Microalbumin Creatinine Ratio And Diabetes Health And Social Care Essay Free Essays

Microalbuminuria ( MA ) is one of the first indexs of kidney harm in diabetics. MA is considered to be a hazard factor for kidney disease, hence, it is recommended by the ADA that type 2 diabetics are screened for MA at diagnosing and yearly. This is so that diabetic kidney harm can be treated every bit shortly as microalbuminuria manifests, detaining patterned advance of kidney disease. We will write a custom essay sample on Microalbumin Creatinine Ratio And Diabetes Health And Social Care Essay or any similar topic only for you Order Now Microalbuminuria occurs infinitesimal measures of albumin enter into the piss from the kidneys. Such bantam sums of urine protein normally can non be detected by conventional urine dipstick methods. Highly specific and sensitiveness immunochemical assaies are utilised to observe microalbumin. MA is defined by the ADA as elimination of 30-300 milligram of urinary albumen /24 hours or elimination of 30 to 300 mg/L of urinary albumen in a random or topographic point urine sample. Urinary albumin-to-creatinine ratio is frequently times measured alternatively of urinary albumen entirely, because ciphering the ratio corrects for the day-to-day fluctuations in protein elimination by the kidneys. Creatinine is excreted by the kidneys at a changeless rate and when compared to urine albumen as a ratio, it is a more dependable step of kidney map. Normoalbuminuria ( NA ) is defined as A ; lt ; 30 ug/mg in a random urine sample. Microalbuminuria ( MA ) is defined as 30-300 ug/mg and Macroalbumi nuria or open albuminuria ( OA ) is defined as A ; gt ; 300 ug/mg in a random urine sample. Recent surveies have indicated that there might be a nexus between cardiovascular disease ( CVD ) and microalbuminuria diabetes and in non-diabetics. The intent of this reappraisal is to happen out what is the grounds of an association between increased urine microalbumin and hazard of developing cardiovascular disease in type 2 diabetic grownups. Methods The database utilized to supply the original and secondary literature research was Ovid MEDLINE ( R ) 1996 to 2nd hebdomad of October 2010. Evidence-based literature databases provided by the Cochrane Library were besides searched. These included The Cochrane Database of Systematic Reviews ( Cochrane Reviews ) , The Database of Abstracts of Reviews of Effects ( Other Reviews ) and The Cochrane Central Register of Controlled Trials ( Clinical Trials ) . Cardinal footings were mapped to medical capable headers ( MESH ) before carry oning an Ovid hunt. Boolean AND was used to unite the cardinal PICO constituents of the research inquiry to contract hunt. Table 1 below shows a list of MESH footings utilized in the hunt. Cardiovascular diseases Urine microalbumin Type 2 diabetes Hazard Adults Cardiovascular Abnormalities Cardiovascular Infections Heart Diseases Pregnancy Complications, Cardiovascular Vascular Diseases Albuminurias Albuminurias Diabetic Kidney diseases Microalbuminuria Diabetess mellitus, type 2 Type ii diabetes Type 2 Diabetes Mellitus Diabetess Mellitus, Slow Onset Hazard Hazard appraisal Hazard factor Adults Table 1 There were 122 articles retrieved, 16 commendations were considered relevant to the research inquiry. Figure 1 below shows the hunt scheme used to recover relevant commendations. Database: Ovid MEDLINE ( R ) A ; lt ; 1996 to October Week 2 2010 A ; gt ; Search Scheme: — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — 1 Cardiovascular Diseases/ur [ Urine ] ( 132 ) 2 Diabetes Mellitus, Type 2/ and Albuminuria/ and Creatinine/ and Biological Markers/ ( 60 ) 3 Risk/ ( 28311 ) 4 Diabetes Mellitus, Type 2/ and Adult/ ( 14744 ) 5 1 and 2 ( 1 ) 5 1 and 2 ( 1 ) 6 Diabetes Mellitus, Type 2/ and Adult/ ( 14744 ) 7 Cardiovascular Diseases/ur [ Urine ] ( 132 ) 8 Diabetes Mellitus, Type 2/ and Albuminuria/ and Cardiovascular Diseases/ ( 194 ) 9 Risk/ or Risk Factors/ ( 353907 ) 10 8 and 9 ( 122 ) Figure 1 Seven commendations retrieved were original surveies and after application of inclusion/exclusion standards, five surveies were chosen for the literature reappraisal. Table 2 below shows inclusion/exclusion standards applied. Choice standards Inclusion Criteria* Exclusion Criteria* Population Adults with diabetes mellitus, type 2 Adults without diabetes mellitus, type 2 Interventions Measure urine micro albumen and creatinine ratio, ( albuminuria, proteinuria ) No measuring of urine microalbumin and creatinine ratio. Result Examine consequences for positive correlativity between urine microalbumin and creatinine ratio and cardiovascular hazard factors Lack of comparison/correlation of UACR values with cardiovascular hazard factors. Study Design Prospective cohort surveies with comparing to gold standard trial. Prospective cohort missing a gilded criterion or cross-sectional or retrospective survey Case series/reports, non-systematic reappraisals, Journal reappraisals Table 2 Other relevant commendations were retrieved by manus seeking mentions of primary and secondary beginnings. These are included in the mention subdivision of the