View from the Top: How Corporate Boards Can Engage on Sustainability Performance

Corporate boards are responsible for overseeing the interests of shareholders in the long term and have a critical role to play in championing sustainability across the enterprise. Over the years, Wall Street research, academic papers, corporate reports and trends from major investors have all underscored the same message: Companies that adopt sustainable practices deliver superior financial results and can face the future with more resilience.Based on interviews conducted with dozens of corporate directors, senior corporate leaders and governance experts, this Ceres report identifies key strategies for effective board engagement that can produce tangible environmental and social impacts. Specifically, the report recommends two inter-related approaches for weaving sustainability more deeply across board functions:Integrating sustainability into board governance systems, andIntegrating sustainability into board actions.By combining robust systems and meaningful actions, boards will have a far better chance of encouraging substantive performance improvements

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Climate Change Is a Systemic Financial Risk

The U.S. Commodity Futures Trading Commission (CFTC) issued a report last month on the impact of climate change that landed like a thunderbolt. The bipartisan report, adopted by a subcommittee of the Commission’s Market Risk Advisory Committee, declared climate change to be a major financial risk to the U.S. economy and recommended a package of actions financial regulators should take to address this risk, including putting a price on carbon. It is one thing for a sustainability organization like the one I work for to issue such a report. For a subcommittee of a major U.S. financial regulator to do so is another thing altogether. The report’s issuance is even more extraordinary when you consider the wide range of perspectives expressed by the subcommittee’s members—including representatives from major banks, institutional investors, power sector companies, and environmental groups. The report is testament to both the urgent need for regulatory action and an emerging universal understanding of climate risks. The devastating impacts of climate change have come into plain view. Only now are Americans living on the West Coast finally able to step outside again after a devastating season of climate-exacerbated wildfires. The Southeast is picking up the pieces from a record-setting series of climate-worsened hurricanes. The Midwest has endured pummeling hail storms. So far this year, climate-related disasters have caused $16 billion in damages. And it is not just the physical impacts of climate that are coming to bear. The economic risks associated with a disjointed and disorderly shift away from fossils fuels is playing out as well. With the pandemic accelerating the high-carbon industry’s long-foreseen decline, oil and gas companies around the world wrote down nearly$90 billion worth of assets during the first quarter of 2020 alone. A new report from Ceres found that the risks of shifting to a lower carbon economy could cost the U.S. banking sector hundreds of billions of dollars. Climate change-based litigation is on the rise as well. In this context, the CFTC’s release of its advisory subcommittee’s report signifies an inflection point. It is no longer just advocates, investors, or lawmakers calling for changes to financial regulation that better mitigate climate risk—it is increasingly the regulators themselves making these pleas. With a U.S. presidential election upon us and a potential for a new Administration and new regulatory appointments, climate regulation of the financial sector could come faster than anticipated. Here are a few key truths that corporate legal counsels should know about the CFTC subcommittee’s report on climate risk and potential regulatory changes that could be looming: Change is coming down the pike. It would behoove corporate managers and directors to begin to engage with this changing regulatory landscape. Corporate counsels can prepare their companies by taking steps now to plan for a regulatory environment that accurately reflects the systemic risk of climate change. Investors, lawmakers, and even regulators themselves are pushing for these changes. Even federal regulatory agencies are starting to sound the alarm bells. Companies should act accordingly so that they can plan for and contribute to this new regulatory reality. It seems to be coming whether we are ready or not

