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Krim Pelangsing Badan Alami Geen Tea - Rahasia Pria

Krim Pelangsing Badan Alami Green Tea adalah pelangsing herbal berbentuk krim berguna untuk melangsingkan dan mempercepat pembakaran lemak perut, lengan dl



  • Sports and Health

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UTech community in mourning over passing of lecturer

The University of Technology, Jamaica (UTech) fraternity has been plunged into mourning following the death of lecturer Jamar Thelwell. The 34-year-old passed away yesterday from cancer. His colleague Jerome Shepherd said Thelwell’s death has...




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Businesses hope to get some action for Mother’s Day

Just last year, one could find a variety of deals and promotions for Mother’s Day with ease, but for 2020, the opposite is true. This change could be connected with the coronavirus pandemic and a number of businesses having to close their doors for...




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Analysing the Recent Changes in Russia

Invitation Only Research Event

17 February 2020 - 10:30am to 12:00pm

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

Event participants

Leonid Gozman, President, Perspective Foundation

The scale of the changes in Russia’s political system is yet to be fully understood, as new suggestions for revising the constitution appear almost daily. This event will discuss the risks of President Putin’s 15 January announcement, and what strategies Russia’s non-systemic opposition might now deploy in response.

Event attributes

Chatham House Rule

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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Webinar: Russian Disinformation's Golden Moment: Challenges and Responses in the COVID-19 Era

Invitation Only Research Event

7 May 2020 - 3:00pm to 4:30pm

Event participants

Anneli Ahonen, Head, StratCom East Task Force, European External Action Service
Keir Giles, Senior Consulting Fellow, Russia and Eurasia Programme, Chatham House
Thomas Kent, Adjunct Associate Professor, Harriman Institute, Columbia University; Senior Fellow, the Jamestown Foundation
Chairs:
James Nixey, Programme Director, Russia and Eurasia, Chatham House
Glen Howard, President, The Jamestown Foundation
The COVID-19 pandemic provides the ideal environment for malign influence to thrive as it feeds on fear and a vacuum of authoritative information. What are the current challenges posed by Russian disinformation, and how should Western nations be responding?
 
In this discussion, jointly hosted by the Jamestown Foundation and the Chatham House Russia and Eurasia Programme, the speakers will consider what best practice looks like in safeguarding Western societies against the pernicious effects of disinformation. 
 
This event will be held on the record.

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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Love the sinner, not the sin

I go to church and sit at the back while you tell me I’m going to hell I go to church and sit at the back while you announce the Dates for ‘Men’s Breakfast’ I go to church and sit at the back while you undress my sin, wanting to love me naked Stripped, beaten, […]




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On Loosing People

How I wish I had another chance at, Caroline, I would rub her stomach until, She fell asleep, And sit there some more, Catch her  when the nightmare , Threatened to be too real, I’d tell her stories about the past, about dragons and princesses and, Hero’s, I’d sit still beside her all night and, […]




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Loosing our minds

  I am right. You may say that I am not, but I have, Demanded love and, You, Are wrong. Black and blue and red hummingbird, I Know what I am saying, you Left the kids again, And we argue, Tall as bamboo we, Kill each other, Taking long hours to, Identify precisely who left […]




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Climate Change: Raising Ambition, Delivering Results

Conference

3 November 2014 - 9:30am to 4 November 2014 - 1:15pm

Chatham House, London

Overview

Agenda

Speakers

Pricing

Media partners

Sponsors

Audience profile

Venue and accommodation

Press registration

Climate change is climbing the political agenda. Extreme weather has raised questions in public discourse about the role of anthropogenic warming and concerns about its future impacts; slowdowns in emerging economies and sluggish recoveries in the developed world mean debates about the impact of climate policies on energy bills and competitiveness have assumed particular significance. Against this background, governments are gearing up for a crucial series of agreements in 2015 with climate change at their core. The international community must agree new global sustainable development goals, a new framework on disaster risk reduction and, at the 21st UN Framework Convention on Climate Change (UNFCCC) meeting of the Conference of Parties (COP 21) in Paris, a new global deal on climate change. 

The 18th Annual Chatham House Conference on Climate Change will take stock of developments in 2014, including the latest science, the findings of high-level commissions, initiatives from the business community and the UN Secretary-General’s High Level Summit at the end of September. Looking forward to COP 20 in Lima and beyond, this conference will examine opportunities to raise ambition and convert this into results.

In particular, it will:

  • Review the latest science on climate risk and the implications for business, society and politics 
     
  • Examine the benefits of a low carbon economy, and assess the costs of climate action and where they fall 
     
  • Discuss concrete measures to decarbonize key sectors and the barriers to action
     
  • Identify the critical path to the UNFCCC’s Conference of the Parties (COP 21) in 2015, and look at whether, and how, support for ambitious action can be built among publics, business and politicians


The Chatham House Rule
To enable as open a debate as possible, this conference will be held under the Chatham House Rule.

Twitter
Suggested hashtag: #CHclimate

DAY ONE
Monday 3 November

Session One
Taking Stock and Mapping the Road Ahead
09:30-11:15

  • What was achieved at the UN Secretary General’s High Level Summit in September? 
  • What is the outlook for COP 20 in Lima, and how can ambition be increased?
  • How will success at COP 21 in Paris be defined?

Chair
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

Keynote Address
Manuel Pulgar-Vidal, Minister of State for the Environment, Peru; President, COP 20, UN Framework for the Convention on Climate Change (UNFCCC) (on the record)

Amber Rudd MP, Parliamentary Under Secretary of State, Department of Energy and Climate Change, United Kingdom (on the record)

Questions and Discussion

Chair
Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Speakers

Selwin Hart, Director, Secretary-General's Climate Change Support Team, United Nations

Dr Halldór Thorgeirsson, Director for Strategy, UN Framework for the Convention on Climate Change (UNFCCC)

Leena Srivastava, Executive Director, The Energy and Resource Institute (TERI) 

Paul Watkinson, Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Questions and Discussion

11:15-11:45 Refreshments

Session Two
Low Carbon Economy: Costs and Benefits
11:45-13:00 

  • What are the economic and social opportunities and benefits of a low carbon economy? Where do these occur? How much are they worth?
  • What are examples of leadership among governments and business? What is needed to accelerate the transition and translate ambition into results?
  • What has been the impact of climate policies on economic competitiveness? Which economies and sectors have been most affected? How has this influenced national and international climate politics?
Chair's Opening Remarks
Marianne Fay, Chief Economist, Climate Change Group, The World Bank
Keynote Panel Discussion

Jeremy Oppenheim, Programme Director, New Climate Economy, Global Commission on the Economy and Climate 

Jos Delbeke, Director General for Climate Action, European Commission 

Dr Qi Ye, Director, Brookings-Tsinghua Center for Public Policy; Professor of Environmental Policy and Management at Tsinghua University’s School of Public Policy and Management

Jeremy Bentham, Vice President, Global Business Environment, Shell

Questions and Discussion

13:00-14:00 Lunch

Session Three
Concrete Steps to Action: Finance and Achieving Net Zero 

There is growing interest in the concept of net zero carbon emissions, for businesses, sectors and even countries. This session will examine the feasibility of net zero for the power and transport sectors, and for buildings and cities.

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Opening Discussion
Manfred Konukiewitz, Co-Chair, the Green Climate Fund 

Matthew Kotchen, Professor of Economics, Yale University 

Farhana Yamin, Associate Fellow, Chatham House

Power and Transport
14:45-15:45

  • What do decarbonization roadmaps for the power and transport sectors look like? Is net zero feasible? If so, by when and how? What are the challenges posed by increasing renewable penetration, and how can they be managed? What are the implications of vehicle electrification for the power sector?
  • What are the implications for infrastructure and investment?

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Speakers
Abyd Karmali, Managing Director, Climate Finance, Bank of America Merrill Lynch

Dries Acke, Policy Manager, European Climate Foundation (Belgium) 

Olivier Paturet, General Manager,  Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer, Co-Founder and Director, South South North;  Co-Director, MAPS Programme 

Questions and Discussion

15:45-16:15 Refreshments

Buildings and Cities
16:15-17:15

  • What is the state of the art for low carbon building; how can this be rolled out at scale? 
  • How can decarbonization objectives be incorporated into urban planning and regulation?
  • How are the challenges and needs different for developed and developing countries? 

Chair
Farhana Yamin, Associate Fellow, Energy, Environment and Resources, Chatham House

Speakers
Ed Mazria, Founder and CEO, Architecture 2030

Tony Mallows, Director, Masdar City 

Questions and Discussion

17:15 Close of day and drinks reception

DAY TWO
Tuesday 4 November

Session Four 
Climate Impacts
9:30-11:15 

Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Keynote Addresses
HE Belete Tafere, Minister, Ministry of Environment Protection and Forestry, Ethiopia (on the record)

Professor Hans Joachim Schellnhuber, Founding Director, Potsdam Institute for Climate Impact Research (on the record)

  • What climate impacts are already being witnessed? Are these in line with expectations? What is the current state of attribution analysis?
  • What are the implications for climate politics?
  • What are the expected social, economic and environmental impacts under different climate scenarios? What is the most recent science since the deadline for Working Group II of the Intergovernmental Panel on Climate Change’s Fifth Assessment Report?  
  • Which countries and sectors are most vulnerable? What are governments and businesses doing to adapt?


Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Speakers
Chris Field, Founding Director, Department of Global Ecology, Carnegie Institution of Science, Co-Chair of Working Group II of the IPCC’s Fifth Assessment Report 

Professor Myles Allen, Leader of ECI Climate Research Programme and Professor of Geosystem Science, University of Oxford 

Nick Mabey, Director, E3G 

Oilver Bettis, Chair, Resource and Environment Board, Institute and Faculty of Actuaries

Questions and Discussion

11:15 - 11.45 Refreshments

Session Five
The Conditions for Action
11:45 - 13:00

  • What is the current state of public support for climate action? What shapes attitudes and beliefs? How does this vary by country? 
  • What can create political ambition, nationally and internationally?
  • What role can different stakeholders play in catalysing climate action?
  • What immediate obstacles need to be overcome and what lessons can be learned from recent success? 
Chair
Simon Maxwell, Executive Chair, Climate Development Knowledge Network
Keynote Address
Bill McKibben, President and Co-Founder, 350.org (on the record)