reappraisal. Literature reappraisal Microalbuminuria as a cardiovascular hazard factor in type 2 diabetic patients After finishing the literature hunt, five surveies clearly established a strong association between the presence of microalbuminuria and increased hazard of cardiovascular events. Four of the surveies were similar in that they were prospective cohort surveies look intoing the [ possible nexus between increased urinary elimination of albumen and cardiovascular disease in type 2 diabetics. Prospective cohort surveies provided the strongest grounds for forecast surveies. The research workers used multivariate statistics to command confusing variables such as age, sex, entire and HDL cholesterin. The surveies likewise showed on norm a two to three fold addition in cardiovascular end points in diabetics with microalbuminuria than those without it. These two surveies besides showed that microalbuminuria, more specifically urinary albumen -to- creatinine ratio ( UACR ) , gross albuminuria and decreased eGFR were independent hazard factors for cardiovascular disease in type 2 diabetics. In t he Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation ( ADVANCE ) survey, Ninomiya et Al. ( 2009 ) investigated the effects of urinary albumen -to- creatinine ratio ( UACR ) and eGFR on cardiovascular and nephritic events in 10,640 patients. Patients were followed for about four old ages. After accommodations for other hazard factors utilizing multivariate statistical analysis, the survey research workers concluded that patients with baseline albuminuria ; UACR A ; gt ; 300 mg/g and eGFR A ; lt ; 60 ml/min per 1.73 M2, had 3 times greater hazard of cardiovascular events and 22 times greater hazard for nephritic events than with patients without these hazard factors. Validity was high in this survey because the sample size was sufficiently big plenty to acquire precise estimations of the effects of proteinuria, and at that place was statistical control for other variables set uping high proteinurias and low eGFR are independent hazard factors f or cardiovascular and nephritic events in patients with type 2 diabetes. Similarly, Valmadrid et Al. ( 2000 ) established that microalbuminuria and gross albuminurias were independent hazard factors for developing cardiovascular disease in type 2 diabetics. A prospective cohort survey of 840 people with diabetes mellitus type 2, established a 1.8-fold increased hazard for cardiovascular decease and a 2-fold increased hazard for CHD mortality in this population than other type 2 diabetics with normoalbuminuria. In this survey, patients were followed for 12 old ages. Persons with normoalbuminuria were compared with those with microalbuminuria and gross albuminuria for hazard of cardiovascular mortality. The comparative hazard RR for CVD was 1.84 ( 95 % [ CI ] , 1.42-2.40 ) for those with microalbuminuria and 2.61 ( 95 % CI, 1.99-3.43 ) for those with gross albuminurias. In another prospective cohort survey by Gimeno et Al. ( 2006 ) , 436 type 2 diabetic patients with a average age of about 65 old ages were followed for approximately 7 and a half old ages until a cardiovascular event occurred. Study topics did non hold albuminurias, and were classified into four groups: based on prevalent or non-prevalent CVD and normoalbuminuria or microalbuminuria.The control group had normoalbuminuria and no CVD. Researchers in this survey found out that the hazard of microalbuminuric patients without open CVD was similar to the hazard of normoalbuminuric patients with open CVD. In cross-sectional analysis by Savage et Al. ( 1996 ) conducted in the Denver country increased urinary protein was associated with an increased prevalence of diabetic retinopathy, neuropathy, and cardiovascular disease. A 2004 Double blind, randomized test by de Zeeuw et Al. ( 2004 ) showed that cut downing proteinurias in the first 6 months appears to afford cardiovascular protection in type 2 diabetic patients. Losartan, an angiotonin II adversary was used dainty proteinurias in these patients and was compared to placebo. Patients with low-level proteinurias were compared to patients with high degrees of proteinuria. Upon posthoc analysis, there was a 1.92-fold ( 95 % CI, 1.54 to 2.38 ) hazard for CVD and a 2.70-fold ( 95 % CI, 1.94 to 3.75 ) higher hazard for bosom failure compared to patients with low proteinurias Other Studies and related reappraisals Several surveies including hypertensive patients, diabetics and non-diabetes showed association of microalbuminuria and CVD. Third National Health and Nutrition Examination Survey ( NHANES ) analyzed informations for 14,586 grownups in the US after a 13year follow-up period from 1988-2000. Low eGFR and high UACR independently predicted cardiovascular and general mortality. Discussion/summary The literature reappraisal shows that there is an association between microalbuminuria and cardiovascular events in type 2 diabetic patients. Some of the literature established that microalbuminuria predicts CVD in patients with high blood pressure. All of the primary surveies reviewed utilized a prospective cohort research design, which is a flat one