Role of Dietary Intervention in Ameliorating Disability

Role of Dietary Intervention in Ameliorating Disability The Role of Dietary Intervention in Ameliorating Disability Experienced by Multiple Sclerosis Patients Mark M. Makar Hypothesis: Diet modification can significantly improve disability and quality of life in multiple sclerosis patients. Abstract (word count: 213) Hypothesis: Diet modification can significantly improve disability and quality of life in multiple sclerosis patients. Methods: The PubMed database was searched on January 18, 2017 to identify studies relevant to this review. The database search combined terms from three themes: 1) multiple sclerosis patients 2) diet and 3) diet modification. This search yielded 118 articles for screening, with no duplicates. With abstract screening and inclusion criteria, 10 articles were included in this final review. Results: Modifying the diet of multiple sclerosis patients can greatly reduce fatigue and moderately help decrease symptoms experienced during this disease. Replacing animal based protein and saturated fatty acids from the diet, with plant-based alternatives that are high in starch showed noticeable improvement in symptoms experienced by multiple sclerosis patients. The plant based diet showed a decrease in inflammatory cells, damage of the blood brain barrier, demyelination, as well as axonal and oligodendrocyte injury. Conclusions: A variety of dietary modifications have been demonstrated to effectively improve quality of life and reduce disability in patients suffering from multiple sclerosis. More studies are needed to assess the efficacy of dietary intervention with respect to reducing episodes of disability experienced by multiple sclerosis patients and including diet modification into the current disease modifying therapies available. Key Words: multiple sclerosis, diet modification, review Ultramini Abstract: A search of the PubMed database yielded 10 articles for review. A variety of randomized controlled trials, cohort studies, case studies, cross sectional studies, and surveys regarding multiple sclerosis patients and diet modification to exclude animal protein from the diet and include only a plant based diet, can help to ameliorate disability. Introduction Multiple Sclerosis has an ongoing prevalence of 33% globally, with its incidence growing in North America and Europe (Evans C et al., 2013). Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system. It is the number one cause of non-traumatic neurodegenerative disability in the young adult population, and is twice as common in women as men (Browne, P et al., 2014). The etiology of multiple sclerosis is still unknown; however, it is believed to have autoimmune origins. Patients tend to experience multiple sclerosis differently; the most common presenting symptoms include sensory (40%), motor (39%), fatigue (30%), and visual (30%), and urinary incontinence (17%) along with less common symptoms presenting as pain and cognitive decline (Evans C et al., 2013). The wide array of symptoms experienced in multiple sclerosis has sprung forth an influx of scholarly research on beneficial disease- modifying therapies (DMTs) and alternative non-traditional methods for treating multiple sclerosis. Many governments across the world subsidize the current platform therapies for multiple sclerosis across the world including interferon-beta and/ or glatiramer acetate (Browne, P et al., 2014). There is a considerable degree of variance between different levels of income groups in society with regards to accessibility of government-funded therapies for multiple sclerosis (Browne, P et al., 2014). Availability of government funded DMTs were accessible to 96% of high-income countries, 45% of lower to middle income countries, and none in the low-income countries (Browne, P et al., 2014). These surprising statistics have led to new research development, which focus on new treatment methods for multiple sclerosis that cannot only be efficacious, but also be economically accessible for all levels of socioeconomic statuses across the world. There is much speculation regarding cost effectiveness of current treatment regiments for multiple sclerosis with interferon-beta and/ or glatiramer ace tate. There is a common consensus that the current platform therapies are not cost effective for the long-term therapy of multiple sclerosis (Bogglid, M et al., 2009). Given the pathology of multiple sclerosis, it is believed that dietary factors play a key role in autoimmune degradation and can induce myelin breakdown in the central nervous system by molecular mimicry (Ashtari, F et al., 2015). Multiple sclerosis prevalence is believed to be high in regions furthest away from the equator, however recent research has found that these regions of the world also consume a greater amount of saturated fat and animal protein such as dairy (Swank, R