Panel Discussion
Antonio Hill, Executive Director, Global Campaign for Climate Action

Michael Jacobs, Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations  

Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Sergio Margulis, National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency of Brazil 

Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Questions and Discussion

Closing remarks
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

1
3:10 End of conference and lunch

 © The Royal Institute of International Affairs 2014

Keynote Speakers

Speakers

Dries Acke

Policy Manager, European Climate Foundation (Belgium)

Myles Allen

Coordinating Lead Author, Intergovernmental Panel on Climate Change Special Report on Global Warming of 1.5 °C; Professor of Geosystem Science, University of Oxford

Oliver Bettis

Chair, Institute and Faculty of Actuaries' Resource and Environment Board

Marianne Fay

Chief Economist, Climate Change Group, The World Bank

Chris Field

Founding Director, Department of Global Ecology, Carnegie Institution of Science

Selwin Hart

Director, Secretary-General's Climate Change Support Team, United Nations

Antonio Hill

Executive Director, Global Campaign for Climate Action

Michael Hogan

Senior Adviser, Regulatory Assistance Project

Professor Michael Jacobs

Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations

Abyd Karmali

Managing Director, Climate Finance, Bank of America Merrill Lynch

Sir David King

Foreign Secretary’s Special Representative for Climate Change

Manfred Konukiewitz

Co-Chair, The Green Climate Fund

Matthew Kotchen

Professor of Economics, Yale University

Nick Mabey

Co-Founding Director and Chief Executive, E3G

Antony Mallows

Director, Masdar City

Sergio Margulis

National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency, Brazil

Simon Maxwell

Executive Chairman, Climate and Development Knowledge Network

Edward Mazria

Founder and CEO, Architecture 2030

Jennifer Morgan

Executive Director, Greenpeace International

Olivier Paturet

General Manager, Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer

Co-Founder and Director, South South North; Co-Director, MAPS Programme

Jose-Manuel Sanoval

Coordinator, Colombian Low Carbon Development Strategy (CLCDS) and Mitigation Action Plans and Scenarios (MAPS)

Leena Srivastava

Hony. Executive Director (Operations), The Energy and Resources Institute (TERI)

Halldór Thorgeirsson

Director for Strategy, UN Framework for the Convention on Climate Change

Paul Watkinson

Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Farhana Yamin

Associate Fellow, Energy, Environment and Resources Programme

[node:event_chair]

Pricing

For any questions about rates, please call +44 (0)20 7314 2782.

                      FULL RATE
EXCL. VATINCL. VAT
Major corporate member rates
All organizations£595£714 
Corporate member rates
Commercial organizations£1,295£1,554
Government departments£775£930
NGOs and academics£495£594
Standard rates
Commercial organizations£1,445£1,734 
Government departments£845£1,014
NGOs and academics£550£660

This conference will offer a unique opportunity to network with senior officials from businesses, government, NGO's and academic institutions.

Our previous Climate Change conferences saw delegates from companies and institutions such as:

