Do domestic interests matter? – Der Einfluss nationaler Interessengruppen auf die Position von Staaten zur Umweltpolitik auf EU-Ebene

Wie kann man Ergebnisse internationaler Umweltpolitik erklären? Wie hilfreich ist dabei die liberale Theorie der Internationalen Beziehungen (IB) von Andrew Moravcsik? Die vorliegende Arbeit versucht diese Fragen anhand eines Fallbeispiels internationaler Umweltpolitik – der Position der Bundesrepublik Deutschland bezüglich der einzelnen Streitfragen der EU-Verordnung 443/2009 über den CO2-Ausstoß von Automobilen – zu beantworten. Es wird eine theoriegeleitete Außenpolitikanalyse durchgeführt, deren Hauptaugenmerk auf der spezifischen nationalen Präferenzbildung in einem bestimmten Fall liegt. Hier weist Moravcsiks Theorie eine „Lücke“ auf. Wessen Interessen sich aus welchen Gründen in einer bestimmten Situation wie durchsetzen und damit Politik beeinflussen bleibt unklar. Deshalb erweitert die Arbeit Moravcsiks liberale Theorie der IB mithilfe von Annahmen und Erkenntnissen aus der Verbändeforschung nach innen. Auf diese Weise werden die situationsspezifischen Interessen und die situationsspezifische Durchsetzungsfähigkeit der betroffenen Akteure – nationale Interessengruppen – erhoben und untersucht, inwiefern man mit ihrer Hilfe die deutsche Position zur EU-Verordnung 443/2009 erklären kann. Empirisch erweist sich dabei, dass die Position der BRD zu acht von neun Streitfragen der EU-Verordnung 443/2009 den Interessen einer Koalition aus Industriegewerkschaft (IG) Metall und Verband der Automobilindustrie (VDA) entsprach, weil diese im vorliegenden Fall mit Abstand die größte Durchsetzungsfähigkeit aufwiesen. Lediglich bezüglich einer Streitfrage wich die Position der BRD von den Interessen von IG Metall und VDA ab. Damit lässt sich festhalten: Die Position der BRD zur EU-Verordnung 443/2009 kann weitgehend mithilfe der nach innen erweiterten liberalen Theorie nach Andrew Moravcsik erklärt werden. Trotz möglicher Schwierigkeiten bei der Übertragung erscheint daher eine Anwendung des nach innen erweiterten Liberalismus auf weitere erklärungsbedürftige Phänomene der internationalen Umweltpolitik und damit eine Überprüfung der Theorie insgesamt eine interessante und sinnvolle Aufgabe zu sein.

Indoor position, localizzazione e tracciamento in ambienti chiusi

Le grandi catene di distribuzione, per sviluppare strategie commerciali sempre più efficaci, sono interessate a comprendere il percorso che ogni cliente effettua all’interno del punto vendita, che reparti visita, il tempo di permanenza in un’area specifica ecc… Quindi è stato necessario trovare un sistema per localizzare e tracciare un cliente all’interno di un ambiente chiuso (indoor position). Prima di tutto ci si è concentrati sulla ricerca e sviluppo di una nuova idea che potesse superare gli ostacoli delle soluzioni attualmente in commercio. Si è pensato di sostituire le tessere punti del punto vendita con delle tessere bluetoothLE e di creare un sistema di posizionamento al chiuso utilizzando la stessa logica di funzionamento del GPS per gli ambienti aperti. Il ricevitore è la tessera BLE posseduta dal cliente e i satelliti sono tre device Android dotati di un’app specifica per rilevare il segnale radio (RSSI) emesso dalla tessera ogni secondo. Le rilevazioni dei tre device Android sono successivamente trasferite all’interno di una web application che si occupa di elaborare i dati tramite il processo di trilaterazione. L’output sono le coordinate x,y di ciascuna tessera in ogni secondo di visita all’interno del punto vendita. Questi dati sono infine utilizzati per mostrare graficamente il percorso effettuato dal cliente, l’orario di ingresso e di uscita e il tempo di permanenza. Riepilogando, il progetto comprende una fase di ricerca e intuizione di una nuova idea, una fase di progettazione per traslare i meccanismi del funzionamento GPS all’utilizzo in un ambiente chiuso, una fase di implementazione dell’app e della web application e infine una fase di sperimentazioni sul campo che si concluderà dopo la laurea con test reali in un supermercato della zona.