et al., 1990). Diets high in animal protein saturated fatty acids tend to worsen progression of multiple sclerosis and increase relapse of symptoms (Hadgkiss, E et al., 2015).It has been proposed that dietary interventions such as low fat, plant-based diet may decrease autoimmune inflammation in the central nervous system and help maintain the protective integrity of the blood brain barrier (Riccio, P et al., 2016). Dietary modifications are thought to be both a cost effective and efficacious treatment option for mitigating symptoms experienced by multiple sclerosis patients such as loss of motor and or sensory function, as well as fatigue (Yadav, V et al., 2016). This paper aims to provide a practical overview of recent scholarly literature in order to answer the research question: Does diet modification significantly decrease the level of disability and improve the quality of life in patients suffering from multiple sclerosis? The review will be guided under the hypothesis: diet modification can significantly improve disability and quality of life in patients suffering with multiple sclerosis. Methods Articles about multiple sclerosis and diet modification were searched on January 19, 2017 using the databases Pub Med and Google Scholar. The database search combined terms from three themes: 1) multiple sclerosis patients (relapsing remitting multiple sclerosis OR primary progressive multiple sclerosis OR multiple sclerosis OR central nervous system demyelination OR autoimmune encephalomyopathy OR demyelinating disease 2) diet (food OR animal protein OR vegan diet OR plant based diet) and 3) diet modification (meal plan OR starch based diet). When searching for articles, screening settings were set to be within 10 years, English language, full text articles, review, meta-analysis, randomized control trials, and clinical trials. Boolean operators used were OR and AND; OR was used to extract specific terms from the three main themes. AND was used to connect the three themes used in this review. This search yielded 118 articles for screening, with no duplicates. With abstract screening and inclusion criteria, 10 articles were included in this final review. Inclusion Criteria All the articles used in this systemic review had to meet the following criteria: 1) English 2) patients with multiple sclerosis for at least 6 months 3) diet modification/ assesment or pharmacological treatment as intervention. The term multiple sclerosis was defined as patients showing symptoms for at least 6 months and diet modification was defined as any change in daily food intake. Exclusion Criteria Articles were excluded from the review if they were published prior to 2007 and/or were not written in the English language and/or if patients had any type of prior chronic disease other than multiple sclerosis. Results Randomized Controlled Studies In a randomized controlled study by Vijayshree Yadav et al, 61 patients with relapsing remitting multiple sclerosis were monitored for a one-year period. The participants were randomly allocated into two groups: Diet group and control group. The diet group was placed on a strict starch plant based diet (potatoes, corn, beans, bread, sweet potato and rice), while the control group was allowed to continue with their usual diet (meat, eggs, dairy products, fish) throughout the study. Each participant was surveyed once every three months or the duration of the study during which disability, and fatigue levels were recorded (by the expanded disability status scale, EDSS and fatigue severity scale, FSS/ modified fatigue impact scale, MFIS respectively). Serum lipid levels and brain MRI were also recorded at the end of the twelve months. The results observed demonstrated a significant reduction (pFigure 1 shows a summary of fatigue improvement throughout the duration of the study. These fin dings suggest that intervention with a plant-based diet does indeed help reduce fatigue in multiple sclerosis patients. Figure 1: Graph of Fatigue Scores as Measured by FSS score (A) and MFIS score (B) over a 12 Month Time Span In a similar randomized control trial by Anja Mahler et al, 18 patients with relapsing remitting multiple sclerosis were randomly divided into two groups. The intervention group was started on 600 mg green tea catechin capsule per day and the control group received a placebo capsule for 12 weeks. A 4-week period was allotted during crossover to assure a sufficient wash out period. The results observed determined there was a significant increase in efficiency of muscle work from 20 (SD= 3) in the placebo group to 25 (SD= 6) in the intervention group (p>0.004). This finding suggests that intervention with plant based green tea extract helps to decrease muscle fatigue in multiple sclerosis patients. Cohort and Cross Sectional Studies: Emily Hadgkiss et al surveyed 2087 patients with multiple sclerosis globally. The