evidenced for forecast surveies. Internal cogency was really strong for the surveies but external cogency was low for the Gimeno survey because patients ‘ were selected from a specialised clinic so they could non be representative of the full diabetic population. In contrast, the ADVANCE survey patients were selected from many different locations supplying strong external cogency. The Gimeno survey used one urine sample for baseline line categorization of urinary albumen degrees and could hold improved cogency by proving at least three urine samples earlier categorization as this is normally recommended. When proving topographic p oint urine samples for microalbumin, one of the restrictions is that there is day-to-day variableness in urine protein degrees and degrees can be affected by transeunt protein signifier vigorous exercising, desiccation urinary piece of land infections. Choice prejudice could hold been farther reduced in the Savage et Al. survey in the Denver country but including a more representative sampling of the country demographics. There was a higher per centum of minorities enrolled in the survey than is true of the Denver country. The mechanism by which microalbuminuria is linked to CVD is non yet known. Further probe is needed so as to effectual cut down microalbuminuria in diabetics and in the general population. Recent surveies have shown angiotensin-converting enzyme ( ACE ) inhibitors and angiotonin II adversaries such as Lorsatan, to cut down urinary albumen degrees in patients. The efficaciousness of other drug therapies to cut down proteinuria is being investigated. The thiazolidinediones drugs used to better glucose control have besides been shown to cut down microalbuminuria in diabetics. In the Framingham Heart Study, MA was determined to be a hazard factor for CVD at really low degrees that were below the recognized scope for subclinical kidney disease. Microalbuminuria is an independent and signii ¬?cant forecaster of CVD events and all-cause mortality in patients ( Astor B.C. , Hallan S.I. , Miller, 3rd, 3rdE.R. , et Al ) ( 2008 ) How to cite Microalbumin Creatinine Ratio And Diabetes Health And Social Care Essay, Essay examples

Long Range Casues Of WWII Essay Research free essay sample

Long Range Casues Of WWII Essay, Research Paper World War I was a really complicated war. It goes back as far back as 1870. Of class the was didn? T last for that many old ages, but it had many casues. Not merely one flicker that started it off. The Franco-Prussian War was one of these casues. There were sevral Franco-Prussian Wars. The last Franco-Prussian War started in 1870. Prussia was in a alliance. A alliance is a group of provinces that are loosly joined together and hold more power than the authorities of the whole state. Prussia was the biggest province. France and Prussia ever fought over Alsace-Lorraince. It was land with really rich dirt. It was on the boundary line between France and Prussia. They kept contending over the land. One clip Prussia would win and would take the land. The the following clip France would win and would take the land. This kept occurrence, but in the last war, which started in 1870, Germany eventually won Alsace-Lorraine. They signed a pact in Versailles, France. The Franco-Prussian War ended in 1871. After the Franco-Prussian War, Bismarck, who was Prussia? s leader made the fusion of Germany. That meant that all the separate provinces joined together to be one counrty. After this, Bismarck became the leader of Germany. After the Franco-Prussian War, France was afraid that Germany would assail France for more land. So so France started constructing up it? s ground forces so that Germany wouldn? t onslaught. Germany wanted a war. This caused the six stronge countires in Europe to get down constructing up their ground forcess and acquire ready for the war. The six stronge states were England, France, Germany, Austria-Hungary, Russia, and Turkey. All of these countires were compeating to be the strongest. Russia and Germany did non acquire along. Russia, excessively, was afriad Germnay would assail, so Russia started to construct up it? s ground forces to do Germany afriad. Russia and Austria-Hungary besides didn? t get along. Austria-Hungary was afriad Russia would assail so they started to construct up their ground forces to intimidate Russia. Turkey didn? t get along with Austria-Hungary. Turkey saw that Austria-Hungary was constructing up their ground forces, and that frightened Turkey, so they sta rted constructing up their ground forcess to frighten Austria-Hungary. All of thse states were compeating to be the best and the strongest. This is an illustration of militerism and patriotism. Nationalism is a deep feeling of pride for one? s state with a desire to turn out that it? s better than all other countires. Patriotism could acquire really unsafe becasue it could get down a war. It was one of the factors that started World War I. What all the states were making was besides an illustration of militerism. Militerism is the manner states build up their ground forcess to construct up for war.Before the war, all immature males had to