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Valuing Vital Resources in India: Potential for Integrated Approaches to Water, Energy and Agricultural Sustainability

Invitation Only Research Event

16 January 2015 - 9:00am to 2:00pm

The India Habitat Centre, New Delhi, India

Event participants

Dr Ashwini Swain, Fellow, CUTS Institute for Regulation and Competition
Glada Lahn, Senior Research Fellow, Energy, Environment and Resources, Chatham House
Dr Gareth Price, Senior Research Fellow, Asia Programme, Chatham House

As part of the international dialogue on Valuing Vital Resources, this seminar will convene policy-makers, scholars, technical practitioners, NGOs, multilateral agencies and the media to discuss recommendations for new policy approaches in India to reorient energy and water use in agriculture. The aim is to gain input to practical policy proposals and identify the work now needed to make them robust. 

Attendance is by invitation only. Please note this event is held in New Delhi, all times are local. 

This event is organized together with the CUTS Institute for Regulation & Competition (CIRC).

Event attributes

External event

Glada Lahn

Senior Research Fellow, Energy, Environment and Resources Programme, Chatham House




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The Economics of Natural Capital

Members Event

24 June 2015 - 1:00pm to 2:00pm

Chatham House, London

Event participants

Professor Dieter Helm CBE, Professor of Energy Policy, University of Oxford

Chair: David Shukman, Science Editor, BBC News

As the global population and economy continues to grow, the international community faces the challenge of accommodating significant growth over the coming decades without a major loss of biodiversity and natural capital, the world’s stock of natural resources. Presenting an economic analysis of these natural assets, Dieter Helm will argue that natural capital and environmental concerns should be placed at the core of economic policy. He will set out a framework for sustainable growth, outlining key measures that could help to preserve the environment while also enabling economic growth. 

Members Events Team




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Covid-19: Nightingale hospitals set to shut down after seeing few patients

The mothballing of Britain’s Nightingale hospitals, some of which have yet to treat a single covid-19 patient, has raised questions about whether resources to fight the pandemic were...




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Vitamin C in Human Health and Disease: Effects, Mechanisms of Action, and New Guidance on Intake




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Reversibility of 68Ga-FAPI-2 Trapping Might Prove an Asset for PET Quantitative Imaging




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Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review




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Digital Jamaica throws sales lifeline to furniture companies

DESPITE TUMBLING sales and challenges with hire-purchase accounts, two of the largest retailers of home furniture and appliances, Courts Jamaica and Singer Jamaica, have found glimmers of hope during the COVID-19 pandemic. That’s because work-from...




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Schapiro Lecture: The Would-Be Federation Next Door – What Next for Britain?

Members Event

6 February 2020 - 6:00pm to 7:15pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Helen Thompson, Professor of Political Economy, University of Cambridge; Host, Talking Politics
Chairs: Hans Kundnani, Senior Research Fellow, Europe Programme, Chatham House
Laura Cram, Professor of European Politics, University of Edinburgh. Co-Editor, Government and Opposition: An International Journal of Comparative Politics
 

Helen Thompson reflects on the changing nature of the EU as a federation and will seek to map post-Brexit options for the UK within this history. 

Since its beginning in the 1950s, the evolution of European integration has created a series of predicaments for the UK which has been forced again and again to redefine its relationship with the European entity. As Britain seeks to leaves the European Union, it will again need to find a new relationship with it at a time when the future of the US commitment to Europe is also uncertain.
 
Assuming Brexit takes place, to what extent could the federalization of the EU pose issues for the UK? What does a move towards federalization mean for security globally? And how would Britain and Northern Ireland navigate a relationship with a customs union federation?
 
The Schapiro Lecture is published in Government and Opposition: An International Journal of Comparative Politics.


 

Event attributes

Livestream

Members Events Team




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Britain Must Balance a Transatlantic Heart With a European Head

19 December 2019

Robin Niblett

Director and Chief Executive, Chatham House
Returning from an EU-rooted foreign and economic policy to one which is more international in outlook will be difficult, take time, and be more costly than the new UK government currently envisages.

GettyImages-1189074470.jpg

Boris Johnson chairs the first cabinet meeting after winning a majority of 80 seats in the 2019 UK general election. Photo by Matt Dunham – WPA Pool/Getty Images.

The convincing general election win for the Conservative Party and Boris Johnson opens a new chapter in British history. On 31 January 2020, Britain will withdraw from the EU and return to its historical position as a separate European power.

Recognising the strategic significance of this change, the Queen’s speech opening the new parliament stated that 'the government will undertake the deepest review of Britain's security, defence, and foreign policy since the end of the Cold War'. But in what context?

Prime Minister Boris Johnson and other Brexit supporters have yearned for Britain to return to its exceptional trajectory. In their view, Britain can once again become a trading nation - more global in outlook and ambition than its European neighbours, freed from the shackles of an ageing and fractured European continent and its deadening regulatory hand.