Climate Change Is a Systemic Financial Risk

The U.S. Commodity Futures Trading Commission (CFTC) issued a report last month on the impact of climate change that landed like a thunderbolt. The bipartisan report, adopted by a subcommittee of the Commission’s Market Risk Advisory Committee, declared climate change to be a major financial risk to the U.S. economy and recommended a package of actions financial regulators should take to address this risk, including putting a price on carbon. It is one thing for a sustainability organization like the one I work for to issue such a report. For a subcommittee of a major U.S. financial regulator to do so is another thing altogether. The report’s issuance is even more extraordinary when you consider the wide range of perspectives expressed by the subcommittee’s members—including representatives from major banks, institutional investors, power sector companies, and environmental groups. The report is testament to both the urgent need for regulatory action and an emerging universal understanding of climate risks. The devastating impacts of climate change have come into plain view. Only now are Americans living on the West Coast finally able to step outside again after a devastating season of climate-exacerbated wildfires. The Southeast is picking up the pieces from a record-setting series of climate-worsened hurricanes. The Midwest has endured pummeling hail storms. So far this year, climate-related disasters have caused $16 billion in damages. And it is not just the physical impacts of climate that are coming to bear. The economic risks associated with a disjointed and disorderly shift away from fossils fuels is playing out as well. With the pandemic accelerating the high-carbon industry’s long-foreseen decline, oil and gas companies around the world wrote down nearly$90 billion worth of assets during the first quarter of 2020 alone. A new report from Ceres found that the risks of shifting to a lower carbon economy could cost the U.S. banking sector hundreds of billions of dollars. Climate change-based litigation is on the rise as well. In this context, the CFTC’s release of its advisory subcommittee’s report signifies an inflection point. It is no longer just advocates, investors, or lawmakers calling for changes to financial regulation that better mitigate climate risk—it is increasingly the regulators themselves making these pleas. With a U.S. presidential election upon us and a potential for a new Administration and new regulatory appointments, climate regulation of the financial sector could come faster than anticipated. Here are a few key truths that corporate legal counsels should know about the CFTC subcommittee’s report on climate risk and potential regulatory changes that could be looming: Change is coming down the pike. It would behoove corporate managers and directors to begin to engage with this changing regulatory landscape. Corporate counsels can prepare their companies by taking steps now to plan for a regulatory environment that accurately reflects the systemic risk of climate change. Investors, lawmakers, and even regulators themselves are pushing for these changes. Even federal regulatory agencies are starting to sound the alarm bells. Companies should act accordingly so that they can plan for and contribute to this new regulatory reality. It seems to be coming whether we are ready or not

Inflammation-induced PELP1 expression promotes tumorigenesis by activating GM-CSF paracrine secretion in the tumor microenvironment

The inflammatory tumor microenvironment has been implicated as a major player fueling tumor progression and an enabling characteristic of cancer, proline, glutamic acid, and leucine-rich protein 1 (PELP1) is a novel nuclear receptor coregulator that signals across diverse signaling networks, and its expression is altered in several cancers. However, investigations to find the role of PELP1 in inflammation-driven oncogenesis are limited. Molecular studies here, utilizing macrophage cell lines and animal models upon stimulation with lipopolysaccharide (LPS) or necrotic cells, showed that PELP1 is an inflammation-inducible gene. Studies on the PELP1 promoter and its mutant identified potential binding of c-Rel, an NF-κB transcription factor subunit, to PELP1 promoter upon LPS stimulation in macrophages. Recruitment of c-Rel onto the PELP1 promoter was validated by chromatin immunoprecipitation, further confirming LPS mediated PELP1 expression through c-Rel–specific transcriptional regulation. Macrophages that overexpress PELP1 induces granulocyte–macrophage colony-stimulating factor secretion, which mediates cancer progression in a paracrine manner. Results from preclinical studies with normal–inflammatory–tumor progression models demonstrated a progressive increase in the PELP1 expression, supporting this link between inflammation and cancer. In addition, animal studies demonstrated the connection of PELP1 in inflammation-directed cancer progression. Taken together, our findings provide the first report on c-Rel–specific transcriptional regulation of PELP1 in inflammation and possible granulocyte–macrophage colony-stimulating factor–mediated transformation potential of activated macrophages on epithelial cells in the inflammatory tumor microenvironment, reiterating the link between PELP1 and inflammation-induced oncogenesis. Understanding the regulatory mechanisms of PELP1 may help in designing better therapeutics to cure various inflammation-associated malignancies