Elements of A New Framework for the principle of Equal Treatment of persons in EC Law

In June and November 2000, the European Parliament and the Council adopted two Directives referring to ‘the principle of equal treatment irrespective of’ in their title, one relating to racial and ethnic origin, the other to disability, age, religion and belief or sexual orientation. A thorough reform of Directive 76/207/EEC on the principle of equal treatment for women and men in employment matters is pending between the European Parliament's second reading and adoption while this is written. Community secondary legislation on equal treatment of persons has thus expanded in scope and number of reasons which must not serve as starting points for differentiation. Does this signify progress in legal protection against personal discrimination? While not providing a ready answer, this article proposes an analytical framework to answer this question, concentrating on conceptions of equality in general and in particular on the problems multi-dimensional discrimination might pose for the law.

Organising EU non-discrimination law around the nodes of ‘race’ gender and disability?

EU non-discrimination law has seen a proliferation of discrimination grounds from 2000. Dis-crimination on grounds of gender (in the field of equal pay) and on grounds of nationality (generally within the scope of application of EU law) were the only prohibited forms of discrimination in EU law, until the Treaty of Amsterdam empowered the Community to legislate in order to combat discrimination on grounds of sex, racial or ethnic origin, religion or belief, disability, age or sexual orientation (Article 13 EC). Proliferation of non-discrimination grounds is also characteristic for international and national non-discrimination law. As such, proliferation of grounds results in an increase in potential cases of “multiple discrimination” and the danger of diluting the demands of equality law by ever more multiplication of grounds. The hierarchy of equality, which has been so widely criticised in EU law, is a signifier of the latter danger.
This chapter proposes to structure the confusing field of non-discrimination grounds by organising them around nodes of discrimination fields. It will first reflect different ways of establishing hierarchies between grounds. This will be followed by a recount of different (narrow and wide) reading of grounds. A comprehensive reading of the grounds gender, ‘race’ and disability as establishing overlapping fields of discrimination grounds will be mapped out, with some examples for practical uses.

Large panel-survey data demonstrated country-level and ethnic minority variation in consent for health record linkage

Objectives
To investigate individual, household and country variation in consent to health record linkage.

Study Design and Setting
Data from 50,994 individuals aged 16-74 years recruited to wave 1 of a large UK general purpose household survey (January 2009 – December 2010) were analysed using multi-level logistic regression models.

Results
Overall, 70.7% of respondents consented to record linkage. Younger age, marriage, tenure, car ownership and education were all significantly associated with consent, though there was little deviation from 70% in subgroups defined by these variables. There were small increases in consent rates in individuals with poor health when defined by self-reported long term limiting illness (adjusted OR 1.11; 95%CIs 1.06, 1.16), less so when defined by General Health Questionnaire score (adjusted OR=1.05; 95%CIs 1.00, 1.10), but the range in absolute consent rates between categories was generally less than 10%. Larger differences were observed for those of non-white ethnicity who were 38% less likely to consent (adjusted OR 0.62; 95%CIs 0.59, 0.66). Consent was higher in Scotland than England (adjusted OR 1.17; 95%CIs 1.06, 1.29) but lower in Northern Ireland (adjusted OR 0.56; 95%CIs 0.50, 0.63).

Conclusion
The modest overall level of systematic bias in consent to record linkage provides reassurance for record linkage potential in general purpose household surveys. However, the low consent rates amongst non-white ethnic minority survey respondents will further compound their low survey participation rates. The reason for the country-level variation requires further study.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

Multi-bubble sonoluminescence: Laboratory curiosity, or real world application?

Sonoluminescence (SL) involves the conversion of mechanical [ultra]sound energy into light. Whilst the phenomenon is invariably inefficient, typically converting just 10^-4 of the incident acoustic energy into photons, it is nonetheless extraordinary, as the resultant energy density of the emergent photons exceeds that of the ultrasonic driving field by a factor of some 10 ¹². Sonoluminescence has specific [as yet untapped] advantages in that it can be effected at remote locations in an essentially wireless format. The only [usual] requirement is energy transduction via the violent oscillation of microscopic bubbles within the propagating medium. The dependence of sonoluminescent output on the generating sound field's parameters, such as pulse duration, duty cycle, and position within the field, have been observed and measured previously, and several relevant aspects are discussed presently. We also extrapolate the logic from a recently published analysis relating to the ensuing dynamics of bubble 'clouds' that have been stimulated by ultrasound. Here, the intention was to develop a relevant [yet computationally simplistic] model that captured the essential physical qualities expected from real sonoluminescent microbubble clouds. We focused on the inferred temporal characteristics of SL light output from a population of such bubbles, subjected to intermediate [0.5-2MPa] ultrasonic pressures. Finally, whilst direct applications for sonoluminescent light output are thought unlikely in the main, we proceed to frame the state-of-the- art against several presently existing technologies that could form adjunct approaches with distinct potential for enhancing present sonoluminescent light output that may prove useful in real world [biomedical] applications.