This imagery makes good copy. But the 21st century does not offer Britain the same opportunities as did the 18th, 19th or early 20th centuries. This is a different world, and Britain’s position in it needs to be crafted with a sharp eye to what is possible.

Geopolitics undergoing wrenching change

This is not declinism. The UK remains an economically strong and politically influential country by relative global standards – it is currently the fifth or sixth largest economy in the world, and the second largest donor of official development assistance. It has ubiquitous cultural brands from fashion and music to the royal family, and an eminent diplomatic and security position at the heart of all of the world’s major international institutions and alliances, from NATO and the UN security council to the IMF, G7, G20 and Commonwealth. 

But Britain leaves the EU just as the geopolitical landscape is undergoing wrenching change. The United States has turned inwards, closer to its own historic norm, and is undermining the international institutions which it created alongside Britain in the 1940s. China’s international influence is on the rise alongside its vast and still growing economy, challenging traditional norms of individual freedom and public transparency.

Russia is navigating the cracks and crevices of the fracturing rules-based international order with ruthless efficiency. Sensing the change in the wind, many governments are now back-tracking on their post-Cold War transitions to more open and democratic societies.

The implications of this new context have yet to be fully internalised by those who look forward to Britain’s future outside the EU. Britain will be negotiating new trade deals in an increasingly transactional, fragmented and protectionist international economic environment. It will be trying to sell its world-class services into markets where national control over finance, law, technology and media is increasingly prized.

Making new diplomatic inroads will be no easier. The government will face strong internal and external criticism if it lends security assistance to states that are simultaneously clamping down on their citizens’ rights. With the number of military personnel in decline and investment in new equipment stretched across multiple expensive platforms, the UK could struggle to project meaningful defence cooperation to new security partners in Asia at the same time as upholding its NATO commitments and its deployments in conflict zones around the world.

Britain also opens its new global chapter at a time when it is changing domestically. There is no over-riding reason for a missionary British foreign policy – neither the economic returns or image of national glory that drove Empire, nor the existential defence of its land, interests and freedom that drove it during the Cold War.

Stretching liberal interventionism to Iraq, as Tony Blair did when he was prime minister, and to Libya as David Cameron did in 2011, has injected a deep dose of popular scepticism to the idea that Britain - with or without allies - can or should help make the world in its own image.

This more defensive mindset – epitomised by parliament’s refusal to use military force to punish President Bashar al Assad’s regime for using chemical weapons against its citizens in 2013 – will not abate soon. Especially when the new government’s political bandwidth will be stretched by fiendishly complex trade-offs between its financial promises to support domestic renewal, the imperatives of striking and implementing a new free trade agreement with the EU, and the economic consequences of leaving the single market.

All this points to the fact that the most important step for Britain at the beginning of this new national chapter will be to establish an effective partnership with the EU and its member states. They face the same international risks as Britain and have as much to gain from the preservation of rules-based international behaviour. Recognising the continued interdependence between Britain and the EU will offer both sides greater leverage in a more competitive and hostile world.

A new transatlantic relationship

Once it has agreed its new relationship with the EU, Britain can turn to crafting its new relationship with the mighty United States. US-UK economic interdependence and close security ties should help discipline the bilateral economic relationship. The more difficult challenge will be for the UK to avoid falling into fissures between the US and the EU over how to manage bilateral relations with China and Russia, particularly if President Trump wins a second term.

Britain will have to get used to this difficult balancing act between its transatlantic heart and European head after Brexit. This makes it all the more important for the UK to develop new diplomatic and commercial initiatives with countries that are also struggling to cope with the current uncertain, transactional international environment.

Canada, Japan, South Korea, Australia and New Zealand can grow as bilateral economic partners and as allies in international institutions, such as the G7, OECD and WTO. They may even open a door to British engagement in regional trade arrangements such as the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CP-TPP), which do not require the same political commitments as EU membership.

Turning from an EU-rooted foreign and economic policy to one that is once again more international in outlook will be difficult, take time and be more costly than the government currently envisages. The irony is that for this to be successful requires sustained political investment by the Johnson government to build a strong relationship with the EU that it is focused on leaving.




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Britain’s Soft Power Potential: In Conversation with Penny Mordaunt

Members Event

5 February 2020 - 6:00pm to 7:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Penny Mordaunt MP, Member of Parliament for Portsmouth North; Secretary of State for Defence (2019); Secretary of State for International Development (2017-2019)

Chair: Thomas Raines, Director, Europe Programme, Chatham House

Drawing on her experience as secretary of state for defence and secretary of state for international development, Penny Mordaunt discusses how soft power can protect, promote and project Britain’s international interests and foreign policy agenda.