comprehensive online survey inquired about dietary habits, quality of life, disability, and relapse rate. Dietary habits were assessed using the Diet Habits Questionnaire (DHQ), baseline quality of life was calculated using the Multiple Sclerosis Quality of Life scale (MSQOL-54), and disability was calculated by using the Expanded Disability Status Scale (EDSS). Results of this study demonstrated that patients who reported higher intake of fruits and vegetables and low intake of fats had significantly higher physical health scores (PHC) ranging from 54 to 68 (pFigure 2 and Figure 3 shows a brief summary of these results. Figure 2: Mean Physical Health Composite by Dietary Factors   Ã‚   Figure 3: Mean Mental Health Composite by Dietary Factors Another significant finding in this study showed that patients who consumed meat and dairy had much poorer disability scores 624 (pTable 1. The frequency ofmultiple sclerosis disease activity was also significantly increased in meat and dairy consumers, 309% and 271% respectively (p Table 1: Level of disability and disease activity by dietary subgroups Soodeh Jahromi et al surveyed the diets of 75 women with multiple sclerosis from Iran. Dietary patterns were assessed using a 168-item food frequency questionnaire (FFQ). This study found patients whos diet consisted mainly of animal fat (high in animal fats, potato, other meat products, sugars, hydrogenated fats and low in whole grains, spices, and poultry without skin) had higher incidence of multiple sclerosis (OR = 1.99; CI: 1.63-2.94; P = 0.04), and patients who had a vegetable based diet (high in green leafy vegetables, hydrogenated fats, tomato, yellow vegetables, fruit juices, onion, and other vegetables) had lower incidence of multiple sclerosis. (OR = 0.42; 95% CI = 0.19-0.90; P = 0.026). These findings suggest an inverse relationship between high amount of hydrogenated fats, green leafy vegetables, fruit juices, and other vegetables and risk of multiple sclerosis. A longitudinal retrospective analysis was conducted by Weinstock-Guttman et al, where lipid levels of 492 multiple sclerosis patients were assessed for one a year time period. The study deduced that increasing LDL (p Geeta Ramsaransing et al investigated the levels of 23 dietary nutrients in 80 patients with multiple sclerosis: 27 with benign course multiple sclerosis, 32 with secondary progressive multiple sclerosis, and 21 with primary progressive multiple sclerosis. The secondary progressive group demonstrated significant decreases in magnesium intake (p In a cohort study by Mike Bogglid et al, 5583 multiple sclerosis patients in the UK were monitored from May 2002 to April 2005 in an effort to establish the long term cost effectiveness of current platform therapy (interferon-beta and/ or glatiramer acetate) for multiple sclerosis. Following the duration of the study, 49% of patients that were on platform therapy were found to have experienced progressive deterioration in EDSS 2.68 at baseline, 2.90 after one year, and 3.24 after two years (p Case Control Studies In a comparable study to Soodeh Jahromi et als work, a cross sectional analysis by Tatjana Pekmezomiv et al was conducted to investigate possible dietary trends in patients living with multiple sclerosis. The dietary habits of 110 multiple sclerosis patients were compared to 110 healthy controls. Results showed that meat intake such as chicken (OR=2.0, p=0.045), lamb (OR=2.1, p=0.013), and beef (OR=1.7, p=0.043) was significantly higher in multiple sclerosis patients as compared to healthy controls. Furthermore, the study found that multiple sclerosis patients consumed significantly higher levels of ice cream (OR=0.18, p=0.031) and butter (OR=1.7, p=0.056) in comparison to controls. Table 2 shows a brief summary of these results. These findings suggest that there is a significant association between dietary intake of meat products such as chicken, lamb, and beef, as well as ice cream and butter to the disease in question. This may suggest that removal or reduction of said food items may be beneficial in decreasing the incidence of multiple sclerosis. Table 2: Consumption frequency of different food groups and food items in MS patients and controls Fereshteh asharti et al conducted a case control study in order to evaluate cows milk allergy (CMA) in multiple sclerosis patients versus healthy individuals. The authors compared 48 multiple sclerosis patients with 48 healthy controls. After 16 weeks there were no differences in the frequency of CMA between the two groups. Contrary from the results of Emily Hadgkiss et als study, the study done by Vahid Shaygannejad et al, found that there was a higher frequency of dairy products consumed by healthy control individuals (67%, p=0.01) compared to multiple sclerosis patients. These findings suggest that there is no reliable association between milk consumption and risk of