develop to be soldiers in school. This was called cosmopolitan military preparation. Another one of the casues of World War I is confederations. An Alliance is and agreemnt of friendly relationship with two or more states. The states all started to do allinaces becasue they needed aid incase of a war. So if state A got into a war with state B, and state A had an confederation with state C, state C would assist state A battle against state B. Then possibly state B would hold an allince with state D, and state D would ahve an allince with state E. So count ries B, D and E could contend against countires A and C. So what would be a small war between states A and B would turn into a really large war. In 1872, Germnay Russia and Austria-Hungary made the first Ternary Alliance. Russia left after the Franco-Prussian War. Alternatively of Russia, Italy came, and in 1882, it became known as the Second Triple Alliance. After Russia backed out of the first confederation, it became friends with France. In 1891, France and Russia made the Double Alliance. In 1904 England jioned the Double Alliance, and so it became the Triple Entant. If a large state makes and confederation with a little state, it doesn? t mean that they? re seeking to be nice. It? s because they want something. All the large states in Europe wanted something in the Balkans. Russia wanted land for sea ports. They couldn? T usage thiers by the Black Sea becasue they hads to go through through aturkey and they were enemies with Turkey. They besides couldn? T use the 1 by the Pacific Ocean becsue it ever froze. Germany wanted a railway that went from Beryn to Baghdad. The railway would travel threw Austria-Hungary. That? s why Germany made an confederation with austria-Hungary and Germany. It besides had to travel threw Turkey so Germany made an confederation with them in 1914. Austria-Hungary wanted sea ports every bit good. Italy wanted natrual resorces. The people in the Balkans though, wanted all the large states out and they wanted to go portion of Serbia. All of this was slightly and illustration of Imperialism. Imperialism is a forigen policy where a state tries to benifit it? s ego at the disbursal of other states. All the large states were jus utilizing the Balkans for what they wanted. Another manner that the confederations are a signifier of Imperialism is that possibly state D has nil has nil against state A, but they? rhenium still contending. Besides, state D has to blow their soldiers becasue they had an confederation with state D had confederation with state B. In order to hold Imperialism you need to ahve a stronge ground forces and navy. England had the strongest naval forcess so they had the biggest imperium. Austria-Hungary and Turkey besides had large imperiums. Germany and France were merely get downing. The lone topographic point left to acquire settlements was Africa, but it wasn? t large plenty. All the states compeated for settlements. This reinforced bad realationships between some states. becasue they were all compesting and nto all the states really got settlements. It was merely a affair of clip before the war started. All of these elemnt together casued World War I. Not merely one factor casued it. Now merely one little thing would casue the war. These are short scope casues. Such as the Balkan Wars and the blackwash of Archduke Ferdinand. These were the short scope casues. Archduke Ferdinand got assassinated on June 28, 1914. Austria-Hungary sent Serbia and ultimatum and said that they had to acknowledge to the violent death of Archduke Ferdinand and to halt seeking to acquire Bosnia off from Austria-Hungary. Leaderships from other states besides tried to convert other leaders to halt the war, but Serbia refused. Austria-Hungary gave Serbia one month to fofill the ultimatum. On July 28. 1914, World War I began. Therefore, many asspects caused World War I. Some of which are the Franco-Prussian War, patriotism, militerism, imperialism and confederations.

Analysis of the French & Indian War essays

Analysis of the French & Indian War essays The ostensible reason of rivalry caused the French Both England and France shared an uncertain, dangerous border in Quebec and Montreal and their Indian allies; this was the spark to ignite the war. Massachusetts soldiers captured French fortresses in Louisbourg, Nova Scotia. From 1754-176l, British In 1747, Virginians formed the Ohio Company. The Company obtained a grant from the king requesting 200,000 acres of forests aside to the Monongahela, Allegheny, and Ohio Rivers. Virginians were interested in this land because of the profits from the resale of land. The French had already settled in this territory. The British were interested in blocking advances of French as well. So, Virginia Governor, Robert Dinwiddie, sent George Washington to warn French that they were on Virginia Land. In the spring of 1754, a small military British force with George Washington went searching for nine-hundred French troops; Washington recruited the Indian support of two dozen Mingos. This was the opening battle of what came to be called the French The French had no intention of departing ...