Often defined as the capacity to influence others without coercion or force, soft power differs from traditional military capabilities in favour of more subtle forms of influence rooted in values, culture and civic institutions.

Consistently upholding democratic values and human rights can contribute to a nation’s soft power as much as its cultural icons and legacies.  However, utilising soft power – the power of attractiveness – is not straightforward: the government is only part of a broad mix of institutions and actors with a role to play.

Can the UK develop a long term approach that brings together all of the components of its soft power for a common purpose?

What are the key sources of Britain’s soft power? How has Brexit affected perceptions of Britain internationally? And with the UK’s departure from the European Union now confirmed, how should we think about its soft power in the future?

Members Events Team




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To Advance Trade and Climate Goals, ‘Global Britain’ Must Link Them

19 March 2020

Carolyn Deere Birkbeck

Associate Fellow, Global Economy and Finance Programme, and Hoffmann Centre for Sustainable Resource Economy

Dr Emily Jones

Associate Professor, Blavatnik School of Government

Dr Thomas Hale

Associate Professor, Blavatnik School of Government
COVID-19 is a sharp reminder of why trade policy matters. As the UK works to forge new trade deals, it must align its trade policy agenda with its climate ambition.

2020-03-19-Boris-Johnson-COP26.jpg

Boris Johnson at the launch of the UK-hosted COP26 UN Climate Summit at the Science Museum, London on February 4, 2020. Photo by Jeremy Selwyn - WPA Pool/Getty Images.

COVID-19 is a sharp reminder of why trade and climate policy matters. How can governments maintain access to critical goods and services, and ensure global supply chains function in times of crisis?

The timing of many trade negotiations is now increasingly uncertain, as are the UK’s plans to host COP26 in November. Policy work continues, however, and the EU has released its draft negotiating text for the new UK-EU trade deal, which includes a sub-chapter specifically devoted to climate. 

This is a timely reminder both of the pressing need for the UK to integrate its trade and climate policymaking and to use the current crisis-induced breathing space in international negotiations - however limited - to catch up on both strategy and priorities on this critical policy intersection.

The UK government has moved fast to reset its external trade relations post-Brexit. In the past month it formally launched bilateral negotiations with the EU and took up a seat at the World Trade Organization (WTO) as an independent member. Until the COVID-19 crisis hit, negotiations were also poised to start with the US.

The UK is also in the climate spotlight as host of COP26, the most important international climate negotiation since Paris in 2015, which presents a vital opportunity for the government to show leadership by aligning its trade agenda with its climate and sustainability commitments in bold new ways.

Not just an empty aspiration

This would send a signal that ‘Global Britain’ is not just an empty aspiration, but a concrete commitment to lead.

Not only is concerted action on the climate crisis a central priority for UK citizens, a growing and increasingly vocal group of UK businesses committed to decarbonization are calling on the government to secure a more transparent and predictable international market place that supports climate action by business.

With COP26, the UK has a unique responsibility to push governments to ratchet up ambition in the national contributions to climate action – and to promote coherence between climate ambition and wider economic policymaking, including on trade. If Britain really wants to lead, here are some concrete actions it should take.

At the national level, the UK can pioneer new ways to put environmental sustainability – and climate action in particular - at the heart of its trade agenda. Achieving the government’s ambitious Clean Growth Strategy - which seeks to make the UK the global leader in a range of industries including electric cars and offshore wind – should be a central objective of UK trade policy.

The UK should re-orient trade policy frameworks to incentivize the shift toward a more circular and net zero global economy. And all elements of UK trade policy could be assessed against environmental objectives - for example, their contribution to phasing out fossil fuels, helping to reverse overexploitation of natural resources, and support for sustainable agriculture and biodiversity.

In its bilateral and regional trade negotiations, the UK can and should advance its environment, climate and trade goals in tandem, and implementation of the Paris Agreement must be a core objective of the UK trade strategy.

A core issue for the UK is how to ensure that efforts to decarbonise the economy are not undercut by imports from high-carbon producers. Here, a ‘border carbon adjustment (BCA)’ - effectively a tax on the climate pollution of imports - would support UK climate goals. The EU draft negotiating text released yesterday put the issue of BCAs front and centre, making crystal clear that the intersection of climate, environment and trade policy goals will be a central issue for UK-EU trade negotiations.

Even with the United States, a trade deal can and should still be seized as a way to incentivize the shift toward a net zero and more circular economy. At the multilateral level, as a new independent WTO member, the UK has an opportunity to help build a forward-looking climate and trade agenda.

The UK could help foster dialogue, research and action on a cluster of ‘climate and trade’ issues that warrant more focused attention at the WTO. These include the design of carbon pricing policies at the border that are transparent, fair and support a just transition; proposals for a climate waiver for WTO rules; and identification of ways multilateral trade cooperation could promote a zero carbon and more circular global economy.  