multiple sclerosis development. Discussion This review attempted to answer the question: Does diet modification significantly decrease the level of disability and improve the quality of life in patients suffering from multiple sclerosis? The general shared consensus of articles included in this review support the proposed hypothesis of diet modification can, indeed, significantly improve disability and quality of life in multiple sclerosis patients (Hadgkiss E et al., 2015; Jahromi S et al., 2012; Shaygannejad V et al., 2016; Yadav V et al., 2016; Ramsaransing G et al., 2009; Jahroomi S., 2012; Pekmezovic T et al., 2012). However, one article concluded that consumption of animal protein in the form of milk did not increase the risk of developing multiple sclerosis (Shaygannejad V et al., 2016). However, these findings should not be generalized to the general population as the sample size used was too small and did not represent a true spectrum of multiple sclerosis prevalence across the world. The remaining articles reviewed corroborated that removal of both animal based protein and saturated fatty acids from the diet, and their replacement, high starch, plant-based alternatives, provided improved disability and fatigue in patients suffering from this disease (Pekmezovic T et al., 2012; Yadav V et al., 2016). The plant based, high starch diet (potato and rice) was found not only be an efficacious treatment option for mitigating symptoms experienced by multiple sclerosis patients but is also economically accessible for all levels of society across the world. It is also evident that most clinicians involved in the articles reviewed, found enough evidence in their research to warrant providing advice to patients with multiple sclerosis about the importance of healthy diet modification in regards to their condition (Hadgkiss E et al., 2015; Jahromi S et al., 2012; Yadav V et al., 2016; Ramsaransing G et al., 2009;). Many of the articles reviewed used a survey platform to assess the diets of multiple sclerosis patients; this may have had some effect on the results due to the nature of the retrospective study design used, making way for possible recall bias, hence potential misreporting of dietary intake (Pekmezovic T et al., 2012; Hadgkiss, E et al., 2015;). As well, since many of the articles used a food frequency survey approach, it may have limited the interventions possible with regards to experimenting with different types of foods that may have improved or worsened multiple sclerosis outcomes. A common limitation in this review is that none of the articles inquired about portion sizes of their meals, just food items (Hadgkiss E et al., 2015; Jahromi S et al., 2012; Yadav V et al., 2016; Ramsaransing G et al., 2009; Jahroomi S., 2012;). Across all articles reviewed, mean age of the study population was between 30- 47 years; therefore the results of this review may not be true for younger or more elderly patients. Many of the researchers in this review found it difficult to recruit many subjects due to health concerns regarding a low protein diet (Hadgkiss E et al., 2015; Jahromi S et al., 2012; Yadav V et al., 2016; Ramsaransing G et al., 2009; Jahroomi S., 2012). It is possible that the results observed with regards to studying the diets of multiple sclerosis patients may have been due to associations with other confounding variables. It is also important to note that given the disabling nature of multiple sclerosis as a disease state, many of the patients may be relying on a caregiver or family member for their meals, which may influence their dietary intake. Limitations encountered in this review include only utilizing articles written within the past 10 years, articles collected from only two databases (PubMed and Google Scholar), and articles were only included only if they were published in the English language. Future research may consider standardizing meal portion sizes during experimentation as various parts of the world have varying standard portion sizes. Future studies should also consider accounting for possible supplementation use in the participants such as vitamin and mineral intake. This would help diminish possible confounding variable. Future research may also utilizing experimental analysis encompassing a larger age range. All together, these factors would help encompass a much broader spectrum of patients living with multiple sclerosis. Conclusion In conclusion, diet modification has been shown to be a viable option not only for effectively improving quality of life, and reducing disability in patients suffering from multiple sclerosis, but also in lowering the risk of developing the disease. Evidence showed that removal of both animal based protein and saturated fatty acids from the diet, and replacing them with plant-based alternatives which are high in starch showed noticeable improvement in muscle weakens and fatigue levels. Unfortunately we do not have sufficient research that definitively demonstrates that diet modification can be used alone without traditional medication to prevent and/ or treat multiple sclerosis. Additional studies are needed to assess the efficacy of dietary intervention with respect to reducing episodes of disability experienced by multiple sclerosis patients and including diet modification into the current disease modifying therapies available. References Ashtari, Fereshteh, Fatemeh Jamshidi, Raheleh Shokouhi Shoormasti, Zahra Pourpak, and Mojtaba Akbari. Cows milk allergy in multiple sclerosis patients. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 18, no. Suppl 1 (2013): S62. PMCID: PMC3743324 Boggild, Mike., Palace, Jackie., Barton, Pelham., Ben-Shlomo, Y., Bregenzer, Thomas., Dobson, Charles., Gray, R. (2009). Multiple sclerosis risk sharing scheme: two year results of clinical cohort study with historical comparator. BMJ, 339, b4677. http://www.bmj.com/content/bmj/339/bmj.b4677.full.pdf. Browne, P., Chandraratna, D., Angood, C., Tremlett, H., Baker, C., Taylor, B. V., Thompson, A. J. (2014). Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology, 83(11), 1022-1024. http://doi.org/10.1212/WNL.0000000000000768 Guggenmos, Johannes, Anna S. Schubart, Sherry Ogg, Magnus Andersson, Tomas Olsson, Ian H. Mather, and Christopher Linington. Antibody cross-reactivity between myelin oligodendrocyte glycoprotein and the milk protein butyrophilin in multiple sclerosis. The Journal of Immunology 172, no. 1 (2004): 661-668. DOI: https://doi.org/10.4049/jimmunol.172.1.661 Emily J Hadgkiss, George A Jelinek, Tracey J Weiland, Naresh G Pereira, Claudia H Marck Dania M van der Meer (2015) The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis, Nutritional Neuroscience, 18:3, 125-136, DOI: 10.1179/1476830514Y.0000000117 Evans, Charity, S-G. Beland, Sophie Kulaga, Christina Wolfson, Elaine Kingwell, James Marriott, Marcus Koch et al. Incidence and prevalence of multiple sclerosis in the Americas: a systematic review. Neuroepidemiology 40, no. 3 (2013): 195-210. doi: 10.1159/000342779. Jahroomi, Soode., Toghae, Mansoureh., Razeghu Jahromi, M., Aloosh, Mahdi. (2012). Dietary pattern and risk of multiple sclerosis. Iranian Journal of Neurology. 11(2), 47-53. PMCID: PMC3829243 Joscelyn, Jennifer., Kasper, Lloyde. H. (2014). Digesting the emerging role for the gut microbiome in central nervous system demyelination. Multiple Sclerosis Journal, 20 (12), 1553-1559. DOI: 10.1177/1352458514541579 Mà ¤hler, Anja, Jochen Steiniger, Markus Bock, Lars Klug, Nadine Parreidt, Mario Lorenz, Benno F. Zimmermann, Alexander Krannich, Friedemann Paul, and Michael Boschmann. Metabolic response to epigallocatechin-3-gallate in relapsing-remitting multiple sclerosis: a randomized clinical trial. The American journal of clinical nutrition 101, no. 3 (2015): 487-495. DOI: 10.3945/ajcn.113.075309 Otaegui, David, Sara Mostafavi, Claude CA Bernard, Adolfo Lopez de Munain, Parvin Mousavi, Jorge R. Oksenberg, and Sergio E. Baranzini. Increased transcriptional activity of milk-related genes following the active phase of experimental autoimmune encephalomyelitis and multiple sclerosis. The Journal of Immunology 179, no. 6 (2007): 4074-4082. doi: 10.4049/jimmunol.179.6.4074 Pekmezovic, Tatjana D., Darija B. Kisic Tepavcevic, Sarlota T. Mesaros, Irena B. Dujmovic Basuroski, Nebojsa S. Stojsavljevic, and Jelena S. Drulovic. Food and dietary patterns and multiple sclerosis: a case-control study in Belgrade (Serbia). Italian Journal of Public Health 6, no. 1 (2012). http://ijphjournal.it/article/view/5808 Ramsaransing, Geeta, Mellema, Sanne. A., De Keyser, J. (2009). Dietary patterns in clinical subtypes of multiple sclerosis: an exploratory study. Nutrition journal, 8(1), 36. DOI: 10.1186/1475-2891-8-36 Riccio, Paolo, and Rocco Rossano. Nutrition facts in multiple sclerosis. ASN neuro 7, no. 1 (2015): doi: 10.1177/1759091414568185 Riccio, Paolo., Rossano, Rocco., Liuzzi, G. Maria. (2011). May diet and dietary supplements improve the wellness of multiple sclerosis patients? A molecular approach. Autoimmune diseases, 2010. http://dx.doi.org/10.4061/2010/249842 Riccio, Paolo, Rocco Rossano, Marilena Larocca, Vincenzo Trotta, Ilario Mennella, Paola Vitaglione, Michele Ettorre et al. Anti-inflammatory nutritional intervention in patients with relapsing-remitting and primary-progressive multiple sclerosis: A pilot study. Experimental Biology and Medicine 241, no. 6 (2016): 620-635. DOI: 10.1177/1535370215618462 Shaygannejad, Vahid, Nooshin Rezaie, Zamzam Paknahad, Freshteh Ashtari, and Helia Maghzi. The environmental risk factors in multiple sclerosis susceptibility: A case-control study. Advanced Biomedical Research 5 (2016). doi: 10.4103/2277-9175.183665 Swank, R. L., and B. Brewer Dugan Effect of low saturated fat diet in early and late cases of multiple