMARY OUTCOME: Sensitivity and specificity. SECONDARY OUTCOMES: Positive/negative likelihood ratios, concordance, cost-effectiveness, proportion of patients requiring subsequent clinical assessment by ophthalmologist. SAMPLE SIZE: 600 individuals who have been referred with suspected angle closure from primary care (community optometry). We will have a 95% probability of detecting the true sensitivity of either test to within ±3.5% based on a sensitivity of 90%. The study would also have a 95% probability of detecting the true specificity of either test to within ±5%, assuming a specificity of 75%. ETHICS AND DISSEMINATION: Ethical Review Board approval was obtained. REC reference: 22/LO/0885. Our findings will be disseminated to those involved in eye care services. We will have a knowledge exchange event at the end of the study, published via the Health Technology Assessment web page and in specialist journals. The results will be presented at professional conferences and directly to patients via patient group meetings and the Glaucoma UK charity. TRIAL REGISTRATION NUMBER: ISRCTN15115867

Aflatoxin Contamination in Food and Body Fluids in Relation to Malnutrition and Cancer Status in Cameroon

Aflatoxins are food contaminants usually associated with hepatitis, immunodepression, impairment of fertility and cancer. The present work was to determine the presence of aflatoxins in eggs, milk, urine, and blood samples that were collected from various sources and periods; and hepatitis B virus antigen in blood samples. Aflatoxin was found in eggs (45.2%), cow raw milk (15.9%), breast milk (4.8%), urine from kwashiorkor and marasmic kwashiorkor children (45.5%), and sera from primary liver cancer patients (63.9%); HbsAg was also detected in 69.4% of the serum samples, but there was no association between both factors. Both AF and hepatitis B virus seem to be risk factors that could increase the incidence and prevalence rates of malnutrition and cancer in Cameroon