To help nudge multilateral discussion along, the UK could also ask to join a critical ‘path finder’ effort by six governments, led by New Zealand, to pursue an agreement on climate change, trade and sustainability (ACCTS). This group aims to find ways forward on three central trade and climate issues: removing fossil fuel subsidies, climate-related labelling, and promoting trade in climate-friendly goods and services.

At present, the complex challenges at the intersection of climate, trade and development policy are too often used to defer or side-step issues deemed ‘too hard’ or ‘too sensitive’ to tackle. The UK could help here by working to ensure multilateral climate and trade initiatives share adjustment burdens, recognise the historical responsibility of developed countries, and do not unfairly disadvantage developing countries - especially the least developed.

Many developing countries are keen to promote climate-friendly exports as part of wider export diversification strategies  and want to reap greater returns from greener global value chains. Further, small island states and least-developed countries – many of which are Commonwealth members – that are especially vulnerable to the impacts of climate change and natural disasters, need support to adapt in the face of trade shocks and to build climate-resilient, trade-related infrastructure and export sectors.

As an immediate next step, the UK should actively support the growing number of WTO members in favour of a WTO Ministerial Statement on environmental sustainability and trade. It should work with its key trading partners in the Commonwealth and beyond to ensure the agenda is inclusive, supports achievement of the UN Sustainable Development Goals (SDGs) and helps developing countries benefit from a more environmentally sustainable global economy.

As the UK prepares to host COP26, negotiates deals with the EU and US, and prepares for its first WTO Ministerial meeting as an independent member, it must show it can lead the way nationally, bilaterally, and multilaterally. And to ensure the government acts, greater engagement from the UK’s business, civil society and research sectors is critical – we need all hands on deck to forge and promote concrete proposals for aligning UK trade policy with the climate ambition our world needs.




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To Advance Trade and Climate Goals, ‘Global Britain’ Must Link Them

19 March 2020

Carolyn Deere Birkbeck

Associate Fellow, Global Economy and Finance Programme, and Hoffmann Centre for Sustainable Resource Economy

Dr Emily Jones

Associate Professor, Blavatnik School of Government

Dr Thomas Hale

Associate Professor, Blavatnik School of Government
COVID-19 is a sharp reminder of why trade policy matters. As the UK works to forge new trade deals, it must align its trade policy agenda with its climate ambition.

2020-03-19-Boris-Johnson-COP26.jpg

Boris Johnson at the launch of the UK-hosted COP26 UN Climate Summit at the Science Museum, London on February 4, 2020. Photo by Jeremy Selwyn - WPA Pool/Getty Images.

COVID-19 is a sharp reminder of why trade and climate policy matters. How can governments maintain access to critical goods and services, and ensure global supply chains function in times of crisis?

The timing of many trade negotiations is now increasingly uncertain, as are the UK’s plans to host COP26 in November. Policy work continues, however, and the EU has released its draft negotiating text for the new UK-EU trade deal, which includes a sub-chapter specifically devoted to climate. 

This is a timely reminder both of the pressing need for the UK to integrate its trade and climate policymaking and to use the current crisis-induced breathing space in international negotiations - however limited - to catch up on both strategy and priorities on this critical policy intersection.

The UK government has moved fast to reset its external trade relations post-Brexit. In the past month it formally launched bilateral negotiations with the EU and took up a seat at the World Trade Organization (WTO) as an independent member. Until the COVID-19 crisis hit, negotiations were also poised to start with the US.

The UK is also in the climate spotlight as host of COP26, the most important international climate negotiation since Paris in 2015, which presents a vital opportunity for the government to show leadership by aligning its trade agenda with its climate and sustainability commitments in bold new ways.

Not just an empty aspiration

This would send a signal that ‘Global Britain’ is not just an empty aspiration, but a concrete commitment to lead.

Not only is concerted action on the climate crisis a central priority for UK citizens, a growing and increasingly vocal group of UK businesses committed to decarbonization are calling on the government to secure a more transparent and predictable international market place that supports climate action by business.

With COP26, the UK has a unique responsibility to push governments to ratchet up ambition in the national contributions to climate action – and to promote coherence between climate ambition and wider economic policymaking, including on trade. If Britain really wants to lead, here are some concrete actions it should take.

At the national level, the UK can pioneer new ways to put environmental sustainability – and climate action in particular - at the heart of its trade agenda. Achieving the government’s ambitious Clean Growth Strategy - which seeks to make the UK the global leader in a range of industries including electric cars and offshore wind – should be a central objective of UK trade policy.

The UK should re-orient trade policy frameworks to incentivize the shift toward a more circular and net zero global economy. And all elements of UK trade policy could be assessed against environmental objectives - for example, their contribution to phasing out fossil fuels, helping to reverse overexploitation of natural resources, and support for sustainable agriculture and biodiversity.