Using the French Expression Bien Sûr

Using the French Expression Bien Sà »r Bien sà »r,  pronounced  byeh(n) soor, is an adverb that means literally very sure, but in everyday use, this French phrase  has come to mean of course and certainly. It is one of the most common idiomatic expressions in the French language, and other European speakers have informally adopted it as well. There are also more colloquial translations of  bien sà »r  that reveal its  versatility. These include: Oh yes  Sure I will  Of course, we do  Sure  Sure thing  By all meansYes indeed  I sure will Bien Sà »r as a Response The French expression bien sà »r  is most often used as a stand-alone response to a question or statement: Est-ce que tu viens la fà ªte ?   Are you coming to the party?Bien sà »r !   Of course! Un moment, sil vous plaà ®t.   Just a moment, please.Bien sà »r.   Of course. Tu me donnes mon stylo ?   Can you give me my pen?Bien  sà »r, voici.   Sure, here it is. Bien Sà »r as a Link ​Bien sà »r can link clauses and ideas: Jai besoin de ton assistance, et bien sà »r je te payerai.   I need your help, and of course Ill pay you. Nous allons visiter le monument franà §ais le plus cà ©là ¨bre, je parle bien sà »r de la tour Eiffel.   Were going to visit the most famous French monument; Im speaking of course about the Eiffel Tower. The Ironic Bien Sà »r The phrase can also be used ironically: Je meurs de faim, et bien sà »r jai oublià © mon portefeuille.   Im starving  and of course I forgot my wallet. Nous sommes pressà ©s, et Lise est en retard, bien sà »r.   We in a hurry, and Lise, of course, is running late. Bien Sà »r Que Oui / Bien Sà »r Que Non Bien sà »r can be followed by que oui to be even more emphatic (of course yes)  or que non  (of course not): Tu le veux ?   Do you want it?Bien sà »r que oui.   I certainly do. / Of course I do. Ne vas-tu pas y aller ? Arent you going to go?Bien sà »r que non.   Of course not. The Conjunctive  Bien Sà »r Que Bien sà »r can also be followed by que plus a subordinate clause.  Bien  sà »r  que  functions as a conjunction: Bien sà »r quil va luniversità ©.   Of course hes going to college. Bien sà »r que nous mangerons ensemble.   Of course well eat together. Bien sà »r quelle navait rien compris  !   Of course, she hadnt understood a thing! Synonyms of Bien Sà »r bien entendu  Ã‚  of course, certainlymais oui, bien sà »r   yes, of coursecertainement  Ã‚  certainlycertes  Ã‚  certainly, admittedly, of courseà ©videmment  Ã‚  obviouslyforcà ©ment  Ã‚  necessarily, inevitablynaturellement  Ã‚  naturally, of course

Research paper Essay Example | Topics and Well Written Essays - 1750 words - 2

Research paper - Essay Example Even in the process of delivery, the female is worried whether she will have a normal or a cesarean delivery involving surgical procedures. The typical cesarean delivery leaves the mother weak and she has to take time and effort to recuperate from her labors. Apart from that, the pain of the surgical procedure makes women dread the prospect of a normal delivery and they would like to do anything to avoid it. This paper focuses on the usefulness and value of parent craft classes in reducing the fears of the females awaiting delivery, by arming them with the required knowledge and confidence in going through even a cesarean delivery. A sample of 30 females awaiting delivery were surveyed and interviewed at a local hospital to get an idea of how much attending parent craft classes helped in assuaging their fears of even a normal delivery. Background The process of childbirth is still one of the world’s scientific miracles. Though medical science has progressed in great strides al ong this path, we still marvel at the intricacies of fertilization, conception and delivery. There are so many different variables and intrinsic and extrinsic factors that can affect the entire process that it is a wonder nevertheless how the whole process goes from start to finish. We have managed feats like invitro-fertilization, test tube babies, cloning, surrogate parenthood and what not, yet there is no disputing the fact that the process of pregnancy is still one of nature’s modern miracles. Medical science may take all the wait and wonder out of the process, even regarding the sex of the child, and reduce it to mechanical principles, but that does in no way reduce its importance. The delivery of a new born child after nine months in its mother’s womb is no less of an event- in fact it is the culmination of the entire process of pregnancy and the result is a healthy breathing baby that is ready to add its voice to the world. Deliveries can be touch and go, from t he simple to the complex, and that is why doctors, surgeons and gynaecologists spend months preparing the would-be mothers in all aspects from diet to exercise and rest, to noting the signs that delivery is imminent. As midwives, we are part and parcel of the delivery process and clients even confide some of their personal feelings and apprehensions regarding delivery and its complications to the surgeon or the midwife as delivery time comes near. Many are concerned about the chances of a normal delivery as compared to a caesarean one, and this remains one of their chief concerns. This paper will show the importance of parent craft classes in reducing the fears and apprehensions of the would–be mother and helping her manage the delivery process in a much more knowledgeable and ready manner. In recent decades, as medical science progressed and customer service and care took on an increasingly important role, involving one or both parents in the process of delivery and pre-nata l and post-natal care also became more important. In fact you would be hard pressed to find a hospital in the UK these days that does not impress upon first time parents, the need for Lamaze and Parent Craft classes. The importance in the nuclear family is all the more accentuated, as the new parents have less help and almost no experience to fall back on in case of issues regarding infant care and health. At the

