9 research outputs found
Why Dealing with Climate Change Means Democratizing Climate Governance
The paper analyses how the quality of democracy influences the climate
performance of established democracies. Two analyses compare established
democracies based on their level of democracy and detect internal mechanisms
to understand their different reactions to climate change. Therewith, the
paper contributes to the question how transformative global climate governance
“après Paris” can be translated successfully into national circumstances.
Findings demonstrate that a higher quality of democracy influences climate
performance for the most part positively. The positive influence of the
quality of democracy, evaluated by empirical translations of control, equality
and freedom, can be observed regarding output (policy targets etc.) and with
certain limitations regarding outcome (GHG emission development). Research
results are robust and show synergy in terms of detailed mechanisms verifying
statistical trends. An initially outlined concept of democratic efficacy
explains these findings by theorizing that democracy’s ability to produce
desired and intended climate performances rises with increasing quality of
democracy. Empirical analysis is conducted by applying an explanatory mixed
methods design. Firstly, panel regressions deliver trends on the influence of
the quality of democracy, as measured by the Democracy Barometer, on climate
performance, as measured by the Climate Change Performance Index. Depending on
combination of data, the number of countries ranges from 39 to 41 in 2004 to
2012 resulting in 193 to 326 country-years. Secondly, a case study of Canada’s
Kyoto Protocol process from 1995 to 2012 follows, providing detailed insights
into the mechanisms of the quality of democracy and climate performance. The
findings are based on documentary analysis and 27 interviews with former
ministers, MPs, NGOs, Think Tanks etc. The fundamental practical implication
of the paper can be translated into specific policy recommendations but is as
simple as complex: to overcome democratic shortcomings and thus democratize
climate governance to make it more efficacious
Deep-time organizations: Learning institutional longevity from history
The Anthropocene as a new planetary epoch has brought to the foreground the deep-time interconnections of human agency with the earth system. Yet despite this recognition of strong temporal interdependencies, we still lack understanding of how societal and political organizations can manage interconnections that span several centuries and dozens of generations. This study pioneers the analysis of what we call ?deep-time organizations.? We provide detailed comparative historical analyses of some of the oldest existing organizations worldwide from a variety of sectors, from the world?s oldest bank (Sveriges Riksbank) to the world?s oldest university (University of Al Quaraouiyine) and the world?s oldest dynasty (Imperial House of Japan). Based on our analysis, we formulate 12 initial design principles that could lay, if supported by further empirical research along similar lines, the basis for the construction and design of ?deep-time organizations? for long-term challenges of earth system governance and planetary stewardship
Deep-time organizations: Learning institutional longevity from history
The Anthropocene as a new planetary epoch has brought to the foreground the deep-time interconnections of human agency with the earth system. Yet despite this recognition of strong temporal interdependencies, we still lack understanding of how societal and political organizations can manage interconnections that span several centuries and dozens of generations. This study pioneers the analysis of what we call ?deep-time organizations.? We provide detailed comparative historical analyses of some of the oldest existing organizations worldwide from a variety of sectors, from the world?s oldest bank (Sveriges Riksbank) to the world?s oldest university (University of Al Quaraouiyine) and the world?s oldest dynasty (Imperial House of Japan). Based on our analysis, we formulate 12 initial design principles that could lay, if supported by further empirical research along similar lines, the basis for the construction and design of ?deep-time organizations? for long-term challenges of earth system governance and planetary stewardship
The temporal cleavage: the case of populist retrotopia vs. climate emergency
How do time perceptions politicize contestation in the case of climate politics? We argue that across Western Europe and North America, contestation in the climate case and beyond forms along an emerging temporal dividing line. The climate movement’s reference to the scientific understanding of climate with its nonnegotiable timescales is at odds with populism’s Great Again ‘retrotopias’ referring to a romanticized fossil fuel past in which climate change is nonexistent. We understand these two distinct temporal positions within society as represented by sometimers and anytimers with each having their very own social structure, collective identity, and organizational manifestation. If supported by further studies, the generalized characteristics of sometimers and anytimers will allow for the development of a substantial temporal cleavage that might be indicative for the Anthropocene.publishedVersio
Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial
Background:
Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor.
Methods:
The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population).
Findings:
Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI.
Interpretation:
In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk