Voluntary business engagement in climate change: A study of the ClimateWise Principles

There is an expectation that the insurance sector should be leading business efforts in responding to climate change due to their inherent exposure to increasing risks. However, insurance companies normally operate on a one year time horizon - underwriting risks through policies which change each year to reflect new knowledge of these risks. The ClimateWise principles is a voluntary initiative of the insurance sector that was launched in 2007 to provide a basis for insurance companies to engage with climate change risks. This paper introduces the ClimateWise initiative and explores progress made since its launch. The paper presents new knowledge on whether this voluntary initiative provides a useful structure for the insurance sector in responding to the challenge of climate change. It finds that while the insurance sector has engaged with climate change, there is much more to do and we welcome the recent changes to ClimateWise that more accurately reflect this. The paper concludes that ClimateWise has been a useful initiative for the insurance companies and as a potential benchmark for the sector it offers some value. However, ClimateWise has not provided a strong enough engagement across the sector to embed climate action into business decisions

A cluster randomized trial of standard quality improvement versus patient-centered interventions to enhance depression care for African Americans in the primary care setting: study protocol NCT00243425

<p>Abstract</p> <p>Background</p> <p>Several studies document disparities in access to care and quality of care for depression for African Americans. Research suggests that patient attitudes and clinician communication behaviors may contribute to these disparities. Evidence links patient-centered care to improvements in mental health outcomes; therefore, quality improvement interventions that enhance this dimension of care are promising strategies to improve treatment and outcomes of depression among African Americans. This paper describes the design of the BRIDGE (Blacks Receiving Interventions for Depression and Gaining Empowerment) Study. The goal of the study is to compare the effectiveness of two interventions for African-American patients with depression--a standard quality improvement program and a patient-centered quality improvement program. The main hypothesis is that patients in the patient-centered group will have a greater reduction in their depression symptoms, higher rates of depression remission, and greater improvements in mental health functioning at six, twelve, and eighteen months than patients in the standard group. The study also examines patient ratings of care and receipt of guideline-concordant treatment for depression.</p> <p>Methods/Design</p> <p>A total of 36 primary care clinicians and 132 of their African-American patients with major depressive disorder were recruited into a cluster randomized trial. The study uses intent-to-treat analyses to compare the effectiveness of standard quality improvement interventions (academic detailing about depression guidelines for clinicians and disease-oriented care management for their patients) and patient-centered quality improvement interventions (communication skills training to enhance participatory decision-making for clinicians and care management focused on explanatory models, socio-cultural barriers, and treatment preferences for their patients) for improving outcomes over 12 months of follow-up.</p> <p>Discussion</p> <p>The BRIDGE Study includes clinicians and African-American patients in under-resourced community-based practices who have not been well-represented in clinical trials to improve depression care. The patient-centered and culturally targeted approach to depression care is a relatively new one that has not been tested in most previous studies. The study will provide evidence about whether patient-centered accommodations improve quality of care and outcomes to a greater extent than standard quality improvement strategies for African Americans with depression.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov NCT00243425</p

Guide to the Woody Ornamentals of the New York State Agricultural Experiment Station, Geneva, New York

This guide was produced for Arbor Day, 24 April 1992, by members of the Geneva Arboretum Association, based on the campus of the New York State Agricultural Experiment Station (NYSAES) in Geneva, NY. It was printed by Communications Services, NYSAES. It is 47 pages and provides maps of the campus indicating where and what all of the various plantings are. Photos were taken by Martin Goffinet and Brian Terhune. Cover design by Elaine Gotham