Voluntary Targets Research Articles

Estimating the potential impact of the Australian government\u2019s reformulation targets on household sugar purchases

BackgroundCountries around the world are putting in place sugar reformulation targets for packaged foods to reduce excess sugar consumption. The Australian government released its voluntary sugar reformulation targets for nine food categories in 2020. We estimated the potential impact of these targets on household sugar purchases and examined differences by income. For comparison, we also modelled the potential impact of the UK sugar reduction targets on per capita sugar purchases as the UK has one of the most comprehensive sugar reduction strategies in the world.MethodsGrocery purchase data from a nationally representative consumer panel (n=7,188) in Australia was linked with a large database (FoodSwitch) with product-specific sugar content information for packaged foods (n=25,261); both datasets were collected in 2018. Potential reductions in per capita sugar purchases were calculated overall and by food category. Differences in sugar reduction across income level were assessed by analysis of variance.ResultsIn 2018, the total sugar acquired from packaged food and beverage purchases consumed at-home was 56.1 g/day per capita. Australia’s voluntary reformulation targets for sugar covered 2,471/25,261 (9.8%) unique products in the FoodSwitch dataset. Under the scenario that all food companies adhered to the voluntary targets, sugar purchases were estimated to be reduced by 0.9 g/day per capita, which represents a 1.5% reduction in sugar purchased from packaged foods. However, if Australia adopted the UK targets, over twice as many products would be covered (n=4,667), and this would result in a more than four times greater reduction in sugar purchases (4.1 g/day per capita). It was also estimated that if all food companies complied with Australia’s voluntary sugar targets, reductions to sugar would be slightly greater in low-income households compared with high-income households by 0.3 g/day (95%CI 0.2 - 0.4 g/day, p<0.001).ConclusionsSugar-reduction policies have the potential to substantially reduce population sugar consumption and may help to reduce health inequalities related to excess sugar consumption. However, the current reformulation targets in Australia are estimated to achieve only a small reduction to sugar intakes, particularly in comparison to the UK’s sugar reduction program.

Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis

BackgroundExcessive sodium consumption is one of the leading dietary risk factors for non-communicable diseases, including cardiovascular disease (CVD), mediated by high blood pressure. Brazil has implemented voluntary sodium reduction targets with food industries since 2011. This study aimed to analyse the potential health and economic impact of these sodium reduction targets in Brazil from 2013 to 2032.MethodsWe developed a microsimulation of a close-to-reality synthetic population (IMPACTNCD-BR) to evaluate the potential health benefits of setting voluntary upper limits for sodium content as part of the Brazilian government strategy. The model estimates CVD deaths and cases prevented or postponed, and disease treatment costs. Model inputs were informed by the 2013 National Health Survey, the 2008–2009 Household Budget Survey, and high-quality meta-analyses, assuming that all individuals were exposed to the policy proportionally to their sodium intake from processed food. Costs included costs of the National Health System on CVD treatment and informal care costs. The primary outcome measures of the model are cardiovascular disease cases and deaths prevented or postponed over 20 years (2013–2032), stratified by age and sex.ResultsThe study found that the application of the Brazilian voluntary sodium targets for packaged foods between 2013 and 2032 could prevent or postpone approximately 110,000 CVD cases (95% uncertainty intervals (UI): 28,000 to 260,000) among men and 70,000 cases among women (95% UI: 16,000 to 170,000), and also prevent or postpone approximately 2600 CVD deaths (95% UI: − 1000 to 11,000), 55% in men. The policy could also produce a net cost saving of approximately US$ 220 million (95% UI: US$ 54 to 520 million) in medical costs to the Brazilian National Health System for the treatment of CHD and stroke and save approximately US$ 71 million (95% UI: US$ 17 to170 million) in informal costs.ConclusionBrazilian voluntary sodium targets could generate substantial health and economic impacts. The reduction in sodium intake that was likely achieved from the voluntary targets indicates that sodium reduction in Brazil must go further and faster to achieve the national and World Health Organization goals for sodium intake.