The strategic management processes of KPMG Assignment

The strategic management processes of KPMG - Assignment Example This essay explores the Human Resource Management (HRM) practices of the company with focus given on the management of employee resources, employee voice and employee relations so as to understand the effectiveness of the management of KPMG in strategically managing the most significant resource of the organization which is the people resource. In relation to the study the company which has been selected is KPMG as one of the biggest professional services and consulting firm in the world. Along with Ernst & Young, PricewaterhouseCoopers and Deloitte Touchà © Consulting, KPMG is one of the Big Four auditing companies in the globe. The headquarters of the company are located in Amstelveen, Netherlands. KPMG is one of the most famous and preferred employers in the financial services sector. Currently, the company employs more than 162000 people in more than 16 geographical locations. The company has three main divisions of service which are advisory, Tax and audio services. The audit s ervices account for 42% of the revenues as of 2014, the advisory services account for 37% and the tax services account for 21% of the total revenue generated by the consulting firm in the year 2014. The company has been able to establish and maintain an ethical, sustainable and responsible image for the business over the years of its operations through a number of strategic management processes including employee management and Corporate Social Responsibility (CSR) activities.

Is there Democratic Deficit in the EU?

Is there Democratic Deficit in the EU? It is argued by many commentators[1] that there exists a `democratic deficit` within the European Union although others argue[2] that there exists no such `democratic deficit`, there are also those who acknowledge the existence of a `democratic deficit` but that argue that it is not problematic[3]. This assignment will look at those arguments and consider whether or not in despite of numerous reforms the democratic credentials of the EC still remain a concern. This argument will be considered in light of the evolving nature and the role of parliament. It is important first to understand what is meant by the `democratic deficit`. It is difficult to find a common definition however, in basic terms this argument suggests that the European Parliament as the only directly elected body holds too minor a role in the legislative process. Supporters of the `democratic deficit` argument, argue that the European Parliament, as the only elected and democratic element of the European Community, should exert more power over the legislative process and that the current situation means that the legislative process is controlled by the non-elected Council. It is argued that one of the major problems that this `democratic deficit` creates is a possibility that â€Å"a small minority in a state could be over-represented in the intergovernmental process and thus be able to impose its preferences even in the face of an overwhelming European majority†[4] Conversely those that support the notion that the current situation does not create a `democratic deficit` point to the fact that public interest in elections to the European Parliament is low[5] and as Bermann points out â€Å"participation in elections for European Parliament in June 2004 dropped to a record low of 45.3 percent across the twenty-five member states.† The argument is therefore that even though the MEP’s are, in theory elected by the public, in reality they are not supported by the majority and if they were provided with greater power it would be of little relevance to persons within a member state. This supports the argument, which will be discussed later, that the solution is not to increase the power of the European Parliament but to increase the power of member states within the legislative process. In order to understand the evolution of the European Parliament it is important to consider briefly the legislative process and the growth of European Parliament’s role in that process. Originally a limited number of Treaty Articles[6] provided that the Council was required to consult the European Parliament as to its opinion before arriving at a decision on Community secondary law[7]. This position was confirmed by the case of Roquette Freres SA v Commission[8], although the Council was permitted to ignore and overrule any opinion expressed by the European Parliament[9]. The Maastricht reforms amended Art 251. The new regime