Environmental justice: human health and environmental inequalities

Annual Review of Public Health, 27: pp. 103-124.In this review, we provide an introduction to the topics of environmental justice and environmental inequality. We provide an overview of the dimensions of unequal exposures to environmental pollution (environmental inequality), followed by a discussion of the theoretical literature that seeks to explain the origins of this phenomenon. We also consider the impact of the environmental justice movement in the United States and the role that federal and state governments have developed to address environmental inequalities. We conclude that more research is needed that links environmental inequalities with public health outcomes

Competence profiles in undergraduate dental education : a comparison between theory and reality

Background: Competence profiles are purposed to provide a blueprint in support to develop and/or benchmark the learning outcomes of undergraduate dental curricula. This study aims to investigate whether a competence profile as proposed by academic- and clinical experts is able to represent the real clinical reality. Methods: A questionnaire was developed including questions about gender and age, perception about required competences, and educational organisation and was distributed among Flemish dentists via email and on paper during a symposium. The data was analysed using descriptive statistics, Chi-square and non-parametric Mann-Whitney U-tests. Results: A total of 312 questionnaires were completed (=6.5% of dentist population, with similar gender and age characteristics). All competences in the European competence profile were rated between 7.2 and 9.4 on a 10-point scale. In dentists under 50 years, females rated the importance of identifying/managing anxiety and abnormal patient behaviour; and promoting/improving oral health as significantly higher than males. In dentists of 50 years and above, females rated 8 competences significantly higher than males, including obtaining/recording a complete history; identifying/managing anxiety and abnormal patient behaviour; obtaining/interpreting radiography; identifying temporomandibular and associated disorders; identifying orthodontic needs; awareness of own limitations/when to refer; managing dental urgencies; and basic-life-support/defibrillation. Clinical practice management was most frequently reported as additional competence to address in dental education. Furthermore, the respondents suggested an undergraduate dental curriculum based on 34% theoretical education, 26% preclinical skills training, and 40% clinical education and 86% agreed with a duration of 5 years. Finally, the respondents also illustrated the dynamic nature of dentistry including a reduction of amalgam fillings, a shift from individual practice to group practices, an increased administrative load, and more assertive patients. Conclusion: Findings in the present study suggest the validation of the proposed competences for graduating European dentists within the clinical reality of dental professionals in daily practice. Nevertheless, the results have also demonstrated heterogeneity regarding gender and age within the dentist population and emphasised a continuously evolving dental profession and required competences. Hence, to maintain high quality of dental care, a strategy should be developed in which dental curricula are continuously benchmarked against an evolving clinical reality

Advertising, individual consumption levels, and the natural environment, 1900–2000

Sociological Inquiry, 77(4): pp. 21.One central determinant of global environmental change is the continued expansion of personal consumption levels. In order to more fully understand the relationship between consumption and environmental degradation, the determinants of consumption must first be identified. Prior research in this area has focused on economic factors, primarily personal disposable income and population demographic characteristics. The role of cultural factors, including advertising, has been actively mentioned in theoretical analyses of the driving forces of individual consumption. However, this has not been empirically tested. In this article, we conduct an analysis of the impact of advertising on consumption levels in the United States. We start with a theoretical discussion of the literature on advertising and consumption. Based on this literature, we establish three hypotheses regarding the relationship between advertising expenditure and personal consumption. These hypotheses are then tested using time series analysis over the time period 1900–2000. The results show that advertising significantly impacts overall consumption and that these effects vary by type of consumption. We conclude with a discussion of the implications of this analysis for further research into the driving forces of global environmental change

Patient-level meta-analysis of the EDITION 1, 2 and 3 studies : glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus glargine 100 U/ml in people with type 2 diabetes

AimsTo conduct a patient-level meta-analysis of the EDITION 1, 2 and 3 studies, which compared the efficacy and safety of new insulin glargine 300 U/ml (Gla-300) with insulin glargine 100 U/ml (Gla-100) in people with type 2 diabetes (T2DM) on basal and mealtime insulin, basal insulin and oral antihyperglycaemic drugs, or no prior insulin, respectively. MethodsThe EDITION studies were multicentre, randomized, open-label, parallel-group, phase IIIa studies, with similar designs and endpoints. A patient-level meta-analysis of the studies enabled these endpoints to be examined over 6 months in a large population with T2DM (Gla-300, n = 1247; Gla-100, n = 1249). ResultsNo significant study-by-treatment interactions across studies were found, enabling them to be pooled. The mean change in glycated haemoglobin was comparable for Gla-300 and Gla-100 [each -1.02 (standard error 0.03)%; least squares (LS) mean difference 0.00 (95% confidence interval (CI) -0.08 to 0.07)%]. Annualized rates of confirmed (3.9 mmol/l) or severe hypoglycaemia were lower with Gla-300 than with Gla-100 during the night (31% difference in rate ratio over 6 months) and at any time (24 h, 14% difference). Consistent reductions were observed in percentage of participants with 1 hypoglycaemic event. Severe hypoglycaemia at any time (24 h) was rare (Gla-300: 2.3%; Gla-100: 2.6%). Weight gain was low ( ConclusionGla-300 provides comparable glycaemic control to Gla-100 in a large population with a broad clinical spectrum of T2DM, with consistently less hypoglycaemia at any time of day and less nocturnal hypoglycaemia.Peer reviewe