Accenture
AEA Energy & Environment
Agulhas
ArcelorMittal
Association of Asia Pacific Airlines (AAPA)
Atkins Ltd
Bank of America Merrill Lynch
BASF plc
Bayerngas Norge AS
Beetle Capital
BG Group plc
BHP Billiton
BIRA-IASB
BirdLife
Booz & Co
BP plc
British Council
BT Group plc
CAFOD
Cairn Energy plc
Cambridge Centre for Energy Studies
Cambridge Programme for Sustainable Leadership
Carbon Capture and Storage Association
Carbon Leapfrog
Carbon Trust
Caritas Internationalis
Catholic Fund for Overseas Development (CAFOD)
CH2M Hill
Chevron Ltd
Chubu Electric Power Co Inc
City of London
ClientEarth
Clifford Chance LLP
Climate & Development Knowledge Network (CDKN)
Climate Action Network (CAN)
Climate and Health Council
Climate Secure
Coalition for an International Court for the Environment (ICE Coalition)
Compassion in World Farming (CIWF)
Conocophillips (UK) Ltd
Control Risks
Co-operative Group
Cranfield University
Deloitte Consulting LLP
Department for Business, Innovation & Skills (BIS)
Department for International Development (DFID)
Department of Energy and Climate Change (DECC)
Ecofys UK Ltd
Ecologic Institute
EDF Energy
Energy Charter Secretariat
Energy Technologies Institute
Eni S.p.A
Environment Agency
Environmental Law Foundation (ELF)
Environmental Protection Agency (EPA)
Environmental Resources Management (ERM)
ENWORKS
Ernst & Young
Ethical Investment Research Services Ltd (EIRIS)
European Bank For Reconstruction & Development
European Commission (Directorate General for Enterprise and Industry)
European Parliament
ExxonMobil International Ltd
Fauna & Flora International
FIA Foundation for the Automobile and Society
Finnish Forest Association
Foreign and Commonwealth Office (FCO)
Forestry Commission
Friends of the Earth
Genesis Investment Management LLP
GLG Partners LP
Global CCS Institute
Global Humanitarian Forum
Global Sustainability Institute
Global Witness
Globeleq Ltd
Grantham Research Institute on Climate Change and the Environment, LSE
Greater Manchester Chamber of Commerce
Greenpeace International
Herbert Smith Freehills LLP
HM Treasury
Imperial College London
INPEX Corporation
Institute for Public Policy Research (IPPR)
Institutional Investors Group on Climate Change (IIGCC)
International Association of Oil & Gas Producers
International Council on Mining and Metals
International Finance Corporation (IFC)
International Institute for Environment and Development (IIED)
International Organization for Standardization (ISO)
Japan External Trade Organization (JETRO)
Joseph Rowntree Foundation
JPMorgan
King's College London
KPMG
Kuwait Petroleum Corporation
London Assembly
London Metropolitan University
London School of Economics and Political Science (LSE)
Maersk Group
Massey University
McKinsey & Company
Met Office
METREX
Ministere des Affaires Etrangeres, France
Ministry of Defence (Development, Concepts and Doctrine Centre)
Ministry of Foreign Affairs, Netherlands
Ministry of Foreign Affairs, Finland
Ministry of Foreign Affairs, Poland
Ministry of Infrastructure and the Environment
Mitsubishi Corporation
National Farmers' Union
National Round Table on the Environment and the Economy
Netherlands Development Finance Company (FMO)
NEXUS Singapore
Nordic Council
Office of National Assessments
Ogilvy
Open Society Foundation
Overseas Development Institute (ODI)
Oxford University
Plan UK
PricewaterhouseCoopers LLP
Privy Council Office
Progressio
Quaker Peace and Social Witness
Québec Government Office
Renewable Energy and Energy Efficiency Partnership (REEEP)
Renewable Energy Systems Ltd (RES)
Rolls-Royce International Ltd
RWE Power AG
Save the Children UK
SCA, Svenska Cellulosa Aktiebolaget
School of Oriental and African Studies (SOAS)
Shell
Standard Chartered Bank plc
Statoil (UK) Ltd
SustainAbility Ltd
Swedish Defence Research Agency (FOI)
Swiss Agency for Development and Cooperation SDC
Task Consult
Texas A&M University
The 40 Foundation
The Climate Group
The Gold Standard Foundation
The Norwegian Institute for Nature Research
The Open University
The Prince of Wales Corporate Leader Group
The Royal Society
The Saudi Fund For Development
Tokyo Electric Power Company
Total Holdings UK Ltd
UK Chamber of Shipping
UK Collaborative on Development Sciences (UKCDS)
United Nations Environment Programme (UNEP)
University College London (UCL)
University of Cambridge
University of East Anglia (School of Environmental Sciences)
University of Edinburgh
University of Oxford (Department of Politics and International Relations)
US Department of State
USAID
Warwick Business School
WaterAid
World Coal Association
World Coal Institute
World Economic Forum
World Society for the Protection of Animals (WSPA)
World Vision UK
WWF-UK
Xynteo Ltd
Yorkshire Forward

Venue

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

conferences@chathamhouse.org

Telephone: +44 (0)20 7957 5729
Fax: +44 (0)20 7957 5710

If you wish to book the venue for your event please phone +44 (0)20 7314 2764


Directions

The nearest tube station is Piccadilly Circus which is on the Piccadilly and the Bakerloo Underground lines. From Piccadilly follow Regent Street southwards towards Pall Mall and take the first road on the right called Jermyn Street. Duke of York Street is the second road on the left and leads to St James's Square. Chatham House is immediately on your right.

Map

Accommodation

Although we cannot book accommodation for delegates, we have arranged a reduced rate at some nearby hotels, where you can book your own accommodation. Please inform the hotel that you will be attending a conference at Chatham House (The Royal Institute of International Affairs) to qualify for the Institute's reduced rate.

Please note all rates are subject to availability.

Flemings Mayfair
Half Moon Street
Mayfair
London W1J 7BH
Tel: + 44 (0)20 7499 2964
Fax: + 44 (0)20 7499 1817
Standard Single from £199 + VAT

The Cavendish London
81 Jermyn Street
London
SW1Y 6JF
Tel: + 44 (0)20 7930 2111
Fax: + 44 (0)20 7839 2125
Standard Single £205 + VAT

To book The Cavendish online

The Stafford London by Kempinski
St James's Place
London
SW1A 1NJ
Tel: 020 7518 1125
Fax: 020 7493 7121
Standard Single £230 +VAT

This conference will be held under the Chatham House Rule. Information for journalists
Press can request a press pass.


Chatham House Conferences

+44 (0)20 7957 5729




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A Good Deal? Assessing the Paris Climate Agreement

Invitation Only Research Event

16 December 2015 - 5:00pm to 6:30pm

Chatham House, London

Event participants

Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources Department, Chatham House

Following the conclusion of the Paris climate negotiations, this expert roundtable will examine the critical elements of the final agreement and what this means for the future of energy and climate policy in key countries.

The discussion will examine what the agreement means for keeping global average temperatures below two degrees Celsius and assess whether ambition will be ratcheted over time. It will also look at the primary implications of the outcome for key regions and countries such as the EU, United States, China and India. Finally, the session will also consider the next steps in terms of implementing the agreement. 

Attendance at this event is by invitation only. 