creates a co-decision procedure whereby the European Parliament can reject a legislative proposal. Once the European Parliament has provided its views on a legislative proposal, the Council shall adopt a common position by a qualified majority. The European Parliament can, within three months, either approve or take no decision in which case the Council can adopt the measure. Alternatively the European Parliament can reject or amend the proposal by an absolute majority, if this situation occurs then the Council can approve those amendments by a qualified majority within a three month time limit. However if the Commission has issued a negative opinion on the amendments, the Council are only able to approve by unanimity. If the Council does then not agree this amended proposal it will be referred to a new Conciliation Committee to in an effort to accomplish a compromise within six weeks. If a joint text is approved, the Council and European Parliament can then accept the provision together within six weeks and the European Parliament may finally reject it within six weeks by an absolute majority. It is arguable that these reforms do not go far enough in addressing the `democratic deficit` and that they only provide a negative power of veto and in addition they will only apply to limited specific areas. Further changes were introduced by the Treaty of Amsterdam, which whilst go someway to decreasing the democratic deficit do not, it is argued, go far enough. The Treaty of Amsterdam increased the use of and streamlined the co-decision procedure. The Treaty also extended the areas in which the assent of the Parliament is to be required to incorporate the structural and cohesion funds. However, it is pointed out that these do not actually increase the level of participation of the European Parliament and its capacity to insist on a specific measure and thus do little to reduce the `democratic deficit` and make the Union more democratic[10]. Finally changes were implemented via the Nice Treaty, although these were very limited in scope and did little to improve the `democratic deficit`. Although they it did extend the Qualified Majority Voting into new areas and also increased the effect of the co-decision procedure which was extended to include more treaty articles. The changes proposed in the Constitution for Europe[11] are likely to set the foundation of the legislative procedures for many years to come and in this regard they are very important. There are essentially three main changes that are proposed by the constitution which seek to improve the `democratic deficit`. The first of these is that there should be more involvement of the European Parliament in the adoption of all EU legislation and this is to be achieved by greater use of the â€Å"Co-decision procedure†, which it is intended, will be the normal procedure for enactment of legislation. The second change that is proposed by the Constitution is that the member states’ parliament has a greater involvement. One of the main proposals is to enact a procedure whereby national parliaments can register formal objections to a European Commission proposal because it failed to respect the principle of subsidiarity[12]. The final proposal is that Council meetings must be public or televised where legislative procedures are being discussed or voted upon, whether or not these proposals will rectify the `democratic deficit` remains to be seen. It is too early to conclude whether or not this will solve the problem. There are two main suggestions for the improvement of democracy in Europe. The first argument, and the one which has been the subject of this assignment, is to increase the power of the European Parliament. The second suggestion involves increasing the power of national parliaments in the legislative process as the general public have little interest in who is elected into the European Parliament. Steiner and Woods consider this second argument but conclude that â€Å"at the level of individual pieces of legislation, national parliaments become involved in the process too late to have any real impact on the outcome, and the level of control exercised by the individual national parliaments may vary significantly between Member States[13]†. Despite the increased power given to the European Parliament following the various treaties that have been discussed above, and as Weiler points out, the European Parliament â€Å"is still characterised by a lesser degree of parliamentary representation and majority decision making in the European political process than its counterparts in national democracies[14]†. However Dehousse[15] argues that the argument that there is a democratic deficit is fundamentally flawed and that the EU encounters similar problems with democracy as are encountered in domestic systems and that some of the â€Å"loudest complaints over a European democratic deficit may be based on idealisations of democracy in the nation-state†. Those who do not support the concept of a `democratic deficit` argue that â€Å"the preoccupation with the concept of democratic deficit is limiting and does little to improve our understanding of the role of the European Parliament†[16]. Finally, Majone argu es that the EU is a â€Å"regulatory state-a state which despite its democratic deficit can be