Ethnic Segregation, Moral Panics and Social Class: A Comparative Study of the Experiences and Perspectives of Working Class and Middle Class Children in Belfast

This paper begins by describing the moral panics that have tended to emerge sporadically in Northern Ireland over the last few years with regard to young people’s involvement in sectarian violence in Belfast. Within this, while these young people have been cast in the traditional role of folk devils, the paper will show how younger children also tend to be explicitly identified and named in an ambiguous way through such moral panics; playing a deviant role as participators, and sometimes instigators, of sectarian violence but also carrying the symbolic responsibility of representing Belfast’s future. It will be shown that it is because of this ambiguous position that it is adults rather than the children themselves that tend to be held responsible for their actions; either as rioters using the children as political pawns or as parents guilty of neglect. With this as a starting point the paper then explores the perspectives and experiences of two groups of 10-11 year old children living in Belfast and the impact of these moral panics on them. One group of children, living in affluent middle class areas were found to be appropriating and re-working these broader moral panics into more general discourses of derision that tended to pathologize working class children and communities more generally. For the other group of children, living in economically deprived areas with high levels of sectarian tensions and violence, their experiences of such violence and their participation in it are discussed. It will be shown that for these children, the broader moral panics that exist tend to have the effect of reinforcing the processes that tend to segregate and exclude them.

Aspects of dietary carbohydrate intake are not related to risk of colorectal polyps in the Tennessee Colorectal Polyp Study

Purpose: High digestible carbohydrate intakes can induce hyperglycemia and hyperinsulinemia and collectively have been implicated in colorectal tumor development. Our aim was to explore the association between aspects of dietary carbohydrate intake and risk of colorectal adenomas and hyperplastic polyps in a large case–control study.

Methods: Colorectal polyp cases (n = 1,315 adenomas only, n = 566 hyperplastic polyps only and n = 394 both) and controls (n = 3,184) undergoing colonoscopy were recruited between 2003 and 2010 in Nashville, Tennessee, USA. Dietary intakes were estimated by a 108-item food frequency questionnaire. Unconditional logistic regression analysis was applied to determine odds ratios (OR) and corresponding 95 % confidence intervals (CI) for colorectal polyps according to dietary carbohydrate intakes, after adjustment for potential confounders.

Results: No significant associations were detected for risk of colorectal adenomas when comparing the highest versus lowest quartiles of intake for total sugars (OR 1.03; 95 % CI 0.84–1.26), starch (OR 1.01; 95 % CI 0.81–1.26), total or available carbohydrate intakes. Similar null associations were observed between dietary carbohydrate intakes and risk of hyperplastic polyps, or concurrent adenomas and hyperplastic polyps.

Conclusion: In this US population, digestible carbohydrate intakes were not associated with risk of colorectal polyps, suggesting that dietary carbohydrate does not have an etiological role in the early stages of colorectal carcinogenesis.

Love Thy Neighbor? Relationships between Religion and Racial Intolerance in Europe.

This article examines relationships between religion and racial intolerance across 47 countries by applying multilevel modeling to European survey data and is the first in-depth analysis of moderation of these relationships by European national contexts. The analysis distinguishes a believing, belonging, and practice-dimension of religiosity. The results yield little evidence of a link between denominational belonging, religious practice, and racial intolerance. The religiosity dimension that matters most for racial intolerance in Europe is believing: believers in a traditional God and believers in a Spirit/Life Force are decidedly less likely, and fundamentalists are more likely than non- believers to be racially intolerant. National contexts also matter greatly: individuals living in Europe’s most religious countries, countries with legacies of ethnic-religious conflict and countries with low GDP are significantly more likely to be racially intolerant than those living in wealthier, secular and politically stable countries. This is especially the case for the religiously devout.

Age, gender, biometry, refractive error, and the anterior chamber angle among Alaskan Eskimos.

BACKGROUND:

The prevalence of angle-closure glaucoma (ACG) is greater for Eskimos/Inuit than it is for any other ethnic group in the world. Although it has been suggested that this prevalence may be due to a population tendency toward shallower anterior chamber angles, available evidence for other populations such as Chinese with high rates of ACG has not consistently demonstrated such a tendency.

METHODS:

A reticule, slit-lamp, and standard Goldmann one-mirror goniolens were used to make measurements in the anterior chamber (AC) angle according to a previously reported protocol for biometric gonioscopy (BG) (Ophthalmology 1999;106:2161-7). Measurements were made in all four quadrants of one eye among 133 phakic Alaskan Eskimos aged 40 years and older. Automatic refraction, dilated examination of the anterior segment and optic nerve, and A-scan measurements of AC depth, lens thickness, and axial length were also carried out for all subjects.

