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Ten new insights in climate science 2021: a horizon scan
- Maria A. Martin, Olga Alcaraz Sendra, Ana Bastos, Nico Bauer, Christoph Bertram, Thorsten Blenckner, Kathryn Bowen, Paulo M. Brando, Tanya Brodie Rudolph, Milena Büchs, Mercedes Bustamante, Deliang Chen, Helen Cleugh, Purnamita Dasgupta, Fatima Denton, Jonathan F. Donges, Felix Kwabena Donkor, Hongbo Duan, Carlos M. Duarte, Kristie L. Ebi, Clea M. Edwards, Anja Engel, Eleanor Fisher, Sabine Fuss, Juliana Gaertner, Andrew Gettelman, Cécile A.J. Girardin, Nicholas R. Golledge, Jessica F. Green, Michael R. Grose, Masahiro Hashizume, Sophie Hebden, Helmke Hepach, Marina Hirota, Huang-Hsiung Hsu, Satoshi Kojima, Sharachchandra Lele, Sylvia Lorek, Heike K. Lotze, H. Damon Matthews, Darren McCauley, Desta Mebratu, Nadine Mengis, Rachael H. Nolan, Erik Pihl, Stefan Rahmstorf, Aaron Redman, Colleen E. Reid, Johan Rockström, Joeri Rogelj, Marielle Saunois, Lizzie Sayer, Peter Schlosser, Giles B. Sioen, Joachim H. Spangenberg, Detlef Stammer, Thomas N.S. Sterner, Nicola Stevens, Kirsten Thonicke, Hanqin Tian, Ricarda Winkelmann, James Woodcock
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- Journal:
- Global Sustainability / Volume 4 / 2021
- Published online by Cambridge University Press:
- 18 October 2021, e25
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Non-technical summary
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.
Technical summaryA synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
Social media summaryHow do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
HYPERBARIC OXYGEN THERAPY FOR DIABETIC ULCERS: SYSTEMATIC REVIEW AND META-ANALYSIS
- Daria O'Reilly, Anjori Pasricha, Kaitryn Campbell, Natasha Burke, Nazila Assasi, James M. Bowen, Jean-Eric Tarride, Ron Goeree
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 29 / Issue 3 / July 2013
- Published online by Cambridge University Press:
- 17 July 2013, pp. 269-281
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Objectives: Approximately 10–15 percent of individuals with diabetes mellitus develop foot ulcers, which precede 85 percent of amputations. Increased oxygen, through the use of hyperbaric oxygen therapy (HBOT), has been suggested to encourage ulcer healing thus reducing the risk of amputation. The objective of this systematic review is to evaluate the efficacy of systemic HBOT for nonhealing ulcers of the lower limb in diabetes patients.
Methods: A systematic search, using controlled and keyword terms focusing on “HBOT” and “lower limb diabetic ulcers,” was conducted. Databases searched included Medline, EMBASE, CINAHL, PubMed, Wiley's Cochrane Library, and Biosis. Randomized controlled trials (RCTs) and observational studies were included. Pooled estimates of outcomes were determined when appropriate.
Results: Of the 654 citations identified, 157 articles underwent full-text review. Data were abstracted from twelve publications (six RCTs and six comparative observational studies). Pooled analysis of the RCT and observational data showed that treatment with HBOT reduced the risk of major amputation by 60 percent (p = .29) and 61 percent (p = .003) compared with standard wound care, respectively. The RCT data revealed that the relative risk of having an unhealed wound following HBOT was 0.54 (p = .10) and 0.24 (p < .0001) based on observational data.
Conclusions: Due to the limited RCT evidence, it is not possible to conclusively establish the benefits and harms of treating diabetic lower limb ulcers with HBOT. No significant effects on amputation rates were found in the RCT evidence and in the high quality studies, no difference was found.