In its bilateral and regional trade negotiations, the UK can and should advance its environment, climate and trade goals in tandem, and implementation of the Paris Agreement must be a core objective of the UK trade strategy.

A core issue for the UK is how to ensure that efforts to decarbonise the economy are not undercut by imports from high-carbon producers. Here, a ‘border carbon adjustment (BCA)’ - effectively a tax on the climate pollution of imports - would support UK climate goals. The EU draft negotiating text released yesterday put the issue of BCAs front and centre, making crystal clear that the intersection of climate, environment and trade policy goals will be a central issue for UK-EU trade negotiations.

Even with the United States, a trade deal can and should still be seized as a way to incentivize the shift toward a net zero and more circular economy. At the multilateral level, as a new independent WTO member, the UK has an opportunity to help build a forward-looking climate and trade agenda.

The UK could help foster dialogue, research and action on a cluster of ‘climate and trade’ issues that warrant more focused attention at the WTO. These include the design of carbon pricing policies at the border that are transparent, fair and support a just transition; proposals for a climate waiver for WTO rules; and identification of ways multilateral trade cooperation could promote a zero carbon and more circular global economy.  

To help nudge multilateral discussion along, the UK could also ask to join a critical ‘path finder’ effort by six governments, led by New Zealand, to pursue an agreement on climate change, trade and sustainability (ACCTS). This group aims to find ways forward on three central trade and climate issues: removing fossil fuel subsidies, climate-related labelling, and promoting trade in climate-friendly goods and services.

At present, the complex challenges at the intersection of climate, trade and development policy are too often used to defer or side-step issues deemed ‘too hard’ or ‘too sensitive’ to tackle. The UK could help here by working to ensure multilateral climate and trade initiatives share adjustment burdens, recognise the historical responsibility of developed countries, and do not unfairly disadvantage developing countries - especially the least developed.

Many developing countries are keen to promote climate-friendly exports as part of wider export diversification strategies  and want to reap greater returns from greener global value chains. Further, small island states and least-developed countries – many of which are Commonwealth members – that are especially vulnerable to the impacts of climate change and natural disasters, need support to adapt in the face of trade shocks and to build climate-resilient, trade-related infrastructure and export sectors.

As an immediate next step, the UK should actively support the growing number of WTO members in favour of a WTO Ministerial Statement on environmental sustainability and trade. It should work with its key trading partners in the Commonwealth and beyond to ensure the agenda is inclusive, supports achievement of the UN Sustainable Development Goals (SDGs) and helps developing countries benefit from a more environmentally sustainable global economy.

As the UK prepares to host COP26, negotiates deals with the EU and US, and prepares for its first WTO Ministerial meeting as an independent member, it must show it can lead the way nationally, bilaterally, and multilaterally. And to ensure the government acts, greater engagement from the UK’s business, civil society and research sectors is critical – we need all hands on deck to forge and promote concrete proposals for aligning UK trade policy with the climate ambition our world needs.




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Healthcare comes to standstill in east Aleppo as last hospitals are destroyed




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Covid-19: the challenge of patient rehabilitation after intensive care




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Covid-19: UK death toll overtakes Italy’s to become worst in Europe




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Lack of Opportunities and Family Pressures Drive Unaccompanied Minor Migration from Albania to Italy

Faced with a lack of employment opportunities and recurrent poverty, Albanian youth migrate to Italy alone in the hopes of improving their educational prospects or making money for their families. Yet upon arrival, they face many vulnerabilities. While some protections for unaccompanied minors exist in the Italy, the system is greatly fragmented and challenges, including how to return them to Albania, remain persistent.




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Noncitizens in the U.S. Military: Navigating National Security Concerns and Recruitment Needs

Noncitizens have long served in the U.S. military, often encouraged by the promise of a fast track to U.S. citizenship. In recent years, however, Congress and the Defense Department have made it more difficult for noncitizens to enlist. This brief give context to these policy changes and explores ways the military could better balance concerns about national security and the need for recruits with key cultural and professional skills.




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Spheres of Exploitation: Thwarting Actors Who Profit from Illegal Labor, Domestic Servitude, and Sex Work

This report analyzes the exploitation of migrants in three spheres: the domestic care sector, the labor market, and the sex industry. It details several obstacles governments face in their efforts to weaken the "bad actors" that profit from exploitation, and shows how one of the biggest challenges facing law enforcement is that serious criminals and lawbreakers often operate on the edge of legality and exploit legal routes wherever possible.




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Chasing the Dubai Dream in Italy: Bangladeshi Migration to Europe

Bangladeshis in 2017 suddenly emerged as one of the top migrant groups entering Europe illegally. While Europe is a new destination, Bangladeshi labor migration has been an important part of the country's development since the 1970s, with growing numbers heading abroad, largely to the Gulf Cooperation Council countries. This article explores and contextualizes the new phenomenon of Bangladeshi migration to Europe.