Owen Grafham

Manager, Energy, Environment and Resources Programme
+44 (0)20 7957 5708




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Inner Circle gives thanks for Jacob Miller on his birthday - Singer would have caused ‘problem’ at King’s House, says ­former bandmate

Long before the existence of the Internet and going viral was a thing, reggae singer Jacob Miller, back in the ‘70s, coined a term that went viral – under heavy manners. Ian Lewis of Inner Circle band, the Bad Boys of Reggae, recalled that his...




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'My Boy Lollipop' singer Millie Small will be sorely missed

There has been an outpouring of grief following the death of legendary Jamaican singer Millicent Dolly May Small, popularly known as Millie Small. She died in the United Kingdom today at the age of 73 after suffering a stroke. The voice...




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Singer Owen Gray remembers ‘Sugar Plum’ Millie Small

BEFORE MILLIE Small became the ‘lollipop girl’, she was a ‘sugar plum’. Not only is it a term of endearment, it is also the title of her first song – a duet as it was called back in 1960 – with singer Owen Gray. This collab was born out of the time...




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Buju Banton calls new single with John Legend 'special'

LOS ANGELES (AP) — It’s been over a decade since reggae king Buju Banton and R&B star John Legend collaborated on a song, and the Grammy winners have reunited for a new track. Banton and Legend released the easygoing love song...




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Lacey-Ann Bartley: carving her name in business

From formalising her father’s business and taking it to higher and more profitable heights to sitting on the board of EXIM Bank and lecturing in the field of business development, Lacey-Ann Bartley has earned her stripes as the Distinguished Woman...




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Danielia Mclean A powerhouse in business

M arketing guru and smashing entrepreneur Danielia McLean is known to the business and communication worlds as a powerhouse fiercely working to clutch success. Finding a novel business idea can be difficult; pursuing it, successfully, even more so...




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Ja’s women have combated and won in business

At age 13, Nadeen Matthews Blair, chief executive officer of the NCB Foundation, challenged the tide to prove to a guidance counsellor at her United States-based school, that black girls can overcome all odds to become powerful leaders. Matthews...




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Orioles considering using 'opener' strategy

Since the Rays debuted "the opener" last May, no fewer than eight teams have helped transform the concept from a fad into a mini-movement. Consider the Orioles a candidate to dive in next.




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Astros have unfinished business this season

The Astros logo outside the Ballpark of the Palm Beaches really is something to see, all the way from Haverhill Rd. The closer you get the bigger it gets, the white "H" right there in front of the huge orange star. Underneath the "H" is the following message, white against orange: "2017 World Champions." It would have been a simple matter to put "2018" down there, too. There was room.




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Bregman progressing from elbow surgery

Astros third baseman Alex Bregman continues to progress from the arthroscopic elbow surgery he had a month to remove bone chips.




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Raising HD awareness personal for Smith, wife

They wrestled with the decision to start a family for five years. It's something most young couples discuss at some point. Timing is important, and considering their busy lives, even more so for Astros pitcher Joe Smith and his wife, TV sports reporter Allie LaForce. The issue facing the couple is far more momentous than most others have to deal with -- one that's a matter of life and death.




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Michelle Sinclair GP - surgery buildings are not up to scratch

Michelle Sinclar, a GP in Hampshire who is concerned that GP premises aren't fit for purpose and limit her ability to provide fully rounded patient care. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on...




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Diagnosing COPD in primary care

Francesca Conway, from the Department of Primary Care and Public Health at Imperial College London is co-author of an article on diagnosis of COPD. She joins us to discuss the major guideline recommendations, and highlights where they concur and where they differ. Read the full article: http://www.bmj.com/content/351/bmj.h6171




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Advertising junk food to children

In the UK, junk food advertising is banned on children’s TV - but manufactures are still able to target children in other ways.  A recent report from the WHO  "Tackling food marketing to children in a digital world", takes a look at the issue. In this podcast we're joined by João Breda, programme manager for nutrition physical activity and...




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Should all American doctors be using electronic medical records?

Evidence shows using electronic health records can increase efficiency, and reduce preventable medical errors - but only if they are used properly. However, in the US, the president of the American Medical Association calls them almost unusable. In this debate, Richard Hurley is joined by George Gellert, Regional Medical Informatics Officer at...




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Assessing and treating an electrical injury

Thankfully, electrical injuries are relatively uncommon - but that means that lack of evidence regarding the management of patients who have been electrocuted, which can cause concern for clinicians when these patients present. In this podcast, Cath Brizzel, clinical editor for The BMJ, is joined by one of the authors of a clinical update on the...




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What Choosing Wisely looks like in the UK

Choosing Wisely was launched in the US, to much fanfare. Since then the movement has spread around the world, with successful chapters set up in Canada, Australia Brazil, Italy, Japan, new Zealand - and most recently the UK. The campaigns have not been without criticism – from how individual recommendations were chosen, to the way in which...




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Chronic Rhinosinusitis

Patients who experience chronic rhinosinusitis may way for a considerable period of time before presenting, because they believe the condition to be trivial. In this podcast, Alam Hannan, ENT Consultant at the Royal Throat Nose and Ear Hospital in London, explains why that belief is not founded, and describes which treatments can be effective at...




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Passing on the secret knowledge of loop diuretics

In every generation there are a few that know the secret; the counterintuitive effects of loop diuretics. In this podcast Steven Anisman, cardiologist at the Dartmouth Hitchcock Department of Cardiovascular Medicine, joins us to explain about the threshold effects of these drugs, and why that might change the way in which you think about...