List of contributors
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- By H. Elliott Albers, Reut Avinun, Karen L. Bales, Jorge A. Barraza, Michael T. Bowen, Sunny K. Boyd, Heather K. Caldwell, Elena Choleris, Amy E. Clipperton-Allen, Bruce S. Cushing, Monica B. Dhakar, Riccardo Dore, Richard P. Ebstein, Craig F. Ferris, Sara M. Freeman, James L. Goodson, Joshua J. Green, Haruhiro Higashida, Eric Hollander, Salomon Israel, Martin Kavaliers, Keith M. Kendrick, Ariel Knafo, Yoav Litvin, Olga Lopatina, David Mankuta, Iain S. McGregor, Richard H. Melloni, Inga D. Neumann, Jerome H. Pagani, Cort A. Pedersen, Donald W. Pfaff, Anna Phan, Benjamin J. Ragen, Amina Sarwat, Idan Shalev, Erica L. Stevenson, Bonnie Taylor, Richmond R. Thompson, Florina Uzefovsky, Erwin H. van den Burg, James C. Walton, Scott R. Wersinger, Nurit Yirmiya, Larry J. Young, W. Scott Young, Paul J. Zak
- Edited by Elena Choleris, University of Guelph, Ontario, Donald W. Pfaff, Rockefeller University, New York, Martin Kavaliers, University of Western Ontario
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- Oxytocin, Vasopressin and Related Peptides in the Regulation of Behavior
- Published online:
- 05 April 2013
- Print publication:
- 11 April 2013, pp xi-xiv
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MATHEMATICAL MODELING: THE CASE OF EMERGENCY DEPARTMENT WAITING TIMES
- Morgan E. Lim, Tim Nye, James M. Bowen, Jerry Hurley, Ron Goeree, Jean-Eric Tarride
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 28 / Issue 2 / April 2012
- Published online by Cambridge University Press:
- 26 April 2012, pp. 93-109
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A decision analytic model often comprises a significant part of a health technology assessment. As health technology assessment in the hospital setting evolves, there is an increased need for modeling methods that account for patient care pathways and interactions between patients and their environment. For example, an evaluation of a computed tomography (CT) scanner for a new indication would need to consider the current and increased demand of the machine and how that may affect service in other areas of the hospital. This problem solving approach views “problems” through a systems perspective.
In search of the evidentiary foundation of published Canadian economic evaluations (2001–06)
- Jean-Eric Tarride, Morgan E. Lim, James M. Bowen, Catherine Elizabeth McCarron, Gord Blackhouse, Robert Hopkins, Daria O'Reilly, Feng Xie, Ron Goeree
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 25 / Issue 2 / April 2009
- Published online by Cambridge University Press:
- 31 March 2009, pp. 214-221
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Objectives: The aim of this study was to present a review of economic evaluations conducted from a Canadian perspective and to characterize sources of evidence and statistical methods to analyze effectiveness measures, resource utilization, and uncertainty.
Methods: A search strategy was developed to identify Canadian economic evaluations published between January 2001 and June 2006. A standardized abstraction form was used to extract key data (e.g., study design, data sources, statistical methods).
Results: A total of 153 unique studies were included for review, of which 75 were evaluations of drug therapies and less than half were funded by industry. Cost-effectiveness analysis was the most common type of economic evaluation and 80 percent of the studies used modeling techniques. A single source of evidence for effectiveness measures was used in half of the studies. Statistical methods were commonly reported to compare effectiveness measures when the economic evaluation was conducted alongside a clinical trial but less commonly when determining effectiveness input parameters in model-based economic evaluations, or to analyze resource utilization data. Authors relied mostly on univariate sensitivity analyses to explore uncertainty.
Conclusions: This review identifies the need to improve the conduct and reporting of statistical methods for economic evaluations to improve confidence in the results.
Economic evaluation of drug-eluting stents compared to bare metal stents using a large prospective study in Ontario
- Ron Goeree, James M. Bowen, Gord Blackhouse, Charles Lazzam, Eric Cohen, Maria Chiu, Rob Hopkins, Jean-Eric Tarride, Jack V. Tu
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 25 / Issue 2 / April 2009
- Published online by Cambridge University Press:
- 31 March 2009, pp. 196-207
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Objectives: To determine the cost-effectiveness (CE) and cost-utility (CU) of drug-eluting stents (DES) compared to bare metal stents (BMS) in Ontario using a large prospective “real-world” cohort study and determine the extent to which results vary by patient risk subgroups.