Position paper on diagnosis and treatment of atopic dermatitis

The diagnosis of atopic dermatitis (AD) is made using evaluated clinical criteria. Management of AD must consider the symptomatic variability of the disease.

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009

Background: Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. Methods: In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. Results: Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. Conclusion: This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncology.

Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

Cardiac patients after an acute event and/or with chronic heart disease deserve special attention to restore their quality of life and to maintain or improve functional capacity. They require counselling to avoid recurrence through a combination of adherence to a medication plan and adoption of a healthy lifestyle. These secondary prevention targets are included in the overall goal of cardiac rehabilitation (CR). Cardiac rehabilitation can be viewed as the clinical application of preventive care by means of a professional multi-disciplinary integrated approach for comprehensive risk reduction and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention and Rehabilitation) has recently completed a Position Paper, entitled 'Secondary prevention through cardiac rehabilitation: A condition-oriented approach'. Components of multidisciplinary CR for seven clinical presentations have been addressed. Components include patient assessment, physical activity counselling, exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise training as central components in all rehabilitation and preventive interventions. Many of the risk factor improvements occurring in CR can be mediated through exercise training programmes. This call-for-action paper presents the key components of a CR programme: physical activity counselling and exercise training. It summarizes current evidence-based best practice for the wide range of patient presentations of interest to the general cardiology community.

Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic stable heart failure. The present position paper aims to provide the practical recommendations on the core components and goals of CR intervention in different cardiovascular conditions, to assist in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all patients eligible. Thus a novel, disease-oriented document has been generated, where all components of CR for cardiovascular conditions have been revised, presenting both well-established and controversial aspects. A general table applicable to all cardiovascular conditions and specific tables for each clinical disease have been created and commented.

How does socio economic position link to health behaviour? Sociological pathways and perspectives for health promotion

Socio economic inequalities in adult health behaviour are consistently observed. Despite a well-documented pattern, social determinants of variations in health behaviour have not been sufficiently clarified. This article therefore presents sociological pathways to explain the existing inequalities in health behaviour. At a micro level, control beliefs have been part of several behavioural theories. We suggest that these beliefs might bridge the gap between sociology and psychology by emphasising their roots in fundamental socio-economic environments. At a meso level, social networks and support have not been explicitly considered as behavioural determinants. This contribution states that these social factors influence health behaviour while being unequally distributed across society. At a macro level, characteristics of the neighbourhood environment influence health behaviour of its residents above and beyond their individual background. Providing further opportunity for policy makers, it is shown that peer and school context equalise inequalities in risky behaviour in adolescence. As a conclusion, factors such as control expectations, social networks, neighbourhood characteristics, and school context should be included as strategies to improve health behaviour in socially disadvantaged people.

Natural variations at position 93 of the invariant Vα24-Jα18 α chain of human iNKT-cell TCRs strongly impact on CD1d binding

Human invariant natural killer T (NKT) cell TCRs bind to CD1d via an "invariant" Vα24-Jα18 chain (iNKTα) paired to semi-invariant Vβ11 chains (iNKTβ). Single-amino acid variations at position 93 (p93) of iNKTα, immediately upstream of the "invariant" CDR3α region, have been reported in a substantial proportion of human iNKT-cell clones (4-30%). Although p93, a serine in most human iNKT-cell TCRs, makes no contact with CD1d, it could affect CD1d binding by altering the conformation of the crucial CDR3α loop. By generating recombinant refolded iNKT-cell TCRs, we show that natural single-nucleotide variations in iNKTα, translating to serine, threonine, asparagine or isoleucine at p93, exert a powerful effect on CD1d binding, with up to 28-fold differences in affinity between these variants. This effect was observed with CD1d loaded with either the artificial α-galactosylceramide antigens KRN7000 or OCH, or the endogenous glycolipid β-galactosylceramide, and its importance for autoreactive recognition of endogenous lipids was demonstrated by the binding of variant iNKT-cell TCR tetramers to cell surface expressed CD1d. The serine-containing variant showed the strongest CD1d binding, offering an explanation for its predominance in vivo. Complementary molecular dynamics modeling studies were consistent with an impact of p93 on the conformation of the CDR3α loop.