RESULTS:

Both central and peripheral AC measurements for the Eskimo subjects were significantly lower than those previously reported by us for Chinese, blacks, and whites under the identical protocol. Eskimos also seemed to have somewhat more hyperopia. There were no differences in biometric measurements between men and women in this Eskimo population. Angle measurements by BG seemed to decline more rapidly over life among Eskimos and Chinese than blacks or whites. Although there was a significant apparent decrease in AC depth, increase in lens thickness, and increase in hyperopia with age among Eskimos, all of these trends seemed to reverse in the seventh decade and beyond.

CONCLUSIONS:

Eskimos do seem to have shallower ACs than do other racial groups. Measurements of the AC angle seem to decline more rapidly over life among Eskimos than among blacks or whites, a phenomenon also observed by us among Chinese, another group with high ACG prevalence. This apparent more rapid decline may be due to a cohort effect with higher prevalence of myopia and resulting wider angles among younger Eskimos and Chinese.

Causes and prevalence of visual impairment among adults in the United States.

OBJECTIVES: To estimate the cause-specific prevalence and distribution of blindness and low vision in the United States by age, race/ethnicity, and gender, and to estimate the change in these prevalence figures over the next 20 years. METHODS: Summary prevalence estimates of blindness (both according to the US definition of < or =6/60 [< or =20/200] best-corrected visual acuity in the better-seeing eye and the World Health Organization standard of < 6/120 [< 20/400]) and low vision (< 6/12 [< 20/40] best-corrected vision in the better-seeing eye) were prepared separately for black, Hispanic, and white persons in 5-year age intervals starting at 40 years. The estimated prevalences were based on recent population-based studies in the United States, Australia, and Europe. These estimates were applied to 2000 US Census data, and to projected US population figures for 2020, to estimate the number of Americans with visual impairment. Cause-specific prevalences of blindness and low vision were also estimated for the different racial/ethnic groups. RESULTS: Based on demographics from the 2000 US Census, an estimated 937 000 (0.78%) Americans older than 40 years were blind (US definition). An additional 2.4 million Americans (1.98%) had low vision. The leading cause of blindness among white persons was age-related macular degeneration (54.4% of the cases), while among black persons, cataract and glaucoma accounted for more than 60% of blindness. Cataract was the leading cause of low vision, responsible for approximately 50% of bilateral vision worse than 6/12 (20/40) among white, black, and Hispanic persons. The number of blind persons in the US is projected to increase by 70% to 1.6 million by 2020, with a similar rise projected for low vision. CONCLUSIONS: Blindness or low vision affects approximately 1 in 28 Americans older than 40 years. The specific causes of visual impairment, and especially blindness, vary greatly by race/ethnicity. The prevalence of visual disabilities will increase markedly during the next 20 years, owing largely to the aging of the US population.

Negotiating Territoriality and Diversity: Young People’s Encounters in Northern Ireland Divided Communities

Neighborhoods across the globe are becoming increasingly ‘divers’, yet we still find their urban encounters reproduced through negotiating differences that escalates moods of social inequality and spatial imbalances. Research on ethnic division also stresses the spatial aspects of their production as shared urban spaces are mostly signified in the literature as ethnic ‘enclaves’. Territoriality and place attachment, in this sense, has a wide impact on the people’s everyday encounters while experiencing segregation. These historical narratives have produced communities that exhibit high levels of intracommunity relations and localized networking. This article investigates how youngster generations in Northern Ireland perceive, accept and respond to their differences, or perhaps how they act against it, to push the boundaries towards more diversity. In fact, the spatial and temporal encounters that occur among one community and the ‘Other’ signify a sort of negotiations and being more constructive about the future. The argument maintains that territoriality and place attachment has a wide impact on the young people’s everyday experiences. The empirical study shows how individuals and community groups position and identify themselves under the impact of social segregation. Building on social identity theories, I explain how people in Derry have established their own sense of belonging, of who they are, based on their group memberships which eventually became an important source of pride and self-esteem.

State History, Historical Legitimacy and Modern Ethnic Diversity

How much does the antiquity of states, and the sometimes arbitrary nature of colonial boundaries, explain the modern degree of ethnic diversity? It is shown that states with greater historical legitimacy (more continuity between the pre-colonial and post-colonial state) have less ethnic diversity. Historical legitimacy is more strongly correlated with ethnic diversity than are the antiquity of states, genetic diversity or the duration of human settlement. Although historical legitimacy is particularly pertinent to Africa, the correlation also holds outside Africa.