Methods: A field evaluation was conducted based on all stent procedures in the province of Ontario between December 1, 2003, and March 31, 2005, with a minimum subject follow-up of 1 year. Effectiveness data from the study using a propensity-score matched cohort were combined with resource utilization and cost data and quality of life (QOL) data from the published literature in a decision analytic modeling framework to determine 2-year cost-effectiveness (cost per revascularization avoided) and cost-utility (cost per quality-adjusted life-year ([QALY] gained). Stochastic model parameter uncertainty was expressed using probability distributions and analyzed using a probabilistic model. Modeling assumptions were assessed using traditional deterministic sensitivity analysis.
Results: Significant differences in revascularization rates were found for patients with two or more high risk factors. Despite these differences, the CE and CU of DES remained high (e.g., $419,000 per QALY gained in the most favorable patient risk subgroup). In sensitivity analysis, the difference in cost between DES and BMS had an impact on the CE and CU results. For example, at a price differential of $500, the CU of DES was $20,000/QALY for one patient subgroup and DES was dominant (i.e., less costly and more effective) in another.
Conclusions: At current prices, the CE/CU of DES compared with BMS is high even in patient high risk subgroups. As the relative price of DES decrease, the value for money attractiveness of DES increases, especially for selected high risk patients.
Economic evaluations conducted by Canadian health technology assessment agencies: Where do we stand?
- Jean-Eric Tarride, Catherine Elizabeth McCarron, Morgan Lim, James M. Bowen, Gord Blackhouse, Robert Hopkins, Daria O'Reilly, Feng Xie, Ron Goeree
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 24 / Issue 4 / October 2008
- Published online by Cambridge University Press:
- 01 October 2008, pp. 437-444
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Objectives: To examine the production of Health Technology Assessments (HTAs) with economic evaluations (EEs) conducted by Canadian HTA agencies.
Methods: This research used a three-step approach: (i) the Web sites of five Canadian organizations promoting HTA were searched to identify HTA reports with EEs; (ii) HTA agencies were surveyed to verify that our information was complete with respect to HTA activities and to describe the factors that influence the HTA process in Canada (i.e., selection of HTA topics, execution, dissemination of results and future trends); (iii) HTAs with EEs were appraised in terms of study design, retrieval of clinical and economic evidence, resource utilization and costing, effectiveness measures, treatment of uncertainty as well as presence of a budget impact analysis (BIA), and policy recommendations.
Results: Two hundred forty-nine HTA reports were identified of which 19 percent included EEs (n = 48). Decision analytic techniques were used in approximately 75 percent of the forty-eight EEs and probabilistic sensitivity analyses were commonly used by all agencies to deal with parameter uncertainty. BIAs or policy recommendations were given in 50 percent of the evaluations. Differences between agencies were observed in terms of selection of topics, focus of assessment and production of HTA (e.g., in-house activities). Major barriers to the conduct of HTAs with EEs were capacity, a lack of interest by decision makers and a lack of robust clinical information.
Conclusions: The results of this research point to the need for increased HTA training, collaboration, evidence synthesis, and use of pragmatic “real world” evaluations.
Contributors
