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Sixteen - Food security, inclusive growth, sustainability and the sustainable development agenda
- Edited by Hany Besada, Leah McMillan Polonenko, Manmohan Agarwal
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- Book:
- Did the Millennium Development Goals Work?
- Published by:
- Bristol University Press
- Published online:
- 12 April 2022
- Print publication:
- 20 September 2017, pp 395-428
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Summary
Introduction
Over the next several decades, the world faces an historic challenge and opportunity at the nexus of food security, economic development and the environment. The world needs to be food secure. The world needs agriculture to contribute to inclusive economic development, and the world needs to reduce agriculture's impact on the environment.
This nexus has several implications for policymakers as they outline and implement the 2030 Agenda for Sustainable Development, adopted by the United Nations in September 2015. Critically, this agenda has an explicit goal on food security. However, it is also important that the food security goal includes some sustainability targets and indicators.
This chapter examines the food security challenge to 2050, and lays out six core propositions related to food security and sustainability. With an eye to implications of the food security challenge for the sustainable development agenda, it then details three proposed food security targets that integrate sustainability. These targets include reducing the rate of food loss and waste, and achieving low-carbon agriculture and water-efficient food production (Table 16.1). Finally, the chapter offers some reflections on how these targets would help the world feed a growing population in a manner that alleviates poverty and advances economic development while reducing pressure on its natural resources.
The food security challenge
Over the next several decades, the world faces a grand challenge – and opportunity – at the nexus of food security, economic development and the environment.
First, the world needs to be food secure
The United Nations Population Division projects the global human population to grow from 7 billion in 2012 to 9.7 billion by 2050 (UN DESA, 2015). Half of the population growth will be in sub- Saharan Africa (UN DESA, 2015), where agricultural productivity and soil quality is exceptionally low and where reliance on imports of basic staples is already high. Moreover, at least 3 billion people are likely to enter the global middle class by 2030, and they will almost certainly demand more resource-intensive foods such as meats and vegetable oils (Foresight, 2011). At the same time, approximately 795 million of the world's poorest people remain undernourished even today (FAO, IFAD and WFP, 2015).
22 - Consent, capacity and the law
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- By Jonathan Waite, Nottinghamshire Healthcare NHS Trust, Richard Barnes, Mossley Hill Hospital, Liverpool, Daniel M. Bennett, University of Aberdeen, Donald Lyons, Mental Welfare Commission for Scotland, Declan M. McLoughlin, St Patrick's University Hospital, Dublin, Ireland, Hugh Series, Oxford Health NHS Foundation Trust
- Edited by Jonathan Waite, Andrew Easton
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- Book:
- The ECT Handbook
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 204-223
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Summary
All medical procedures, be they therapeutic or investigative, touch on the issue of consent – that is a measure of willingness on the part of the patient to undertake the procedure proposed. In this, ECT is no different to other therapeutic interventions. However, ECT has a particular status both within psychiatry and within the law that makes specific discussion of issues with regard to consent necessary.
General issues regarding consent
Electroconvulsive therapy is unusual in that consent obtained is for a course of treatments rather than for an individual procedure. It is also customary that the person seeking the consent will not be the person giving the treatment. The fact that the person receiving treatment has a psychiatric disorder sufficiently severe for ECT to be considered raises questions about their capacity; this makes it particularly important that consent is properly obtained and valid. It is unlawful and unethical to treat a patient who is capable of understanding the nature of any procedure, its purpose and implications, the anticipated benefits and any reasonably foreseeable adverse effects without first explaining it. The patient must then agree. Even if patients choose not to be informed of the full details of their diagnosis and treatment, they must be given the option of receiving this information. Guidance on good practice in consent can be found in publications from the Department of Health in England and Wales (2009), the Department of Health, Social Services and Public Safety in Northern Ireland (2003) and the Scottish Executive (2006), as well as from the General Medical Council (2008).
Obtaining valid consent should be considered a process rather than an event and it is necessary for patients to be given an adequate length of time to consider the benefits and drawbacks of the proposed treatment before making an informed decision. Patients should be informed of the risks and unwanted effects of ECT (Chapters 7–9) and they need to realise that a general anaesthetic is involved. If there are specific anaesthetic risks, the anaesthetist should explain these and obtain the necessary consent.
It is helpful for patients and carers to be provided with information obtained from different sources. Written information sheets may be useful (e.g. Appendix V); these need to be accompanied by the opportunity to discuss issues with members of the therapeutic team, family members, carers, advocates, etc.