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A Tightening Grip Abroad: Authoritarian Regimes Target Their Emigrant and Diaspora Communities

Authoritarian states have long attempted to restrict citizens’ movement. But what happens when their reach extends beyond their borders? The October 2018 assassination of Saudi journalist Jamal Khashoggi brought into sharp relief the long arm of these regimes in reaching citizens abroad. This phenomenon, “transnational authoritarianism,” further shows that the relationship between migration and authoritarianism is becoming more complex.




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With Engaged Parenting, "Terrible Twos" Are Not Inevitable

Source:

Parents should not feel pressured to make their young children undertake structured learning or achieve specific tasks, particularly during lockdown. A new study of children under the age of two has found that parents who take a flexible approach to their child's learning can minimize behavioral problems during toddlerhood.






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Reaching a “Fair Deal” on Talent: Emigration, Circulation, and Human Capital in Countries of Origin

While skilled migration brings widely acknowledged economic benefits for destination countries and migrants, its impact on countries of origin has been the subject of more debate. Despite a growing consensus that origin countries can benefit from emigration and the circulation of skills, enabling this potential to be fully exploited remains a challenge. This report examines initiatives that develop skills and human capital.




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Despite Trump Invitation to Stop Taking Refugees, Red and Blue States Alike Endorse Resettlement

Forty-two governors, Republican and Democrat alike, have affirmed their consent for continued refugee resettlement, bypassing an invitation from the Trump administration to stop accepting refugees. These actions, which reportedly surprised the White House, suggest there may be limits to the Trump immigration agenda when it comes to refugees, as this Policy Beat explores.




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Clinical Outcomes in Patients With Isolated or Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: A Retrospective, Hospital-Based Cohort Study

OBJECTIVE

Many patients with hyperglycemic crises present with combined features of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). The implications of concomitant acidosis and hyperosmolality are not well known. We investigated hospital outcomes in patients with isolated or combined hyperglycemic crises.

RESEARCH DESIGN AND METHODS

We analyzed admissions data listing DKA or HHS at two academic hospitals. We determined 1) the frequency distributions of HHS, DKA, and combined DKA-HHS (DKA criteria plus elevated effective osmolality); 2) the relationship of markers of severity of illness and clinical comorbidities with 30-day all-cause mortality; and 3) the relationship of hospital complications associated with insulin therapy (hypoglycemia and hypokalemia) with mortality.

RESULTS

There were 1,211 patients who had a first admission with confirmed hyperglycemic crises criteria, 465 (38%) who had isolated DKA, 421 (35%) who had isolated HHS, and 325 (27%) who had combined features of DKA-HHS. After adjustment for age, sex, BMI, race, and Charlson Comorbidity Index score, subjects with combined DKA-HHS had higher in-hospital mortality compared with subjects with isolated hyperglycemic crises (adjusted odds ratio [aOR] 2.7; 95% CI 1.4, 4.9; P = 0.0019). In all groups, hypoglycemia (<40 mg/dL) during treatment was associated with a 4.8-fold increase in mortality (aOR 4.8; 95% CI 1.4, 16.8). Hypokalemia ≤3.5 mEq/L was frequent (55%). Severe hypokalemia (≤2.5 mEq/L) was associated with increased inpatient mortality (aOR 4.9; 95% CI 1.3, 18.8; P = 0.02).

CONCLUSIONS

Combined DKA-HHS is associated with higher mortality compared with isolated DKA or HHS. Severe hypokalemia and severe hypoglycemia are associated with higher hospital mortality in patients with hyperglycemic crises.




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Vitamin E Reduction of Protein Glycosylation in Diabetes: New Prospect for Prevention of Diabetic Complications?

Antonio Ceriello
Jan 1, 1991; 14:68-72
Short Report




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Prevalence of Hyper- and Hypoglycemia Among Inpatients With Diabetes: A national survey of 44 U.S. hospitals

Deborah J. Wexler
Feb 1, 2007; 30:367-369
BR Epidemiology/Health Services/Psychosocial Research




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In-Hospital Prognosis of Ppatients With Fasting Hyperglycemia After First Myocardial Infarction

John J O'Sullivan
Aug 1, 1991; 14:758-760
Short Report




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Serum 25-Hydroxyvitamin D3 Concentrations and Prevalence of Cardiovascular Disease Among Type 2 Diabetic Patients

Massimo Cigolini
Mar 1, 2006; 29:722-724
BR Cardiovascular and Metabolic Risk




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A Low-Glycemic Load Diet Facilitates Greater Weight Loss in Overweight Adults With High Insulin Secretion but Not in Overweight Adults With Low Insulin Secretion in the CALERIE Trial