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Talk evidence - cancer causing food, prostate cancer and disease definitions

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.05) Carl rants about bacon causing cancer (7.10) Helen talks about prostate cancer, and we hear from the author of the research paper which won Research Paper Of The Year at the BMJ awards. We also cover disease definition and...




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Reversing our preconceptions about where innovation comes from

Reverse innovation may sound like some attempt to return to the dark ages - but it has a specific meaning, especially when it comes to med-tech. It’s about where we look for innovation - and overturning our preconceived ideas of where new ideas come from. Mark Skopec, and Matthew Harris - both from Imperial College London are two of the authors...




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Writing a good outpatient letter means addressing it to the patient

In many countries (including the UK and Australia) it is still common practice for hospital doctors to write letters to patients’ general practitioners (GPs) following outpatient consultations, and for patients to receive copies of these letters. However, Hugh Rayner, consultant nephrologist, and Peter Rees, former Chair of the Academy of...




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Predictive Modeling of Type 1 Diabetes Stages Using Disparate Data Sources

This study aims to model genetic, immunologic, metabolomics, and proteomic biomarkers for development of islet autoimmunity (IA) and progression to type 1 diabetes in a prospective high-risk cohort. We studied 67 children: 42 who developed IA (20 of 42 progressed to diabetes) and 25 control subjects matched for sex and age. Biomarkers were assessed at four time points: earliest available sample, just prior to IA, just after IA, and just prior to diabetes onset. Predictors of IA and progression to diabetes were identified across disparate sources using an integrative machine learning algorithm and optimization-based feature selection. Our integrative approach was predictive of IA (area under the receiver operating characteristic curve [AUC] 0.91) and progression to diabetes (AUC 0.92) based on standard cross-validation (CV). Among the strongest predictors of IA were change in serum ascorbate, 3-methyl-oxobutyrate, and the PTPN22 (rs2476601) polymorphism. Serum glucose, ADP fibrinogen, and mannose were among the strongest predictors of progression to diabetes. This proof-of-principle analysis is the first study to integrate large, diverse biomarker data sets into a limited number of features, highlighting differences in pathways leading to IA from those predicting progression to diabetes. Integrated models, if validated in independent populations, could provide novel clues concerning the pathways leading to IA and type 1 diabetes.




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Downswell reaches out to Central Village - Carry Me singer delivers care packages to community

The wet weather last Saturday (May 2) could not dampen the spirits of award-winning gospel artiste and ordained evangelist Kevin Downswell as he ventured into the St Catherine community of Central Village, where he spent some of his formative years...




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Sector groups: Increase business hours

No sooner than the Government’s announced its intention to restart the economy, private sector groups are advocating for longer working hours to fast-track recovery during the COVID-19 pandemic. In a collaborative move, the Jamaica Manufacturers...




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Public health leaders slam Boris Johnson over “sin tax” review plan




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Obesity: raising price of sugary snacks may be more effective than soft drink tax




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Obesity: medical leaders call for end to “stigmatising” language




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Reds' statement on passing of Frank Robinson

Frank Robinson is considered one of the greatest players to ever wear a Cincinnati Reds uniform. His talent and success brought dynamic change to the Reds and to our City.




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Letter of the Day | Tourism won’t be ‘business as usual’

THE EDITOR, Madam: With most things grinding to a halt worldwide, this pandemic has proven to be as much of an economic crisis as it is a health one. Many sectors have changed their day-to-day operations, with some allowing for greater flexibility...




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A Single Bout of One-Legged Exercise to Local Exhaustion Decreases Insulin Action in Nonexercised Muscle Leading to Decreased Whole-Body Insulin Action

A single bout of exercise enhances insulin action in the exercised muscle. However, not all human studies find that this translates into increased whole-body insulin action, suggesting that insulin action in rested muscle or other organs may be decreased by exercise. To investigate this, eight healthy men underwent a euglycemic-hyperinsulinemic clamp on 2 separate days: one day with prior one-legged knee-extensor exercise to local exhaustion (~2.5 h) and another day without exercise. Whole-body glucose disposal was ~18% lower on the exercise day as compared with the resting day due to decreased (~37%) insulin-stimulated glucose uptake in the nonexercised muscle. Insulin signaling at the level of Akt2 was impaired in the nonexercised muscle on the exercise day, suggesting that decreased insulin action in nonexercised muscle may reduce GLUT4 translocation in response to insulin. Thus, the effect of a single bout of exercise on whole-body insulin action depends on the balance between local effects increasing and systemic effects decreasing insulin action. Physiologically, this mechanism may serve to direct glucose into the muscles in need of glycogen replenishment. For insulin-treated patients, this complex relationship may explain the difficulties in predicting the adequate insulin dose for maintaining glucose homeostasis following physical activity.




