114 resultados para cross-border genetic testing


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The management of invasive non-native species is a frequent cause of conflict in the field of biodiversity conservation because perceptions of their costs and benefits differ among stakeholder groups. A lack of cohesion between scientific researchers, the commercial sector and policy makers lies at the root of a widespread failure to develop and implement sustainable management practices for invasive species. The crisis of this situation is intensified by drivers stemming from international conventions and directives to address invasive species issues. There are further direct conflicts between legislative instruments promoting biodiversity conservation on the one hand while liberalizing trade at the national, European and global level on the other. The island of Ireland provides graphic illustration of the importance of cross-jurisdictional approaches to biological invasions. Using primarily Irish examples in this review, we emphasize the importance of approaching risk assessment, risk reduction and control or eradication policies from a cost-efficient, highly flexible perspective, incorporating linkages between environmental, economic and social objectives. The need for consolidated policies between Northern Ireland and the Republic of Ireland is particularly acute, though few model cross-border mechanisms for such consolidation are available. The importance of engaging affected stakeholders through positive interactions is discussed with regard to reducing the currently fragmented nature of invasive species management between the two jurisdictions.

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The Irish border has been described as a ‘natural’ cultural divide between the island's two dominant indigenous ethno-national communities. However, an examination of key resources of ethno-national group culture - religion, sport and language - provides evidence to challenge this representation. Moreover, in the post-1994 period of conflict transformation, evidence is also presented to support the proposition that the Irish border region has developed into a cultural space in which Irish nationalist and Ulster unionist ethno-national communities can explore cultural differences and commonalities through cross-border, cross-community contact and communication in small group encounters. This space underpins the reconfiguration of the border from barrier to political bridge between North and South. European Union (EU) Peace programmes for Ireland, beginning in 1995, provided the support for a cross-border approach to escaping the cage of ethno-national conflict in Northern Ireland. However, post-2004 EU enlargement signalled the beginning of the end for EU Peace funding and severe economic recession has undermined the expectation of British-Irish intergovernmental intervention to support cross-border partnerships and their work. Therefore, the outlook for the sustainability of this cross-border cultural space is gloomy with potentially deleterious consequences for the continued reconfiguration of the border from barrier to bridge.

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This paper examines how anxieties about ethnic identity proliferate as state borders begin to shift and open in response to accelerating possibilities of cross-border cooperation. As the border becomes more porous, social and cultural boundaries become marked in other ways, spatially re-scaled to reflect new uncertainties consequent upon border change. Using an example from the Irish land border, the paper traces how national space is re-imagined and re-placed in the everyday practices of residents in a violent border zone from which the state is ostensibly retreating. It shows that communal division is as sharply drawn as ever at a time when the ‘visibility’ of the state border itself is beginning to diminish.

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Background: The majority of women (71%) who undergo BRCA1/2 testing—designed to identify genetic mutations associated with increased risk of cancer—receive results that are termed ‘ambiguous’ or ‘uninformative negative’. How women interpret these results and the association with numerical ability was examined. Methods: In this study, 477 women at increased risk for breast and ovarian cancer were recruited via the Cancer Genetics Network. They were presented with information about the four different possible BRCA1/2 test results—positive, true negative, ambiguous and uninformative negative—and asked to indicate which of six options represents the best response. Participants were then asked which treatment options they thought a woman receiving the results should discuss with her doctor. Finally, participants completed measures of objective and subjective numeracy. Results: Almost all of the participants correctly interpreted the positive and negative BRCA1/2 genetic test results. However, they encountered difficulties interpreting the uninformative and ambiguous BRCA1/2 genetic test results. Participants were almost equally likely to think either that the woman had learned nothing from the test result or that she was as likely to develop cancer as the average woman. Highly numerate participants were more likely to correctly interpret inconclusive test results (ambiguous, OR = 1.62; 95% CI [1.28, 2.07]; p < 0.001; uninformative, OR = 1.40; 95% CI [1.10, 1.80]). Discussion: Given the medical and psychological ramifications of genetic testing, healthcare professionals should consider devoting extra effort to ensuring proper comprehension of ambiguous and uninformative negative test results by women. Copyright © 2014 John Wiley & Sons, Ltd.

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I charted unofficial border-crossings along Ireland's border, those not found on any other map.

During many surveys of Ireland's border I discovered that it is often perforated. Gates are set in hedgerows for the convenience of farmers, stepping stones and community-built bridges span rivers, walkers’ routes and muddy by-ways go wherever they please. These kinds of connections have always been there, although I think it is fair to say that their numbers have increased during the Peace Process. Roads blocked or cratered during the Troubles are being re-connected at a rate too fast for the Ordnance Survey to keep up with. On the local level cross-border movement is quietly happening, unchecked and often unmapped, until now.

This map attempts to throw the borderline in perpendicular, showing it as a place of connection rather than division.

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The sustainability of cross-border peacebuilding initiatives is increasingly pertinent in a context of reduced public funding (national and European), yet the potential contribution to be made to this from private sector cooperation remains under-explored. This paper brings together quantitative data on cross-border trade with qualitative evidence from business leaders in the Irish border region in order to examine the nature of cross-border cooperation within the private sector and its possible connections to peacebuilding. This evidence is analysed in the light of three theses: spillover, contact and business-based peacebuilding. The first part of this paper assesses the conditions for cross-border business cooperation in Ireland, including funding support for economic development, European integration, and (post-Agreement) institutional change. The second part examines the particular contributions made by the private sector to peace, centring upon consciously non-political motivations (such as pragmatism and profit), networking and leadership.