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- By Robert S. Agnew, Lara M. Belliston, Daniel M. Blonigen, Michel Boivin, Jeanne Brooks‐Gunn, Andrew Canastar, Noel A. Card, Emil F. Coccaro, Nicki R. Crick, Linda L. Dahlberg, Garth Davies, Scott H. Decker, Kenneth A. Dodge, Dorothy L. Espelage, Jeffrey Fagan, Albert D. Farrell, David P. Farrington, Daniel J. Flannery, Mark S. Fleisher, Vangie A. Foshee, Holly Foster, Richard J. Gelles, Denise C. Gottfredson, Gary D. Gottfredson, Michael R. Gottfredson, Richard E. Heyman, James C. (Buddy) Howell, Megan Q. Howell, Li Huang, L. Rowell Huesmann, Cynthia Irvin, Gary F. Jensen, Yoshito Kawabata, Lucyna Kirwil, Jeff M. Kretschmar, Robert F. Krueger, Markus J. P. Kruesi, Benjamin B. Lahey, Royce Lee, Scott O. Lilienfeld, Todd D. Little, Anne Martin, Rebecca A. Matthew, Stephen C. Maxson, Jacquelyn Mize, Terrie E. Moffitt, Daniel S. Nagin, Jamie M. Ostrov, Christopher J. Patrick, Bowen Paulle, Gregory S. Pettit, Adrian Raine, Soo Hyun Rhee, Angela Scarpa, Jean R. Séguin, Michelle R. Sherrill, Mark I. Singer, Amy M. Smith Slep, Kevin J. Strom, Patrick Sylvers, Patrick H. Tolan, Elizabeth Trejos‐Castillo, Richard E. Tremblay, Manfred van Dulmen, Johan van Wilsem, Alexander T. Vazsonyi, Edelyn Verona, Frank Vitaro, Monique Vulin‐Reynolds, Irwin D. Waldman, Mark Warr, Stanley Wasserman, Deanna L. Wilkinson
- Edited by Daniel J. Flannery, Kent State University, Ohio, Alexander T. Vazsonyi, Auburn University, Alabama, Irwin D. Waldman, Emory University, Atlanta
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- Book:
- The Cambridge Handbook of Violent Behavior and Aggression
- Published online:
- 05 June 2012
- Print publication:
- 03 September 2007, pp xi-xviii
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Older Adults and Functional Decline: A Cross-Cultural Comparison
- Susan M. McCurry, Laura E. Gibbons, Gail E. Bond, Linda Teri, Walter A. Kukull, Roger Higdon, James D. Bowen, Wayne C. McCormick, Eric B. Larson, Madeline Murguia Rice, Amy Borenstein Graves
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- Journal:
- International Psychogeriatrics / Volume 14 / Issue 2 / June 2002
- Published online by Cambridge University Press:
- 10 January 2005, pp. 161-179
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Background: The study was conducted to examine the relationships between functional decline, health risk factors, lifestyle practices, and demographic variables in two culturally diverse, community-based samples of White and Japanese American older adults. Design: The study was an analysis of data from two ongoing studies of aging and dementia in King County, Washington. Functional status at baseline was evaluated, and factors associated with functional decline over a 4-year follow-up period were identified. The sample included 1,083 Japanese American and 1,011 White cognitively intact, community-dwelling adults aged 65 and older, who had no functional limitations at baseline and participated in at least one follow-up examination. Results: In 4 years of follow-up, 70% of the subjects reported no increase in functional limitation, and fewer than 5% of subjects declined in five or more activities. Risk factors associated with functional decline included increased age, female gender, medical comorbidity (particularly cerebrovascular disease, arthritis, and hypertension), elevated body mass index, poorer self-perceived health, and smoking. Depression and diabetes were also significant for persons with the greatest functional decline over the 4-year follow-up. Japanese speakers were significantly less likely to decline over the follow-up period than White or English-speaking Japanese American subjects. However, Japanese speakers were more likely to discontinue participation during the follow-up period, and may also have been more likely to underreport symptoms of functional decline. Conclusions: The present study provides further support that healthy lifestyle practices and prevention of chronic disease are important for maintaining functional independence in older adults. Japanese-speaking subjects were less likely to decline over time, although this could be due in part to differential dropout and reporting bias. These findings have important implications for the design and interpretation of longitudinal studies of older adults. Researchers interested in the effects of ethnicity on health and aging should be cognizant of differences in recruitment and enrollment strategies among studies, and the ways in which these affect study findings. This study also demonstrates the importance of devoting adequate resources to minimize dropouts, and of including measures of health and functioning that are culturally equivalent and less reliant on self-report data.