accountable†[17]. Having considered the arguments it seems clear that perhaps one of the primary reasons for the belief that there exists a `democratic deficit` is that powers that were once controlled by national parliaments have now been transferred to the EU where they are subject to a lower degree of parliamentary participation[18]. Therefore it is argued that the `democratic deficit` does exist, but only in so far as it does not match political ideologies and does not mirror the political system of other member states. It is arguable that deficit does not in fact exist and that the EU system is simply different to member states political systems. Even if it could be concluded that a `democratic deficit` did exist how to correct this deficit is problematic in itself. Some argue that a democratic model similar to that of the state should be developed whereas others argue that democracy can only be achieved through national democracies.[19] One certainty is that it is an argument that will not be se ttled in the near future and it is doubtful that the constitution will resolve the problem to the satisfaction of all member states. Bibliography Cases EP v Council (C-65/91) Parliament v Council (C-392/95) Roquette Freres SA v Commission (Case 20/88) [1989] ECR 1553 Treaties Maastricht Treaty 1997 Nice Treaty Treaty of Amsterdam 1997 Journal Articles Barnard C, Dashwood A, (2006) â€Å"The EU Constitution – Dealing with the Deficit†, 156 New Law Journal 173 Bermann G, Monet J Gelhorn W, (2005) â€Å"Executive Power in the New European Constitution†, International Journal of constitutional Law 3.2 (440) Maduro M, (2005) â€Å"The Importance of Being Called a Constitution: Constitutional Authority and the Authority of Constitutionalism†, International Journal of Constitutional Law 3.2 (332) Majone G, (1998) â€Å"Europes Democratic Deficit: The Question of Standards†4 European Law Journal 5 Weiler J, (2005) â€Å"On the Power of the Word: Europe’s Constitutional Iconography†, International Journal of Constitutional Law 3.2 (173) Books Craig P De Bà ºrca G, (2003)†EU Law, Text, Cases and Materials, Third Edition, Oxford University Press Fairhurst J , (2004) â€Å"Law of the European Union†, Fifth Edition, Pearson Longman Harlow C, (2002) â€Å"Accountability in The European Union†, Oxford University Press, Oxford Hartley T, (2003) â€Å"The Foundations of European Community Law†, Fifth Edition, Oxford University Press Horspool M Humphreys M, (2006) â€Å"European Union Law†, Oxford University Press Lenaerts K Van Nuffel P,(2005)†Constitutional Law of the European Union†, Second Edition, Sweet and Maxwell Steiner J Woods L, (2003) â€Å"Textbook on EC Law†, Eighth Edition, Oxford University Press Weatherill S, (2005) â€Å"Cases and Materials on EU Law†, Seventh Edition, Oxford University Press Weiler J Winds M (eds) (2003) â€Å"European Constitutionalism Beyond the State†, Cambridge University Press Websites http://european-convention.eu.int/ accessed on 21.10.2006 1 Footnotes [1] See for example the comments of Weiler J, (2005) â€Å"On the Power of the Word: Europe’s Constitutional Iconography†, International Journal of Constitutional Law 3.2 (173) [2] See for example the comments of Dehousse R in Weiler J Winds M (eds) (2003) â€Å"European Constitutionalism Beyond the State†, Cambridge University Press [3] See for example Majone G, (1998) â€Å"Europes Democratic Deficit: The Question of Standards†4 European Law Journal 5 [4] Weiler J, (2005) â€Å"On the Power of the Word: Europe’s Constitutional Iconography†, International Journal of Constitutional Law 3.2 (173) [5] Bermann G, Monet J Gelhorn W, (2005) â€Å"Executive Power in the New European Constitution†, International Journal of constitutional Law 3.2 (440) [6] 17 [7] old Arts 54 or 56 [8] (Case 20/88) [1989] ECR 1553 [9] Although consider EP v Council (C-65/91) and Parliament v Council (C-392/95) where the Court annulled Regulations which the Council had amended without further Consultation to the European Parliament. [10]Lenaerts K Van Nuffel P,(2005)†Constitutional Law of the European Union†, Second Edition, Sweet and Maxwell at page [11] http://european-convention.eu.int/ accessed on 21.10.2006 [12] For further discussion see Barnard C, Dashwood A , (2006) â€Å"The EU Constitution – Dealing with the Deficit†, 156 New Law Journal 173 [13] Steiner J Woods L, (2003) â€Å"Textbook on EC Law†, Eighth Edition, Oxford University Press at page 25 [14]Weiler J, (2005) â€Å"On the Power of the Word: Europe’s Constitutional Iconography†, International Journal of Constitutional Law 3.2 (173) [15]Dehousse R in Weiler J Winds M (eds) (2003) â€Å"European Constitutionalism Beyond the State†, Cambridge University Press – Chapter 6 Page 135 [16] Harlow C, (2002) â€Å"Accountability in The European Union†, Oxford University Press, Oxford See Chapter 1 generally [17] Majone G, (1998) â€Å"Europes Democratic Deficit: The Question of Standards†4 European Law Journal 5 [18] Maduro M, (2005) â€Å"The Importance of Being Called a Constitution: Constitutional Authority and the Authority of Constitutionalism†, International Journal of Constitutional Law 3.2 (332) [19] Maduro M, (2005) â€Å"The Importance of Being Called a Constitution: Constitutional Authority and the Authority of Constitutionalism†, International Journal of Constitutional Law 3.2 (332)