Implications of Climate Targets at a Local Level: The Study of Mumbai Metropolitan Region, India

Paris agreement’s 2°C target has set a goal for the entire World to reduce emissions. Simultaneously, the countries which are a party to United Nations Framework Convention on Climate Change are also required to set voluntary national climate targets to reduce emissions. For achieving these targets, mitigations efforts have to be made at every possible level, especially from the metropolitan cities as they are the prominent source of emissions. This raises the requirement of elucidating the meaning of climate targets at local levels. In this context, the present study tries to interpret the global and national targets at the level of a metropolitan region and quantify the amount of emission reduction required. Mumbai Metropolitan Region in India was studied for this purpose. Paris Agreement’s 2°C target as a global target and India’s climate target defined in its Intended Nationally Determined Contributions as the national target were studied. These climate targets were translated into emission budgets for Mumbai Metropolitan Region. Comparing these with Mumbai Metropolitan Region’s emission forecast showed that it requires a 16.8% reduction to meet the national target while a 40% to 47% reduction to meet the global target. The results are significant for policy makers and planners to design focused mitigation policies and support national efforts to govern climate change.

Health Impact and Cost-Effectiveness of Achieving the National Salt and Sugar Reduction Initiative Voluntary Sugar Reduction Targets in the United States: A Microsimulation Study.

High intake of added sugar is linked to weight gain and cardiometabolic risk. In 2018, the US National Salt and Sugar Reduction Initiative proposed government-supported voluntary national sugar reduction targets. This intervention's potential effects and cost-effectiveness are unclear. A validated microsimulation model, CVD-PREDICT (Cardiovascular Disease Policy Model for Risk, Events, Detection, Interventions, Costs, and Trends), coded in C++, was used to estimate incremental changes in type 2 diabetes, cardiovascular disease (CVD), quality-adjusted life-years (QALYs), costs, and cost-effectiveness of the US National Salt and Sugar Reduction Initiative policy. The model was run at the individual level, incorporating the annual probability of each person's transition between health statuses on the basis of risk factors. The model incorporated national demographic and dietary data from the National Health and Nutrition Examination Survey across 3 cycles (2011 through 2016), added sugar-related diseases from meta-analyses, and policy costs and health-related costs from established sources. A simulated nationally representative US population was created and followed until age 100 years or death, with 2019 as the year of intervention start. Findings were evaluated over 10 years and a lifetime from health care and societal perspectives. Uncertainty was evaluated in a 1-way analysis by assuming 50% industry compliance and probabilistic sensitivity analyses through a second-order Monte Carlo approach. Model outputs included averted diabetes cases, CVD events and CVD deaths, QALYs gained, and formal health care cost savings, stratified by age, race, income, and education. Achieving the US National Salt and Sugar Reduction Initiative sugar reduction targets could prevent 2.48 million CVD events, 0.49 million CVD deaths, and 0.75 million diabetes cases; gain 6.67 million QALYs; and save $160.88 billion net costs from a societal perspective over a lifetime. The policy became cost-effective (<150 000/QALYs) at 6 years, highly cost-effective (<50 000/QALYs) at 7 years, and cost-saving at 9 years. Results were robust from a health care perspective, with lower (50%) industry compliance, and in probabilistic sensitivity analyses. The policy could also reduce disparities, with greatest estimated health gains per million adults among Black or Hispanic individuals, lower income, and less educated Americans. Implementing and achieving the US National Salt and Sugar Reduction Initiative sugar reformation targets could generate substantial health gains, equity gains, and cost savings.

Non-communicable Disease Surveillance in Malaysia: An Overview of Existing Systems and Priorities Going Forward.

In 2012, the World Health Organization (WHO) set a comprehensive set of nine global voluntary targets, including the landmark “25 by 25” mortality reduction target, and 25 indicators. WHO has also highlighted the importance of Non-Communicable Disease (NCD) surveillance as a key action by Member States in addressing NCDs. This study aimed to examine the current national NCD surveillance tools, activities and performance in Malaysia based on the WHO Global Monitoring Framework for NCDs and to highlight gaps and priorities moving forward. A desk review was conducted from August to October in 2020, to examine the current national NCD surveillance activities in Malaysia from multiple sources. Policy and program documents relating to NCD surveillance in Malaysia from 2010 to 2020 were identified and analyzed. The findings of this review are presented according to the three major themes of the Global Monitoring Framework: monitoring of exposure/risk factor, monitoring of outcomes and health system capacity/response. Currently, there is a robust monitoring system for NCD Surveillance in Malaysia for indicators that are monitored by the WHO NCD Global Monitoring Framework, particularly for outcome and exposure monitoring. However, Malaysia still lacks data for the surveillance of the health system indicators of the framework. Although Malaysia has an NCD surveillance in place that is adequate for the WHO NCD Global Monitoring Framework, there are areas that require strengthening. The country must also look beyond these set of indicators in view of the increasing burden and impact of the COVID-19 pandemic. This includes incorporating mental health indicators and leveraging on alternate sources of data relating to behaviors.