Looking Backward, Looking Forward: MLA Members Speak
- April Alliston, Elizabeth Ammons, Jean Arnold, Nina Baym, Sandra L. Beckett, Peter G. Beidler, Roger A. Berger, Sandra Bermann, J.J. Wilson, Troy Boone, Alison Booth, Wayne C. Booth, James Phelan, Marie Borroff, Ihab Hassan, Ulrich Weisstein, Zack Bowen, Jill Campbell, Dan Campion, Jay Caplan, Maurice Charney, Beverly Lyon Clark, Robert A. Colby, Thomas C. Coleman III, Nicole Cooley, Richard Dellamora, Morris Dickstein, Terrell Dixon, Emory Elliott, Caryl Emerson, Ann W. Engar, Lars Engle, Kai Hammermeister, N. N. Feltes, Mary Anne Ferguson, Annie Finch, Shelley Fisher Fishkin, Jerry Aline Flieger, Norman Friedman, Rosemarie Garland-Thomson, Sandra M. Gilbert, Laurie Grobman, George Guida, Liselotte Gumpel, R. K. Gupta, Florence Howe, Cathy L. Jrade, Richard A. Kaye, Calhoun Winton, Murray Krieger, Robert Langbaum, Richard A. Lanham, Marilee Lindemann, Paul Michael Lützeler, Thomas J. Lynn, Juliet Flower MacCannell, Michelle A. Massé, Irving Massey, Georges May, Christian W. Hallstein, Gita May, Lucy McDiarmid, Ellen Messer-Davidow, Koritha Mitchell, Robin Smiles, Kenyatta Albeny, George Monteiro, Joel Myerson, Alan Nadel, Ashton Nichols, Jeffrey Nishimura, Neal Oxenhandler, David Palumbo-Liu, Vincent P. Pecora, David Porter, Nancy Potter, Ronald C. Rosbottom, Elias L. Rivers, Gerhard F. Strasser, J. L. Styan, Marianna De Marco Torgovnick, Gary Totten, David van Leer, Asha Varadharajan, Orrin N. C. Wang, Sharon Willis, Louise E. Wright, Donald A. Yates, Takayuki Yokota-Murakami, Richard E. Zeikowitz, Angelika Bammer, Dale Bauer, Karl Beckson, Betsy A. Bowen, Stacey Donohue, Sheila Emerson, Gwendolyn Audrey Foster, Jay L. Halio, Karl Kroeber, Terence Hawkes, William B. Hunter, Mary Jambus, Willard F. King, Nancy K. Miller, Jody Norton, Ann Pellegrini, S. P. Rosenbaum, Lorie Roth, Robert Scholes, Joanne Shattock, Rosemary T. VanArsdel, Alfred Bendixen, Alarma Kathleen Brown, Michael J. Kiskis, Debra A. Castillo, Rey Chow, John F. Crossen, Robert F. Fleissner, Regenia Gagnier, Nicholas Howe, M. Thomas Inge, Frank Mehring, Hyungji Park, Jahan Ramazani, Kenneth M. Roemer, Deborah D. Rogers, A. LaVonne Brown Ruoff, Regina M. Schwartz, John T. Shawcross, Brenda R. Silver, Andrew von Hendy, Virginia Wright Wexman, Britta Zangen, A. Owen Aldridge, Paula R. Backscheider, Roland Bartel, E. M. Forster, Milton Birnbaum, Jonathan Bishop, Crystal Downing, Frank H. Ellis, Roberto Forns-Broggi, James R. Giles, Mary E. Giles, Susan Blair Green, Madelyn Gutwirth, Constance B. Hieatt, Titi Adepitan, Edgar C. Knowlton, Jr., Emanuel Mussman, Sally Todd Nelson, Robert O. Preyer, David Diego Rodriguez, Guy Stern, James Thorpe, Robert J. Wilson, Rebecca S. Beal, Joyce Simutis, Betsy Bowden, Sara Cooper, Wheeler Winston Dixon, Tarek el Ariss, Richard Jewell, John W. Kronik, Wendy Martin, Stuart Y. McDougal, Hugo Méndez-Ramírez, Ivy Schweitzer, Armand E. Singer, G. Thomas Tanselle, Tom Bishop, Mary Ann Caws, Marcel Gutwirth, Christophe Ippolito, Lawrence D. Kritzman, James Longenbach, Tim McCracken, Wolfe S. Molitor, Diane Quantic, Gregory Rabassa, Ellen M. Tsagaris, Anthony C. Yu, Betty Jean Craige, Wendell V. Harris, J. Hillis Miller, Jesse G. Swan, Helene Zimmer-Loew, Peter Berek, James Chandler, Hanna K. Charney, Philip Cohen, Judith Fetterley, Herbert Lindenberger, Julia Reinhard Lupton, Maximillian E. Novak, Richard Ohmann, Marjorie Perloff, Mark Reynolds, James Sledd, Harriet Turner, Marie Umeh, Flavia Aloya, Regina Barreca, Konrad Bieber, Ellis Hanson, William J. Hyde, Holly A. Laird, David Leverenz, Allen Michie, J. Wesley Miller, Marvin Rosenberg, Daniel R. Schwarz, Elizabeth Welt Trahan, Jean Fagan Yellin
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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