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Troponin T Parallels Structural Nerve Damage in Type 2 Diabetes: A Cross-sectional Study Using Magnetic Resonance Neurography

Clinical studies have suggested that changes in peripheral nerve microcirculation may contribute to nerve damage in diabetic polyneuropathy (DN). High-sensitivity troponin T (hsTNT) assays have been recently shown to provide predictive values for both cardiac and peripheral microangiopathy in type 2 diabetes (T2D). This study investigated the association of sciatic nerve structural damage in 3 Tesla (3T) magnetic resonance neurography (MRN) with hsTNT and N-terminal pro-brain natriuretic peptide serum levels in patients with T2D. MRN at 3T was performed in 51 patients with T2D (23 without DN, 28 with DN) and 10 control subjects without diabetes. The sciatic nerve’s fractional anisotropy (FA), a marker of structural nerve integrity, was correlated with clinical, electrophysiological, and serological data. In patients with T2D, hsTNT showed a negative correlation with the sciatic nerve’s FA (r = –0.52, P < 0.001), with a closer correlation in DN patients (r = –0.66, P < 0.001). hsTNT further correlated positively with the neuropathy disability score (r = 0.39, P = 0.005). Negative correlations were found with sural nerve conduction velocities (NCVs) (r = –0.65, P < 0.001) and tibial NCVs (r = –0.44, P = 0.002) and amplitudes (r = –0.53, P < 0.001). This study is the first to show that hsTNT is a potential indicator for structural nerve damage in T2D. Our results indirectly support the hypothesis that microangiopathy contributes to structural nerve damage in T2D.




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Promoting Legal and Sustainable Timber: Using Public Procurement Policy

8 September 2014

This paper examines governments’ efforts to use public procurement policy to promote the use of legal and sustainable timber. Timber procurement can provide valuable lessons to governments when developing sustainable procurement policies for other products associated with deforestation.

Duncan Brack

Associate Fellow, Energy, Environment and Resources Programme

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Logging and timber production and transportation on the Isle of Mull in the Inner Hebrides of Scotland. Photo by Getty Images.

Governments are increasingly using public procurement policy to promote the use of legal and sustainable timber, thereby helping to reduce deforestation and illegal logging and encouraging sustainable forestry. 

At least 26 countries, mostly in the EU, currently possess some form of timber procurement policy at central government level. Although some have been implemented more recently than others and all tend to vary in their design, the evidence suggests that they are having a positive effect on increasing market share for verified legal and sustainable timber. Although government purchasing accounts for only a limited share of the market, the evidence also suggests that these timber procurement policies are having a broader impact on consumer markets, partly through their impact on suppliers and partly through the signals they send to the market. 

These policies are also relatively straightforward to introduce: many countries already possess some form of green procurement policy, and criteria for legal and sustainable timber can easily be tailored to fit. In general no new legislation is needed, though the more comprehensive policies benefit from training and advice to government purchasers. 

The gradual spread of the EU Green Procurement Policy programme, and commitments by an increasing number of private companies to eliminate deforestation from their supply chains are likely to encourage further uptake of procurement policies for sustainable timber. Timber procurement can also provide valuable lessons to governments when developing sustainable procurement policies for other products associated with deforestation, such as palm oil. 




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Addressing Resource Conflicts: Working Towards More Effective Resolution of Natural Resource Disputes

Invitation Only Research Event

26 June 2014 - 9:00am to 5:00pm

Chatham House, London

Disputes over resources are a persistent challenge to international peace and security. Natural resources (such as oil, natural gas, minerals, timber and water) are a major source of national income for many countries and, alongside land, are essential to the livelihoods of many millions of people. There is a growing recognition among researchers and decision-makers that in many fragile states disputes over these resources have fed into, and underpinned, violent conflict and instability. 

Although international engagement in national resource disputes is not always desirable or feasible, where it is necessary and possible to support, supplement (or even substitute) national dispute resolution processes it is important to think through the parameters of such action: Who gets involved? With what financial resources? When does an intervention begin? How do they act? 

This one-day roundtable will bring together around 30 experts from policy, academia and business to discuss these questions and more.

The event will be held under the Chatham House Rule. Attendance is by invitation only.

Event attributes

Chatham House Rule

Owen Grafham

Manager, Energy, Environment and Resources Programme
+44 (0)20 7957 5708




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Legal Aquisition of CITES Timber: Lessons from the Congo Basin

Invitation Only Research Event

26 February 2015 - 10:30am to 27 February 2015 - 4:30pm

Chatham House, London

This event will focus on the trade in Pericopsis elata (Afrormosia/Assamela) harvested in West and Central Africa, and will be co-chaired by Emmanuel Heuse, FLEGT facilitator in the Democratic Republic of Congo.

This workshop is supported by the Climate and Land Use Alliance, the UK Department of International Development and the European Union Action to Fight Environmental Crime.

Attendance at this event is by invitation only.

Adelaide Glover

Digital Coordinator, Energy, Environment and Resources Programme




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Reducing Deforestation in Agricultural Commodity Supply Chains: Using Public Procurement Policy

2 September 2015

This paper explores the potential of using public procurement policy to promote the uptake of sustainable food products in order to reduce imports of agricultural products associated with deforestation.

 

Duncan Brack

Associate Fellow, Energy, Environment and Resources Programme

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Workers sort cocoa fruits near the Mendoa Chocolates plant in the state of Bahia near Ilheus, Brazil. Photo: Getty Images.