The sugar content of foods in the UK by category and company: A repeated cross-sectional study, 2015-2018.

Consumption of free sugars in the UK greatly exceeds dietary recommendations. Public Health England (PHE) has set voluntary targets for industry to reduce the sales-weighted mean sugar content of key food categories contributing to sugar intake by 5% by 2018 and 20% by 2020. The aim of this study was to assess changes in the sales-weighted mean sugar content and total volume sales of sugar in selected food categories among UK companies between 2015 and 2018. We used sales data from Euromonitor, which estimates total annual retail sales of packaged foods, for 5 categories-biscuits and cereal bars, breakfast cereals, chocolate confectionery, sugar confectionery, and yoghurts-for 4 consecutive years (2015-2018). This analysis includes 353 brands (groups of products with the same name) sold by 99 different companies. These data were linked with nutrient composition data collected online from supermarket websites over 2015-2018 by Edge by Ascential. The main outcome measures were sales volume, sales-weighted mean sugar content, and total volume of sugar sold by category and company. Our results show that between 2015 and 2018 the sales-weighted mean sugar content of all included foods fell by 5.2% (95% CI -9.4%, -1.4%), from 28.7 g/100 g (95% CI 27.2, 30.4) to 27.2 g/100 g (95% CI 25.8, 28.4). The greatest change seen was in yoghurts (-17.0% [95% CI -26.8%, -7.1%]) and breakfast cereals (-13.3% [95% CI -19.2%, -7.4%]), with only small reductions in sugar confectionery (-2.4% [95% CI -4.2%, -0.6%]) and chocolate confectionery (-1.0% [95% CI -3.1, 1.2]). Our results show that total volume of sugars sold per capita fell from 21.4 g/d (95% CI 20.3, 22.7) to 19.7 g/d (95% CI 18.8, 20.7), a reduction of 7.5% (95% CI -13.1%, -2.8%). Of the 50 companies representing the top 10 companies in each category, 24 met the 5% reduction target set by PHE for 2018. The key limitations of this study are that it does not encompass the whole food market and is limited by its use of brand-level sales data, rather than individual product sales data. Our findings show there has been a small reduction in total volume sales of sugar in the included categories, primarily due to reductions in the sugar content of yoghurts and breakfast cereals. Additional policy measures may be needed to accelerate progress in categories such as sugar confectionery and chocolate confectionery if the 2020 PHE voluntary sugar reduction targets are to be met.

A gentle nudge: Can choice architecture play a role in retailers’ efforts to promote healthier choices?

AbstractFood retailers in the UK have a responsibility to look after the health of their customers. In recognition of this, they have established a number of internal and external commitments to provide access to a wider range of healthier and more sustainable foods to support the health of their customers. However, they are also presented with specific voluntary targets from Public Health England and other organisations. Meeting these targets can present technical challenges and may be costly. Alongside more traditional approaches (such as reformulation), changing customer behaviour is being explored as an additional tool to help food retailers meet their commitments by altering customers choices towards more healthy foods. Choice architecture and ‘nudging’ are approaches that can be adopted by retailers to encourage behaviour change in customers. In this article, we explore the theoretical uses of nudge theory in a food retail environment and discuss its potential as a tool for retailers to mitigate some of the challenges presented by other approaches, but also to identify potential pitfalls in the use of nudges. There is some evidence to suggest that nudging can be a useful method to encourage behaviour change amongst consumers and that these approaches can be relatively cost‐effective and quick to implement, although they may be context‐specific. These approaches are best utilised in parallel with more established methods, such as reformulation and information campaigns, due to their relatively small effect sizes. Additionally, any nudges that are implemented should be carefully considered for both their potential efficacy and the ethical implications of their enforcement and should have adequate monitoring in place to track their effectiveness.