Agricultural trade publications and the 2012 Midwestern U.S. drought: a missed opportunity for climate risk communication

The Midwestern United States experienced a devastating drought in 2012, leading to reduced corn and soybean yields and increased instances of pests and disease. Climate change induced weather variability and extremes are expected to increase in the future, and have and will continue to impact the agricultural sector. This study investigated how agricultural trade publications portrayed the 2012 U.S. Midwestern drought, whether climate change was associated with drought, and whether these publications laid out transformative adaptation measures farmers could undertake in order to increase their adaptive capacity for future climate uncertainty. We performed a content analysis of 1000 media reports between April 1, 2012 and March 31, 2014, sampled from ten agricultural trade publications. The results lead us to suggest that trade publications’ 2012 U.S. Midwestern drought discussion lacked information that would allow farmers and agricultural advisors to assess climate change risk and subsequent potential adaptive management strategies. Agricultural risk from climate change is very real, and farmers will need to adapt. The agricultural trade publications studied missed an opportunity to convey risk from climate change and the transformative adaptation practices necessary for a sustainable and resilient agricultural system

Glycaemic control and hypoglycaemia risk with insulin glargine 300 U/mL versus glargine 100 U/mL: A patient-level meta-analysis examining older and younger adults with type 2 diabetes

Abstract Aim Older people with type 2 diabetes (T2DM) are at an increased risk of hypoglycaemia and its consequences. However, efficacy and safety data for basal insulin therapy are limited in these individuals. This patient-level meta-analysis assessed the treatment effects of insulin glargine 300 U/mL (Gla-300) versus glargine 100 U/mL (Gla-100) in people with T2DM ≥ 65 years old. Methods Data were pooled for patients randomised to receive Gla-300 or Gla-100 in the Phase 3a, treat-to-target EDITION 1, 2 and 3 trials. Glycaemic efficacy, hypoglycaemia, changes in body weight and insulin dosage and adverse events were examined over 6 months' treatment with Gla-300 versus Gla-100 for participants aged ≥ 65 and  Results Of 2496 participants randomised, 662 were ≥ 65 years (Gla-300, n = 329; Gla-100, n = 333). Glycaemic control was comparable for Gla-300 and Gla-100 in participants ≥ 65 years (LS mean [95% CI] difference in HbA1c change from baseline to month 6: 0.00 [−0.14 to 0.15] %; 0.00 [−1.53 to 1.64] mmol/mol) and  Conclusion Gla-300 was associated with a reduced risk of nocturnal hypoglycaemia versus Gla-100, accompanied by comparable glycaemic improvement, for people aged ≥ 65 an

CSSN Research Report 2021:2: The Mises Institute Network and Climate Policy. 9 Findings

Think tanks have played a decisive role in the organised obstruction of climate action, denying, minimising, or derailing ambitious climate change mitigation. This research briefing reviews the case of the Ludwig von Mises Institutes and the Property and Freedom Society, a network of ultra-libertarian groups active around the world, which we refer to as the Mises Institute Network in the mobilisation and the dissemination of climate policy opposition discourse. We review the origins, the history, the global distribution and the climate-related output of 31 Mises Institutes between 2000 and 2021. Our analysis reveals climate obstruction messaging based on a critique of climate science, principled objections to state intervention and planning and the social forces supporting climate change mitigation, as well as advocacy of free-market environmentalism as a suitable alternative to established climate politics. While Mises social theory includes a determined critique of environmentalism, it paid limited attention to climate change before 2016. From 2016, there has been a concerted effort to disseminate climate opposition discourse featuring a clear spike in published articles during 2019. Contextually, 2019 saw the U.S. Green New Deal proposal and the European Union Green Deal decision suggesting a tipping point for advocating free-market environmentalism in response to climate change to contend the increased state intervention discourse emerging in domestic and international climate policy planning. Additionally, ties exist between scholars of Mises Institutes to a broad range of business groups ranging from gold, trade and investment firms in Germany, tobacco companies in the U.S., business school, consulting and service firms in Spain, and metal employer association and financial groups in Sweden. Furthermore, the network is engaging in an international effort to recruit new members into the ultra-libertarian movement, with an active university presence and active online campaign to spread Mises’ philosophy and recruit more members, particularly students and young people, to the movement. Despite the lack of transparency and limited evidence of fossil industry funding, the Mises Network of think tanks has a clear voice in the denial and delaying think tank train, gaining speed at this pivotal moment in time. Our results indicate a dedicated effort to spread climate change opposition messages across the network. The core ideology of the Austrian economics tradition related to Ludwig von Mises provides the climate change opposition with a straightforward repertoire of arguments. Put simply, the coordinated activities of Mises Institutes across countries illustrates an attempt to circulate widely opposition to climate policy based on the radicalism of Mises social theory that focuses on resistance to government intervention and a form of market fundamentalism as a primer to maintain business as usual at the behest of the planet