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Essay Review of Katarzyna Stokłosa and Gerhard Besier (eds) (2014) European Border Regions in Comparison: Overcoming Nationalistic Aspects or Re-Nationalization? (London: Routledge)

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Analysis of colorectal carcinoma (CRC) tissue for KRAS codon 12 or 13 mutations to guide use of anti-epidermal growth factor receptor (EGFR) therapy is now considered mandatory in the UK. The scope of this practice has been recently extended because of data indicating that NRAS mutations and additional KRAS mutations also predict for poor response to anti-EGFR therapy. The following document provides guidance on RAS (i.e., KRAS and NRAS) testing of CRC tissue in the setting of personalised medicine within the UK and particularly within the NHS. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such RAS testing.

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The incidence of melanoma has increased rapidly over the past 30 years, and the disease is now the sixth most common cancer among men and women in the U.K. Many patients are diagnosed with or develop metastatic disease, and survival is substantially reduced in these patients. Mutations in the BRAF gene have been identified as key drivers of melanoma cells and are found in around 50% of cutaneous melanomas. Vemurafenib (Zelboraf(®) ; Roche Molecular Systems Inc., Pleasanton, CA, U.S.A.) is the first licensed inhibitor of mutated BRAF, and offers a new first-line option for patients with unresectable or metastatic melanoma who harbour BRAF mutations. Vemurafenib was developed in conjunction with a companion diagnostic, the cobas(®) 4800 BRAF V600 Mutation Test. The purpose of this paper is to make evidence-based recommendations to facilitate the implementation of BRAF mutation testing and targeted therapy in patients with metastatic melanoma in the U.K. The recommendations are the result of a meeting of an expert panel and have been reviewed by melanoma specialists and representatives of the National Cancer Research Network Clinical Study Group on behalf of the wider melanoma community. This article is intended to be a starting point for practical advice and recommendations, which will no doubt be updated as we gain further experience in personalizing therapy for patients with melanoma.

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It is necessary to understand how state borders in Europe are changing in order to fully assess the factors which facilitate and encourage cross-border cooperation. This article considers the enduring social significance of borders, the need for a historical understanding of the nature and extent of border change in Europe, and the impact of recent European integration. Change in the structure, functions and meanings of European state borders has been the norm rather than the exception. Although much of this change has been associated with war, violence and coercion, a key contemporary issue facing the architects of European integration is how the ambiguity and contradictory nature border change can be regulated democratically and managed cooperatively.

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This paper explores the potential for active biological citizenship in the discursive space opened by the Community law rights to receive cross-border health care services. By focusing on the European Patients’ Forum and the European Public Health Association as examples of actors facilitated by the European Union, the paper notes how this space might provide some opportunities for patients’ strategic engagement, but also how EU governance discourse is shaping and undermining the potential for activism.

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Practice learning is viewed as one of the most important components of social work education wherever in the world social work is practised. Northern Ireland and the Republic of Ireland provide an interesting case example of the educational impact on students resulting from their experience of different models of practice learning. Although sharing a common historical legacy, recent developments in policy in both jurisdictions have tended to engender greater divergences in how programmes organise and deliver social work education and practice learning. Drawing on findings from a joint-research project with students in Queen’s University, Belfast and Trinity College, Dublin, the authors highlight significant cross-border similarities as well as differences in the way practice learning is conceptualised, organised and delivered. Through comparing and contrasting student experiences, the authors reflect on how the findings might help to inform the future development of practice learning standards in both jurisdictions.

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Objectives: Genetic testing for the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 has important implications for the clinical management of people found to carry a mutation. However, genetic testing is expensive and may be associated with adverse psychosocial effects. To provide a cost-efficient and clinically appropriate genetic counselling service, genetic testing should be targeted at those individuals most likely to carry pathogenic mutations. Several algorithms that predict the likelihood of carrying a BRCA1 or a BRCA2 mutation are currently used in clinical practice to identify such individuals.

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Breast cancer is the most common cause of cancer death in the United Kingdom, with a lifetime risk of one in nine in women. Only 5-10% of all cancers is thought to be due to strongly penetrant inherited predisposing genes, such as BRCA1 and BRCA2. However, other less penetrant genes, including some autosomal recessive genes, are likely to be of etiological importance in other families. This review addresses the current knowledge of breast cancer susceptibility genes and explores the possibilities for future developments. Features of tumor pathology, prognosis, and the scope for targeted treatments in mutation carriers are discussed, and the management of known carriers and those at increased risk for developing breast cancer are evaluated. Genetic testing for cancer susceptibility may become widely available in the future, and has important ethical and management implications. (C) 2004 Wiley-Liss, Inc.

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The decades of conflict in Northern Ireland created divisions between communities, with few opportunities for cooperation. However, in the 1990s opposition to a proposed cross-border incinerator brought the divided communities together. The 1990s economic boom in the Republic of Ireland generated a waste management crisis as the by-products of rampant consumerism overwhelmed the state's rudimentary waste disposal system. Three Irish anti-incinerator campaigns which have pitted local communities against the Irish state or the Northern Ireland Department of the Environment are examined. Community attempts to gain leverage within the political governance frameworks in operation on both sides of the border are examined and the various ways in which environmental movements respond to the crisis of waste management under different governance regimes are illuminated.