Summary

  • Procurement policy has been used effectively to exclude illegal and unsustainable timber from consumer-country markets.
  • As the public sector is a major purchaser of food and catering services for schools, nurseries, hospitals, care homes, canteens, prisons and the military, public procurement policies in this area clearly have the potential to promote the uptake of sustainable products not associated with deforestation.
  • Many public authorities, particularly at local and regional level, already have a procurement policy for food; in principle, criteria for sustainable production could be incorporated relatively easily.
  • Some products – particularly palm oil, cocoa, coffee and tea – are better suited than others to this approach; for all these products, voluntary certification initiatives currently under way could provide identification mechanisms on which procurement policies could rest.
  • Other commodities may not be as suited to procurement policy, and it may be more effective to use other regulations; this applies particularly to soy, for which biofuel regulations are likely to have a bigger impact.
  • In cases in which private-sector initiatives are under way to achieve 100 per cent sustainable imports (such a target has been set for palm oil in several countries), procurement policy may be unnecessary. In other cases, the adoption of a new procurement policy could serve as the spur to a private-sector initiative. 




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Covid-19: Trump says added deaths are necessary price for reopening US businesses

A rise in mortality is a price worth paying to restart the US economy, President Trump has said, as many states flout advice from scientists and reopen beaches, cinemas, or hair salons while new...




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Head-to-Head Comparison of 68Ga-PSMA-11 with 18F-PSMA-1007 PET/CT in Staging Prostate Cancer Using Histopathology and Immunohistochemical Analysis as a Reference Standard

18F-PSMA-1007 is a novel prostate-specific membrane antigen (PSMA)–based radiopharmaceutical for imaging prostate cancer (PCa). The aim of this study was to compare the diagnostic accuracy of 18F-PSMA-1007 with 68Ga-PSMA-11 PET/CT in the same patients presenting with newly diagnosed intermediate- or high-risk PCa. Methods: Sixteen patients with intermediate- or high-risk PCa underwent 18F-PSMA-1007 and 68Ga-PSMA-11 PET/CT within 15 d. PET findings were compared between the 2 radiotracers and with reference-standard pathologic specimens obtained from radical prostatectomy. The Cohen -coefficient was used to assess the concordance between 18F-PSMA-1007 and 68Ga-PSMA-11 for detection of intraprostatic lesions. The McNemar test was used to assess agreement between intraprostatic PET/CT findings and histopathologic findings. Sensitivity, specificity, positive predictive value, and negative predictive value were reported for each radiotracer. SUVmax was measured for all lesions, and tumor-to-background activity was calculated. Areas under receiver-operating-characteristic curves were calculated for discriminating diseased from nondiseased prostate segments, and optimal SUV cutoffs were calculated using the Youden index for each radiotracer. Results: PSMA-avid lesions in the prostate were identified in all 16 patients with an almost perfect concordance between the 2 tracers ( ranged from 0.871 to 1). Aside from the dominant intraprostatic lesion, similarly detected by both radiotracers, a second less intense positive focus was detected in 4 patients only with 18F-PSMA-1007. Three of these secondary foci were confirmed as Gleason grade 3 lesions, whereas the fourth was shown on pathologic examination to represent chronic prostatitis. Conclusion: This pilot study showed that both 18F-PSMA-1007 and 68Ga-PSMA-11 identify all dominant prostatic lesions in patients with intermediate- or high-risk PCa at staging. 18F-PSMA-1007, however, may detect additional low-grade lesions of limited clinical relevance.




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18F-FET PET Imaging in Differentiating Glioma Progression from Treatment-Related Changes: A Single-Center Experience

In glioma patients, differentiation between tumor progression (TP) and treatment-related changes (TRCs) remains challenging. Difficulties in classifying imaging alterations may result in a delay or an unnecessary discontinuation of treatment. PET using O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) has been shown to be a useful tool for detecting TP and TRCs. Methods: We retrospectively evaluated 127 consecutive patients with World Health Organization grade II–IV glioma who underwent 18F-FET PET imaging to distinguish between TP and TRCs. 18F-FET PET findings were verified by neuropathology (40 patients) or clinicoradiologic follow-up (87 patients). Maximum tumor-to-brain ratios (TBRmax) of 18F-FET uptake and the slope of the time–activity curves (20–50 min after injection) were determined. The diagnostic accuracy of 18F-FET PET parameters was evaluated by receiver-operating-characteristic analysis and 2 testing. The prognostic value of 18F-FET PET was estimated using the Kaplan–Meier method. Results: TP was diagnosed in 94 patients (74%) and TRCs in 33 (26%). For differentiating TP from TRCs, receiver-operating-characteristic analysis yielded an optimal 18F-FET TBRmax cutoff of 1.95 (sensitivity, 70%; specificity, 71%; accuracy, 70%; area under the curve, 0.75 ± 0.05). The highest accuracy was achieved by a combination of TBRmax and slope (sensitivity, 86%; specificity, 67%; accuracy, 81%). However, accuracy was poorer when tumors harbored isocitrate dehydrogenase (IDH) mutations (91% in IDH-wild-type tumors, 67% in IDH-mutant tumors, P < 0.001). 18F-FET PET results correlated with overall survival (P < 0.001). Conclusion: In our neurooncology department, the diagnostic performance of 18F-FET PET was convincing but slightly inferior to that of previous reports.




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Prospective registration and reporting of trial number in randomised clinical trials: global cross sectional study of the adoption of ICMJE and Declaration of Helsinki recommendations