Gridded bias correction of modeled PM2.5 for exposure assessment, and estimation of background concentrations over a coastal valley region of northwestern British Columbia, Canada

ABSTRACT Chemical transport models (CTM) can have large biases and errors when simulating pollutant concentrations. To improve the characterization of fine particulate matter (PM2.5) over complex terrain for exposure assessments, three mathematical formulae that utilized the relationship between modeled and observed quantile concentrations at a monitor location were developed. These were then applied to 1 year of CMAQ model output of PM2.5 over the Terrace–Kitimat Valley of northwestern British Columbia, Canada. The final products enhanced the representation of ambient levels at existing monitoring stations when evaluated with conventional statistical measures. Better agreement of corrected outputs with observed compliance metrics was also found. On average, the absolute errors of amended outputs were 11% and 10% for the annual mean PM2.5 and 98th percentiles of daily concentrations, respectively, compared to 45% and 61%, respectively, in the original outputs. These improvements provided greater confidence to use the amended outputs to estimate concentrations at locations without monitors. The predominance of pristine conditions in the modeling domain was exploited to derive annual background PM2.5 concentrations over the valley, which was estimated to be 2.0–2.3 μg m−3. To our knowledge, this is the first study to calculate background PM2.5 concentrations over northern BC coastlands using bias-corrected outputs from an air quality model. Implications: Bias correction of CMAQ model output was necessary for assessing regulatory compliance for ambient PM2.5. The implications are notable. First, for low to moderate spatial heterogeneity in monitoring data, the use of regression equations that relates quantile mean concentrations of model outputs to those of observational data enhances the estimation of PM2.5 at unmonitored locations. Second, by providing spatial pollutant distribution ahead of planned industrial development in Terrace–Kitimat Valley (TKV), corrected model output offers a baseline for tracking progress in airshed management. Third, correction improved pollutant exposure classification, for which the risk was predominantly low. Finally, 2.0–2.3 μg m−3 should be considered as PM2.5 concentrations that are irreducible when setting voluntary targets for ambient levels in the area.

The International Society for Behavioral Medicine (ISBM) and the Society of Behavioral Medicine (SBM) advocate for the inclusion of behavioral scientists in the implementation of the Global Action Plan for the prevention of non-communicable diseases (NCDs) in low- and middle-income countries

Non-communicable diseases (NCDs) are the leading cause of death and disability in the world with the majority of deaths occurring in low- and middle-income countries (LMICs). The financial implications of disease and disability due to NCDs, combined with the costs of long-term management, are major causes of impoverishment and serve as barriers to socio-economic development. The transition from infectious diseases to NCDs as leading causes of mortality in LMICs is driven by several factors, primarily increasing globalization, urbanization, ageing of populations and economic development. Responding to these challenges will require local and comprehensive primary and secondary prevention efforts. The World Health Organization's Global Action Plan provides a road map and an array of policy options to achieve nine voluntary global targets by 2025. The primary responsibility of governments in responding to the challenge of NCDs includes international scientific cooperation to support national and local efforts. The implementation of such efforts to prioritize the prevention of NCDs will create an environment in which the rising trend of the NCD burden could be potentially halted and reversed. When developing NCD policies, stakeholders should consider evidence-based strategies which can be implemented by multidisciplinary teams that are led or have the participation of behavioral medicine scientists. Behavioral medicine strategies should be incorporated into the policy and intervention framework developed to target NCDs in LMICs.

Policy Progress in Reducing Sodium in the American Diet, 2010-2019.

Most Americans consume dietary sodium exceeding age-specific government-recommended targets of 1,500-2,300 mg/day per person. The majority (71%) of US dietary sodium comes from restaurant and packaged foods. Excess sodium intake contributes to hypertension and cardiovascular disease, which is the leading cause of death in the United States. This review summarizes evidence for policy progress to reduce sodium in the US food supply and the American diet. We provide a historical overview of US sodium-reduction policy (1969-2010), then examine progress toward implementing the 2010 National Academy of Medicine (NAM) sodium report's recommendations (2010-2019). Results suggest that the US Food and Drug Administration made no progress in setting mandatory sodium-reduction standards, industry made some progress in meeting voluntary targets, and other stakeholders made some progress on sodium-reduction actions. Insights from countries that have significantly reduced population sodium intake offer strategies to accelerate US progress toward implementing the NAM sodium-reduction recommendations in the future.