Anastassios G. Pittas
Dec 1, 2005; 28:2939-2941
BR Clinical Care/Education/Nutrition




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Precipitation of Autoimmune Diabetes With Anti-PD-1 Immunotherapy

Jing Hughes
Apr 1, 2015; 38:e55-e57
e-Letters: Observations




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Effects of Metformin, Metformin Plus Rosiglitazone, and Metformin Plus Lifestyle on Insulin Sensitivity and {beta}-Cell Function in TODAY

TODAY Study Group
Jun 1, 2013; 36:1749-1757
TODAY Study




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Concentrations of Serum Vitamin D and the Metabolic Syndrome Among U.S. Adults

Earl S. Ford
May 1, 2005; 28:1228-1230
BR Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes




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India police: Security forces kill top militant commander in Kashmir

Police in India said security forces killed a top Hizbul Mujahideen commander amid a series of gunfights in the disputed Jammu and Kashmir region on Wednesday.




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Memo: Prior COVID-19 diagnosis 'permanently disqualifying' for U.S. military service

Military Entrance Processing Stations won't process individuals who have had COVID-19 for military service, even if they've fully recovered from the virus, the Pentagon confirmed this week.




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Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital

Guillermo E. Umpierrez
Aug 1, 2018; 41:1579-1589
Diabetes Care Symposium




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Amid an Unfolding Humanitarian Crisis in Syria, the European Union Faces the Perils of Devolving Migration Management to Turkey

The high-stakes gambit taken by Turkish President Recep Tayyip Erdoğan to allow tens of thousands of asylum seekers and migrants free movement to the Greek border demonstrated the fragility of the EU-Turkey deal and the European Union's broader approach to outsource migration management to third countries. This article examines the causes for the tensions, the EU approach to external partnerships, and a hardening European attitude towards unwanted arrivals.




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Humanitarian Protection in an Era of Pandemic

MPI and MPI Europe experts discuss the effects of the coronavirus pandemic on asylum systems in Europe and North America, as well as in developing regions, where 85 percent of refugees live. During this freeform conversation, our analysts also assess the implications for the principle of asylum and the future for a post-World War II humanitarian protection system that is under threat.




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Stony Brook University opens Center for Implant and Digital Technology

Stony Brook School of Dental Medicine opened Dec. 5 its Center for Implant and Digital Technology, which will serve as a state-of-the-art space for digital dentistry-focused education, patient care and research.




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Dr. Loree Bolin is ADA’s 2020 Humanitarian Award recipient

Dr. Loree Bolin’s humanitarian work has drawn accolades from the dental community in her home state of Washington, and now Dr. Bolin is being recognized nationally by being named the recipient of the ADA’s 2020 Humanitarian Award, bestowed by the ADA Board of Trustees.




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HIPAA fee limitation no longer applies to third-party access to health records

Following a ruling in federal court two days prior, the Department of Health and Human Services announced Jan. 25 that the Health Insurance Portability and Accountability Act Privacy Rule fee limitations do not apply to requests to transmit copies of records to third-parties.




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ADA Board of Trustees holds historic all-digital meeting April 3

The ADA Board of Trustees traditionally holds six meetings a year at Association Headquarters in Chicago, but this year, for the first time, the Board held its April meeting via Zoom — an all digital meeting.




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Northern California dentist heads to Uganda, ends up becoming a humanitarian

Traveling with purpose is what has led Nevada City, California-based general dentist Dr. Jean Creasey to a rural district in the southwestern region of Uganda over the past 15 years as a member of the Kellermann Foundation, treating and helping educate the villagers on the importance of good oral health as a way to a better future.




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Hospitalization for Lactic Acidosis Among Patients With Reduced Kidney Function Treated With Metformin or Sulfonylureas

OBJECTIVE

To compare the risk of lactic acidosis hospitalization between patients treated with metformin versus sulfonylureas following development of reduced kidney function.

RESEARCH DESIGN AND METHODS

This retrospective cohort combined data from the National Veterans Health Administration, Medicare, Medicaid, and the National Death Index. New users of metformin or sulfonylureas were followed from development of reduced kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 or serum creatinine ≥1.4 mg/dL [female] or 1.5 mg/dL [male]) through hospitalization for lactic acidosis, death, loss to follow-up, or study end. Lactic acidosis hospitalization was defined as a composite of primary discharge diagnosis or laboratory-confirmed lactic acidosis (lactic acid ≥2.5 mmol/L and either arterial blood pH <7.35 or serum bicarbonate ≤19 mmol/L within 24 h of admission). We report the cause-specific hazard of lactic acidosis hospitalization between metformin and sulfonylureas from a propensity score–matched weighted cohort and conduct an additional competing risks analysis to account for treatment change and death.