Genome-wide association study of response to cognitive–behavioural therapy in children with anxiety disorders
- Jonathan R. I. Coleman, Kathryn J. Lester, Robert Keers, Susanna Roberts, Charles Curtis, Kristian Arendt, Susan Bögels, Peter Cooper, Cathy Creswell, Tim Dalgleish, Catharina A. Hartman, Einar R. Heiervang, Katrin Hötzel, Jennifer L. Hudson, Tina In-Albon, Kristen Lavallee, Heidi J. Lyneham, Carla E. Marin, Richard Meiser-Stedman, Talia Morris, Maaike H. Nauta, Ronald M. Rapee, Silvia Schneider, Sophie C. Schneider, Wendy K. Silverman, Mikael Thastum, Kerstin Thirlwall, Polly Waite, Gro Janne Wergeland, Gerome Breen, Thalia C. Eley
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- Journal:
- The British Journal of Psychiatry / Volume 209 / Issue 3 / September 2016
- Published online by Cambridge University Press:
- 02 January 2018, pp. 236-243
- Print publication:
- September 2016
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- Article
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Background
Anxiety disorders are common, and cognitive–behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent.
AimsTo perform the first genome-wide association study (GWAS) of psychological treatment response in children with anxiety disorders (n = 980).
MethodPresence and severity of anxiety was assessed using semi-structured interview at baseline, on completion of treatment (post-treatment), and 3 to 12 months after treatment completion (follow-up). DNA was genotyped using the Illumina Human Core Exome-12v1.0 array. Linear mixed models were used to test associations between genetic variants and response (change in symptom severity) immediately post-treatment and at 6-month follow-up.
ResultsNo variants passed a genome-wide significance threshold (P=5×10–8) in either analysis. Four variants met criteria for suggestive significance (P<5×10–6) in association with response post-treatment, and three variants in the 6-month follow-up analysis.
ConclusionsThis is the first genome-wide therapygenetic study. It suggests no common variants of very high effect underlie response to CBT. Future investigations should maximise power to detect single-variant and polygenic effects by using larger, more homogeneous cohorts.
22 - Consent, capacity and the law
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- By Jonathan Waite, Consultant Psychiatrist, Nottinghamshire Healthcare NHS Trust, Richard Barnes, Consultant in Old Age Psychiatry, Mossley Hill Hospital, Liverpool, Daniel M. Bennett, Consultant Forensic Psychiatrist, NHS Tayside, and Honorary Senior Lecturer in Psychiatry, University of Aberdeen, Donald Lyons, Mental Welfare Commission for Scotland, Declan M. McLoughlin, Research Professor of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, and St Patrick's University Hospital, Dublin, Ireland, Hugh Series, Consultant Psychiatrist, Oxford Health NHS Foundation Trust
- Edited by Jonathan Waite, Andrew Easton
-
- Book:
- The ECT Handbook
- Published online:
- 02 January 2018
- Print publication:
- 01 May 2013, pp 204-223
-
- Chapter
- Export citation
-
Summary
All medical procedures, be they therapeutic or investigative, touch on the issue of consent – that is a measure of willingness on the part of the patient to undertake the procedure proposed. In this, ECT is no different to other therapeutic interventions. However, ECT has a particular status both within psychiatry and within the law that makes specific discussion of issues with regard to consent necessary.
General issues regarding consent
Electroconvulsive therapy is unusual in that consent obtained is for a course of treatments rather than for an individual procedure. It is also customary that the person seeking the consent will not be the person giving the treatment. The fact that the person receiving treatment has a psychiatric disorder sufficiently severe for ECT to be considered raises questions about their capacity; this makes it particularly important that consent is properly obtained and valid. It is unlawful and unethical to treat a patient who is capable of understanding the nature of any procedure, its purpose and implications, the anticipated benefits and any reasonably foreseeable adverse effects without first explaining it. The patient must then agree. Even if patients choose not to be informed of the full details of their diagnosis and treatment, they must be given the option of receiving this information. Guidance on good practice in consent can be found in publications from the Department of Health in England and Wales (2009), the Department of Health, Social Services and Public Safety in Northern Ireland (2003) and the Scottish Executive (2006), as well as from the General Medical Council (2008).
Obtaining valid consent should be considered a process rather than an event and it is necessary for patients to be given an adequate length of time to consider the benefits and drawbacks of the proposed treatment before making an informed decision. Patients should be informed of the risks and unwanted effects of ECT (Chapters 7–9) and they need to realise that a general anaesthetic is involved. If there are specific anaesthetic risks, the anaesthetist should explain these and obtain the necessary consent.