Contribution of major food companies and their products to household dietary sodium purchases in Australia

BackgroundThe Australian federal government will soon release voluntary sodium reduction targets for 30 packaged food categories through the Healthy Food Partnership. Previous assessments of voluntary targets show variable industry engagement, and little is known about the extent that major food companies and their products contribute to dietary sodium purchases among Australian households.MethodsThe aim of this cross-sectional study was to identify the relative contribution that food companies and their products made to Australian household sodium purchases in 2018, and to examine differences in sodium purchases by household income level. We used 1 year of grocery purchase data from a nationally representative consumer panel of Australian households who reported their grocery purchases (the Nielsen Homescan panel), combined with database that contains product-specific sodium content for packaged foods and beverages (FoodSwitch). The top food companies and food categories were ranked according to their contribution to household sodium purchases. Differences in per capita sodium purchases by income levels were assessed by 1-factor ANOVA. All analyses were modelled to the Australian population in 2018 using sample weights.ResultsSodium data were available from 7188 households who purchased 26,728 unique products and purchased just under 7.5 million food product units. Out of 1329 food companies, the top 10 accounted for 35% of unique products and contributed to 58% of all sodium purchased from packaged foods and beverages. The top three companies were grocery food retailers each contributing 12–15% of sodium purchases from sales of their private label products, particularly processed meat, cheese and bread. Out of the 67 food categories, the top 10 accounted for 73% of sodium purchased, particularly driven by purchases of processed meat (14%), bread (12%) and sauces (11%). Low-income Australian households purchased significantly more sodium from packaged products than high-income households per capita (452 mg/d, 95%CI: 363-540 mg/d, P < 0.001).ConclusionsA small number of food companies and food categories account for most of the dietary sodium purchased by Australian households. Prioritizing government engagement with these groups could deliver a large reduction in population sodium intake.

Effect of combustion chamber material on the performance of an improved biomass cookstove

Increased material efficiency in cookstove designs aids in reduction of specific fuel consumption, emissions and increased energy efficiency. In this work, three (3) improved biomass cookstoves with different combustion chamber materials (aluminium, ceramic clay and mild steel) were designed, developed and tested under the Water Boiling Test (WBT) protocol. The stoves design specifications were carefully altered to prevent significant variations in performance. The energy efficiency, specific fuel consumption and emission performance parameters of the three stoves indicated the ceramic clay combustion chamber as the material of choice in achieving the set target of Tier 2 of the International Organization for Standardization (ISO)/Technical Report (TR) 19867–3:18 voluntary performance targets.

Does Board Gender Diversity Matter?

We analyze the relationship between the proportion of women directors on the boards of UK listed firms and their financial performance and risk. We find that firms with greater gender diversity are more profitable and enjoy higher market valuations. However, consistent with prior research, we do not find any reliable evidence to suggest that gender diversity affects stock returns or risk. Our findings make two important contributions to the literature. First, we show that greater representation of women on boards is not merely an issue about social inclusion but it is economically beneficial. Second, the UK’s approach of using voluntary targets to increase the board gender diversity seems to be effective.

Mapping Dietary Sodium Reduction Policies and Initiatives in the Region of the Americas