RESULTS

The weighted cohort included 24,542 metformin and 24,662 sulfonylurea users who developed reduced kidney function (median age 70 years, median eGFR 55.8 mL/min/1.73 m2). There were 4.18 (95% CI 3.63, 4.81) vs. 3.69 (3.19, 4.27) lactic acidosis hospitalizations per 1,000 person-years among metformin and sulfonylurea users, respectively (adjusted hazard ratio [aHR] 1.21 [95% CI 0.99, 1.50]). Results were consistent for both primary discharge diagnosis (aHR 1.11 [0.87, 1.44]) and laboratory-confirmed lactic acidosis (1.25 [0.92, 1.70]).

CONCLUSIONS

Among veterans with diabetes who developed reduced kidney function, occurrence of lactic acidosis hospitalization was uncommon and not statistically different between patients who continued metformin and those patients who continued sulfonylureas.




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A Randomized Controlled Trial Comparing Glargine U300 and Glargine U100 for the Inpatient Management of Medicine and Surgery Patients With Type 2 Diabetes: Glargine U300 Hospital Trial

OBJECTIVE

The role of U300 glargine insulin for the inpatient management of type 2 diabetes (T2D) has not been determined. We compared the safety and efficacy of glargine U300 versus glargine U100 in noncritically ill patients with T2D.

RESEARCH DESIGN AND METHODS

This prospective, open-label, randomized clinical trial included 176 patients with poorly controlled T2D (admission blood glucose [BG] 228 ± 82 mg/dL and HbA1c 9.5 ± 2.2%), treated with oral agents or insulin before admission. Patients were treated with a basal-bolus regimen with glargine U300 (n = 92) or glargine U100 (n = 84) and glulisine before meals. We adjusted insulin daily to a target BG of 70–180 mg/dL. The primary end point was noninferiority in the mean difference in daily BG between groups. The major safety outcome was the occurrence of hypoglycemia.

RESULTS

There were no differences between glargine U300 and U100 in mean daily BG (186 ± 40 vs. 184 ± 46 mg/dL, P = 0.62), percentage of readings within target BG of 70–180 mg/dL (50 ± 27% vs. 55 ± 29%, P = 0.3), length of stay (median [IQR] 6.0 [4.0, 8.0] vs. 4.0 [3.0, 7.0] days, P = 0.06), hospital complications (6.5% vs. 11%, P = 0.42), or insulin total daily dose (0.43 ± 0.21 vs. 0.42 ± 0.20 units/kg/day, P = 0.74). There were no differences in the proportion of patients with BG <70 mg/dL (8.7% vs. 9.5%, P > 0.99), but glargine U300 resulted in significantly lower rates of clinically significant hypoglycemia (<54 mg/dL) compared with glargine U100 (0% vs. 6.0%, P = 0.023).

CONCLUSIONS

Hospital treatment with glargine U300 resulted in similar glycemic control compared with glargine U100 and may be associated with a lower incidence of clinically significant hypoglycemia.




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House probe: Trump admin failed to adequately screen travelers from South Korea, Italy for COVID-19

The Trump administration failed to conduct effective screening of passengers from South Korea and Italy for the coronavirus when those countries were experiencing rapid expansion in COVID-19 cases.




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Honey bees face chronic paralysis pandemic in Britain

The virus responsible for chronic bee paralysis is spreading rapidly among honey bee colonies in Britain, according to a new study.




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Look: Brian May visits hospital after injuring buttocks while gardening

Queen guitarist Brian May is recovering after tearing his gluteus maximus during a moment of "over-enthusiastic" gardening.




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Can Return Migration Revitalize the Baltics? Estonia, Latvia, and Lithuania Engage Their Diasporas, with Mixed Results

Faced with high emigration rates and shrinking, aging populations, the Baltic states—Estonia, Latvia, and Lithuania—are exploring different ways to lure back nationals who have emigrated and establish or solidify ties with members of the diaspora. Of the three countries, Estonia is proving the most successful, while Latvia appears to be ignoring the looming demographic crisis and lacks an immigration plan.




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[ Politics ] Open Question : IF Cons rewrote the Constitution of the United States would it have less laws, more liberty, & move power from DC to the State Capitals?

Oh would that 'less laws/more liberty/more state capital power' look anything like Mike Pence's Religious Freedom Restoration Act or in other words the 'we Conservative Republican Christians are such oppressed persecuted victims WAAAAA WAAAA' Bill. https://www.youtube.com/watch?v=KIikqPmbgvI 




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From Emigration to Asylum Destination, Italy Navigates Shifting Migration Tides

Long a country of emigration—13 million Italians went abroad between 1880 and 1915—Italy has also experienced significant inflows of Middle Eastern and sub-Saharan African workers in recent decades. Italy has also been on the frontlines of Europe's refugee crisis. This country profile examines Italy's shifting migration patterns, policy responses over time, and debates.