sclerosis. The Lanet 336, no. 8706(1990): 37-39. DOI:10.1016/0140-6736(90)91533 Tlaskalovà ¡-Hogenovà ¡, Helena, Renata Ã…Â  tĆºpà ¡nkovà ¡, Hana Kozà ¡kovà ¡, Tomà ¡Ãƒâ€¦Ã‚ ¡ Hudcovic, Luca Vannucci, Ludmila TuÄ kovà ¡, Pavel Rossmann et al. The role of gut microbiota (commensal bacteria) and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer: contribution of germ-free and gnotobiotic animal models of human diseases. Cellular molecular immunology 8, no. 2 (2011): 110-120. http://www.nature.com/cmi/journal/v8/n2/abs/cmi201067a.html Vieira, Silvio. M., Pagovich, Odelya. E., Kriegel, Martin. A. (2014). Diet, microbiota and autoimmune diseases. Lupus, 23(6), 518-526. doi: 10.1177/0961203313501401 Weinstock-Guttman, Bianca, Robert Zivadinov, Naeem Mahfooz, Ellen Carl, Allison Drake, Jaclyn Schneider, Barbara Teter et al. Serum lipid profiles are associated with disability and MRI outcomes in multiple sclerosis. Journal of neuroinflammation 8, no. 1 (2011): 127.DOI: 10.1186/1742-2094-8-127 Yadav, Vijayshree., Marracci, Gaild., Kim, Edward., Spain, Rebecca., Cameron, Michelle., Overs, Shanon., Murchison, C. (2016). Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial. Multiple Sclerosis and Related Disorders, 9, 80-90. DOI: 10.1016/j.msard.2016.07.001. Appendix First Author Population Year of Publication Study Design Outcome Ashtari, F. 48 patients with Multiple Sclerosis and 48 healthy patients as control group, mean age 30.7 March 18, 2013 Case control Study Serum IgE levels against cows milk antigen was taken from both groups. Results were very similar between both groups and showed no statistical significance (30.7  ± 6.9 vs. 30.9  ± 6.3 respectively, P value = 0.83) Boggild, M. 5583 patients with multiple sclerosis monitored from May 2002 to April 2005 from neurology clinics across the UK August 5, 2009 Prospective Cohort Study Patients received Interferon Beta treatment to determine long term cost effectiveness. Results showed worse disability progression than in the untreated group (deviation score of 113%; increase in mean disability status scale 0.28) Hadgkiss, E. 2087 patients with multiple sclerosis, mean age 45.5 participated in a comprehensive online survey March 17, 2014 Cross Sectional Study

the eu egyptian partnership :: essays research papers

A new round of EU - Egyptian association agreement negotiations started in Cairo with the objective of ratifying an agreement between the two sides. During their two-day deliberations the two sides will discuss three main issues, covering "renovation of industry, the exports, rules of origin (the original source of the production) and agriculture." A comprehensive report will be submitted on the results of the meetings which will conclude today to the political leadership in Egypt and the European Union to take the proper decision concerning pending issues, foremost being agricultural issues. The Egyptian side is led by chief of the partnership unity at the Egyptian Foreign Ministry, Gamal al Bayoumi, and the EU by the head of unity, Peter Zingle Taking part in the session were a number of negotiators in all matters debated for discussions, especially agricultural issues. It is expected that number of these issues will be totally settled at the end of the meetings, and a number of agricultural issues will be left for decisions to be taken on the political level by the European and Egyptian sides. The new round of negotiations for Egyptian partnership with the European Union, is to be held in Cairo, on November 9 - 12. Egypt's assistant foreign minister and chairman of Egyptian - European partnership, Gamal Bayoumi, said that the new talks are aimed at resolving as many issues as possible, so the EU and Egypt can submit subjects that are not settled yet to their political leadership. Despite grave shortcomings in environmental provisions, the EU's association and trade agreement with Egypt has been adopted at the EU's General Council meeting in Luxembourg from 21-22 June 1999, warns Friends of the Earth Europe (FoEE), a federation of independent environmental groups in 29 countries. The association agreement now needs to be reviewed in a high-level ministerial committee in Egypt, then to be signed in autumn and afterwards ratified in the 15 EU national parliaments and the European Parliament. 'At this stage we will call upon government representatives in the EU and in the Egyptian government not to sign the agreement. Deficiencies in environmental protection measures first need to be rectified so that an association agreement will lead to the benefit for the people and the environment', says Alexandra Wandel, Trade and Sustainability expert of FoEE. 'The EU committed itself in various EU and international agreements to incorporate environmental considerations int o all its community policies. The EU does not live up to its commitments in the association agreement with Egypt.