Abstract Objectives To map existing country policies addressing population dietary sodium reduction in the Americas; to identify policy gaps in the region following what is outlined in the World Health Organization (WHO) “Best Buys” most cost-effective recommendations for the prevention and control of diet-related noncommunicable diseases (NCDs); and to discuss priorities for future work in the Region. Methods This study used mixed methods to analyze data from 34 countries. Data were collected through a structured review, of mostly national official sources, to identify current policies in place to reduce population sodium intake. Also, responses from the last Pan American Health Organization (PAHO) online Survey on National Initiatives for Sodium Reduction in the Americas were included. Finally, country profiles were prepared and sent to each country's Public Health Agency for validation and comments. Results Almost all countries (n = 23/34) had a recommendation to reduce salt intake included in policies related to NCDs. Only six countries had specific and comprehensive policies to reduce sodium intake, and only one of them was a National Law. Adoption of the WHO “Best Buys” in national policies included: reformulation of food products with voluntary (n = 9/34) and mandatory targets (n = 2/34); establishment of a supportive environment in public institutions (n = 14/34); and implementation of front-of-pack labelling (n = 5/34). Some countries have implemented regulations restricting marketing of foods high in sodium to children (n = 5/34); nutritional labelling that includes sodium content, either voluntary (n = 9/34) or mandatory (n = 10/34); and no country has yet implemented taxes on high sodium foods. Conclusions In recent years, there has been a significant advance in policies to reduce sodium intake in the Region of the Americas. However, this review identified that the level of implementation in practice is complex to assess and quite heterogeneous. Reducing sodium consumption is a cost-effective intervention that can save many lives, by preventing and reducing the burden of diet related NCD's. Therefore, a further call to action is needed for governments to accelerate efforts in order to meet the 2025 global target of a 30% relative reduction in mean population intake of sodium. Funding Sources Pan American Health Organization (PAHO/WHO).

Global carbon surcharge for the reduction of anthropogenic emission of carbon dioxide

BackgroundMany governments take the view that voluntary national targets to reduce greenhouse gas emissions are sufficient to avoid negative climate effects. In the absence of independent verification, however, pledges are unlikely to be sufficient for a rapid and strong reduction of emissions. It is often claimed that a global carbon tax could be an effective instrument. However, such a tax is difficult to set and to collect, especially in countries with poor administrative infrastructure.ResultsHere, we formulate and discuss a novel approach, the Global Carbon Surcharge (GCS), that mimics a carbon tax but does not require tax collection by governments. We define GCS as a requirement or a voluntary commitment encompassing all companies extracting carbon-carrying raw materials, namely coal, oil, gas and limestone, with the aim to burden their extraction with costs proportional to their carbon intensity. GCS mandates all companies to store these materials immediately after mining for a given period of time in the vicinity of the production site. Thereby, GCS generates additional costs that propagate through all sectors of the global economy. We elucidate how the investment costs for the storage infrastructure translate into surcharges on the raw materials.ConclusionsWe show that by a proper choice of the storage time and the size of the storage unit, GCS becomes equivalent to a carbon tax in the range between 50 and 100 € per ton of CO2 that is assumed to be necessary for the transition to a carbon-neutral energy system. An attractive feature of GCS is that it can be verified, in particular by citizens themselves, using publicly available satellite data. Finally, if compulsory storage is coupled to blockchain-based smart contracts and a mandatory (expensive) mining of cryptocurrency, GCS can be operated without governmental protectionism, corruption and fraud. However, the main uncertainties of the GCS approach lie in the substantial expansion of infrastructure and the fact that the induced price effects must be sufficient to achieve a rapid and far-reaching substitution of fossil fuels.

Acceptance of salt reduction in bakery bread among Moroccan consumers

Background: The use of cooking salt (sodium chloride) for bread preparation is due to several important sensory and technological properties. Even considered as an essential micronutrient and a salty taste stimulus, a significant dietary sodium intake is positively correlated with high blood pressure levels and some heart diseases. Recently, Morocco has adopted a plan to reduce salt consumption aiming to reinforce the prevention of Non-Communicable Diseases (NCDs) and to contribute to the achievement of 2025 global voluntary targets, set by the Second International Conference on Nutrition (ICN2). Aims: The aim of the present study was to determine the acceptance of bakery bread with a different percentage reduction of salt by the Moroccan population. Subjects and Methods: Various percentages of salt reduction in experimental bread; 7%, 10%, 16%, 23%, 30%, and 53%, were tasted and compared with standard market bread by 201 individuals. “Just About Right” (JAR) and purchase scales were utilized to score the different sample bread. Results: Bread with 10% and 16% salt reduction were highly accepted by 76% and 79% of tasters, respectively. Based on the JAR score, these types of bread were considered as “just about right’ by 50% and 57% of the participants respectively. The best average score of purchase intent was obtained for salt content of 1.62g and 1.56g per 100g for a reduction of 10% and 16% respectively. Conclusions: The current adopted strategy allows a 16% sodium reduction while maintaining taste quality. Keywords: Sodium chloride, bread, salt reduction, Moroccan population.