The Women Suffrage Movement (1840 -1920)

It would seem unbelievable that the women who lived before the 19th century were confined to their homes and actually had no freedom to choose the leaders that they wanted simply because they could not vote.This was not until the suffrage movement was formed to fight for the women's right to vote. During this time, men were still seen as more superior and women were only allowed to manage and participate in the domestic roles (Rossi 6).Only adult males were allowed to vote. Even though, they had to own property in order to qualify to vote. With changes in education and social conditions, women in the 19th century began to seek their rights and equality with men and top in their agenda was the right of women to vote just like their male counterparts.This saw the rise of the women suffrage movement of 1840 to 1920. The birth of this revolution is said to have occurred at a women rights meeting in Seneca Falls in New York. Women could see they were limited by their place in the society and in the Seneca Falls meeting the ‘Created Equal' campaign was launched (Rossi 8).Despite the many challenges that the women faced during this movement and an eighty years struggle, theirs became a won battle when the 19th amendment was signed in 1920 giving women the right to vote in national elections (Sochen 176).A suffragist known as Elizabeth Cady Stanton is the one that introduced women's sentiments at the Seneca Falls convection and wrote the plan for the feminist movement (Sochen 131). Later, together with Susan B. Anthony, she led women in the movement to fight for their rights of equality and their freedom to vote. Other significant leaders and suffrages included Lucretia Mott, Lucy Stone, Alice Paul, Virginia minor and Sojourner Truth.Elizabeth Stanton became the leading feminist philosopher guiding the American women towards the achievement of women's right. She was a determined woman rights activist who despite her responsibility as a wife and mother devoted as much time as she could in the movement (Salibury 131).Susan Anthony worked closely with Elizabeth and the two were said to be inseparable. Elizabeth is even said to have written Susan's speech at the Seneca Falls meeting. Susan was an acknowledged spokeswoman for the campaigns of the National American Women Suffrage Association (NAWSA) formed in 1878. She also wrote a magazine on women rights (Sochen 131). Alice Paul founded the founded the national women's party.The main objectives of this movement were for women to acquire their rights to vote equal to that of their male counterparts. The movement also sought to defend African American women who even after being granted franchise were not included in the fourteenth and fifteenth amends that gave them an equal opportunity to vote regardless of their race.The reasoning behind this movement is that no one should be denied a right to vote based on their gender or race. They wanted the fifteenth amend not only to include right to vote irrespective of race and color but to also include gender (Rossi 17). Other reasons were specialized for example in Utah; women believed that their rights to vote would bring an end to polygamy.The women suffrage movement managed to gain government support in granting voting rights to women. This they did through numerous campaigns and gaining the support of women all over America to support them. Many conferences and organizations to campaign for women rights to vote were organized in the leadership of Susan Anthony and Elizabeth Stanton.In 1871, about fifteen women registered and participated in the elections. Susan was arrested and in the following years, several more were arrested and harassed. The largest campaign was held in 1913 in Washington D. C when around five thousand women paraded showing signatures of one million women supporting suffrage for women (Rossi 35).Apart from national wide campaigns, women pursued suffrage in individual towns and gradually many of them were granted the rights to vote. Grants of suffrage were more successful in the west with the first suffrage succeeding in Wyoming in 1869. Other examples by years are Illinois; 1891, California; 1911, Arizona and Oregon; 1912 and Montana; 1914.The women of Utah were defeated after they voted for polygamy. The women suffrage was first introduced to the congress in 1915. The bill failed at least two times when it did not gain the support of two thirds majority required to pass a bill in the senate.   Women started participating in politics and being voted for positions in the government (Sochen 178, 179).

The Banning Of The Headscarf - 1229 Words

In most countries around the world, it is not uncommon to see a woman in an article of clothing that is representative of the Muslim faith and history. This type of dress is typically worn in countries located in the Middle East. The wardrobe of a woman in these countries would contain articles such as an al-Amira, burka, or a hijab. Some women wear these clothing items for religious or traditional purposes, but others wear them solely by choice. However, there are certain countries around the world that oppose the wearing of certain Muslim-style clothing. One country in particular, Turkey, does not issue total support of the wearing of headscarves for women. In fact, the government has issued a ban on the wearing of headscarves by women in government facilitated places. The banning of the headscarf is a heavily debated subject in Turkey due to political and social beliefs of the Turkish people. Since the ban was put into existence, the Turkish people, specifically women, have felt t he negative effects that have resulted from it. The headscarf is an item of clothing that is worn by Turkish women for several reasons, not solely for religious practices. The scarf has a deep history behind it, stemming from the Ottoman influence on the Middle East. Since the beginning of the