Gender Quotas on Corporate Boards: Similarities and Differences in Quota Scenarios

In this article, the use of gender quotas to strengthen gender equality on corporate boards is explored. Examining national practices in ten European countries we provide an overview, categorizing the design of various corporate board quotas (CBQs) and the contexts in which they are embedded. In particular, similarities and differences along two dimensions are investigated: the design of the CBQs in terms of their hardness and progressiveness, and the institutional context in which they are embedded. From patterns of design and context configurations, different quota scenarios are discerned. We advance the discussion of female representation and the strategies of corporate boards beyond the rather misleading dichotomy of voluntary targets versus mandatory quotas, proposing a framework for understanding various CBQ designs. Moreover, we suggest that the configuration of design and institutional context, resulting in different quota scenarios affects female representation on corporate boards.

China no âmbito da mudança climática. Negociações exteriores e políticas domésticas

El cambio climático, derivado del creciente calentamiento global, ya se siente en diversas partes del planeta. La cooperación entre los Estados es necesaria para que las emisiones de gases del efecto invernadero disminuyan, controlando el aumento de la temperatura global. Las negociaciones sobre cambio climático presentaban la división entre países desarrollados y en desarrollo, sustituida por el nuevo modelo en París 2015. China es actor central en las negociaciones y el mayor emisor global. Las emisiones chinas se derivan en mayor medida del sector de energía, basado en el carbón y en el petróleo. El país indicó sus metas voluntarias en Copenhague 2009, lo que es entendido como evolución en su política climática. En el año 2015, antes de la cop 21, el país comunicó la Intención Nacional Designada (ndc), reducción de intensidad de emisiones entre el 60 % y el 65 % en relación con el año 2005, y un 20 % de la matriz energética basada en energía renovable, ambas hasta el año 2030. El cambio climático recibió atención en las políticas domésticas chinas, sobretodo en la reformulación de la matriz energética. El país apoya el principio de la responsabilidad común, pero diferenciada, para mantener su política externa climática. El riesgo del cambio climático está presente en el país, que adoptó a partir de 2007 políticas nacionales sobre el clima. El objetivo del artículo es realizar el levantamiento de las acciones de China sobre cambio climático, tanto en el ámbito interno como internacional, en el período hasta el Acuerdo de París 2015.

Innovations at scale only, capable of offering access to care solution: Example of district cancer care model (Pendharkar model).

19 Background: Sustainable development goals and voluntary global NCD targets 2025 plan to achieve 80% coverage by essential NCD medicines and technologies and drug therapy and counselling coverage to the tune of 50%. This can only be achieved by making coverage wider, going to periphery and urgently creating workforce capable of doing such an activity at scale. District cancer care model (Pendharkar model) tried to involve these principles and shown a scalable acceptance by the health system. Methods: To expand the access administratively, most peripheral but medically most suitable, district hospitals, were used to create nodal cancer units. To achieve the scale, all districts of a state were targeted. For creating an alternate workforce existing medical officers and nurses were utilised. Results: Over a period of 5 years seven states of India, having a population of more than 250 million, have agreed to join the programme.176 districts have created nodal cancer units with physician and two nurses in-charge of the programme. They delivery variety of care including counselling, chemotherapy, supportive, palliative, follow up care. They serve as nodal units for public education driving government programmes including public education. At least 300-500 patients avail the services on a daily basis, including more than 200 chemotherapy procedures in a day. On world cancer day educational activities happened in all these districts simultaneously creating massive impact. Conclusions: This unique innovative model has proven that health system changes can be brought at very large scale using existing government possibilities. Available infrastructure, human resource, minimal financial changes with administrative reforms can lead to impactful change in access to cancer care at scale.

Federal Funds Rate Control with Voluntary Reserve Targets

This note describes a framework for implementing monetary policy, dubbed a voluntary reserve targets framework, that could reintroduce significant margins in the federal funds market, reviving the market no matter the aggregate quantity of reserves, while simultaneously limiting the volatility of rates.