headscarf wearing, the framework of the headscarf has developed into many different ideals. Different groups of women wear the item for different purposes. Marlene Breau explains that the scarf can beShow MoreRelatedIs the Ban on Muslim Headscarves in French Schools Justified?1271 Words   |  6 PagesI will advance the thesis that the banning on Muslim headscarves in French schools is not justified. By saying that the French ban on Muslim headscarves in public schools is not justified, I mean that, even though this ban was implemented as a means to neutralize public space, in hope of developing autonomy, as well as to protect females’ rights in traditional Muslim communities, the ban actually infringes on a more pressing rights of a person, and thus means that it is not justified as it does moreRead MoreSnow By Orhan Pamuk : Final Paper1371 Words   |  6 Pagesinclude non-Muslims in the discourse and debate. In Snow, the headscarves controversy overshadowed turkey and the modernized state, the secularist elites implement secularism by forcing women to unveil themselves in public. This is done through banning headscarf wearing in schools and public buildings, thus, executing its control over Muslim women. In response, Muslim women, who are represented by the character named Kadife, Hande, and Teslime, resist the domination to defend their rights upon wearingRead MoreThe Controversy Of American Muslims And European Muslims980 Words   |  4 Pagesexperts argue that the influx of immigrants is necessary to combat the inevitable social security and aging workers crisis, yet others argue technology will solve the problem (Glazer, 2010). With tensions high, questions come to the limelight over the banning of burqa’s in European countries, and the effects these policies will have on future immigration to Europe (Glazer, 2010). In general, what are the main differences between American Muslims and European Muslims? While American Muslims are mainlyRead MoreThe Folly Of Secularism By Jeffrey Stout1305 Words   |  6 PagesThe Muslim headscarf, or Hijab has been a matter of ongoing debate and controversy in the secular state that is France. Secularism does not exist in a vacuum in France it builds upon ‘complicated emotional inheritance, specifically the negotiation between the religious and state secularism which appears to continually lead to an image of hostility being constructed for Islam, despite the promotion of universality that is allegedly key to the French Republic. This essay discusses the Hijab in FranceRead MoreThe Justice And Development Party1089 Words   |  5 Pagesand why was it formed? Throughout the 1990s, headscarfs was one of the problems for the secularist to preserve power in public. At this time period, The Welfare party, also known as RP, was in power. This was a secularist party and had strict laws and bans on practicing Islam. They had banned headscarfs in pu blic, but still many people ignored this law. The party kept on banning and separating religion from the state, which initially led to their banning from turkish politics in 1998. In the same yearRead MoreSeparation Of Church And State1207 Words   |  5 PagesFrance, it is being alienated and treated like an inferior minority, despite intentions of the constitution. This is particularly evident within â€Å"The 2004 law banning the Islamic headscarf from being worn in public schools in the name of of laà ¯cità ©.† (Krasnyy, J 2015). Many of the French agreed with the law, justifying the Muslim headscarf as a symbol of women’s oppression, however, they fail to acknowledge that the law itself is oppressive because it discriminates the right of acess to educationRead MoreFrance and Human Rights2016 Words   |  9 Pagesbe practiced in private. In 2004, France issued a law banning any religious symbols in public schools. This law was not created to single any one reli gion out, but the largest backlash came from the Muslim communities. In an article written by the Human Rights Watch in February 2004, executive director Kenneth Roth stated, â€Å"The proposed law is an unwarranted infringement on the right to religious practice. For many Muslims, wearing a headscarf is not only about religious expression, it is about religiousRead MoreHijab Battles Around the World2894 Words   |  12 Pagesbecause of the possibility of an opportunity for their family and children, something that they may not have back home. In order for a Muslim woman to distinguish herself from others, she dresses a certain way - either burkha, hijab or niqab. The headscarf covering is an identifier that a woman has reached a fertile age and depending on the way she wears it, in most Islamic practices, can be distinguished if she is available for marriage or already married. Hijab is a mandatory religious practiceRead MoreUnderstanding Of Securitization By Breaking Down Discourse1413 Words   |  6 Pagesreligious practices and organizations of Islam itself. Maybe, the most unmistakable sign of this manifestations has been the headscarf contentions. In spite of the fact that veil discussions have been a historical issues several states, it picked up momentum after 9/11 as a result of rising concerns and worries about Islam. Scott (2007, p. 3) proposes: Banning the headscarf or veil is a symbolic motion; for some countries it is a method for standing firm against Islam, announcing whole Muslim massesRead MoreEssay on Religion and Public Policy2873 Words   |  12 Pagesin 2004, when French lawmakers banned ostentatious religious symbols – most notably the Islamic headscarf, Jewish yarmulkes and large crosses as worn by some Christian believers - from public schools across the country (Adrian 345). More specifically, the significance of the Mus lim veil was sacrificed to the greater concern of state politics. As an ostentatious religious symbol, the Islamic headscarf became an obstacle for collective citizenship; people saw it as a threat to French understandings