Household preferences for reducing greenhouse gas emissions in four European high-income countries: Does health information matter? A mixed-methods study protocol

BACKGROUND

It is now universally acknowledged that climate change constitutes a major threat to human health. At the same time, some of the measures to reduce greenhouse gas emissions, so-called climate change mitigation measures, have significant health co-benefits (e.g., walking or cycling more; eating less meat). The goal of limiting global warming to 1,5° Celsius set by the Conference of the Parties to the United Nations Framework Convention on Climate Change in Paris in 2015 can only be reached if all stakeholders, including households, take actions to mitigate climate change. Results on whether framing mitigation measures in terms of their health co-benefits increases the likelihood of their implementation are inconsistent. The present study protocol describes the transdisciplinary project HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) that investigates the role of health co-benefits in households' decision making on climate change mitigation measures in urban households in France, Germany, Norway and Sweden.

METHODS

HOPE employs a mixed-methods approach combining status-quo carbon footprint assessments, simulations of the reduction of households' carbon footprints, and qualitative in-depth interviews with a subgroup of households. Furthermore, a policy analysis of current household oriented climate policies is conducted. In the simulation of the reduction of households' carbon footprints, half of the households are provided with information on health co-benefits of climate change mitigation measures, the other half is not. Households' willingness to implement the measures is assessed and compared in between-group analyses of variance.

DISCUSSION

This is one of the first comprehensive mixed-methods approaches to investigate which mitigation measures households are most willing to implement in order to reach the 1,5° target set by the Paris Agreement, and whether health co-benefits can serve as a motivator for households to implement these measures. The comparison of the empirical data with current climate policies will provide knowledge for tailoring effective climate change mitigation and health policies.

Omeprazole for treatment of chronic erosive esophagitis in children: a multicenter study of efficacy, safety, tolerability and dose requirements. International Pediatric Omeprazole Study Group

OBJECTIVES

To determine the efficacy, safety, and tolerability of omeprazole in children and to determine the doses required to heal chronic, severe esophagitis.

STUDY DESIGN

Open multicenter study in children aged 1 to 16 years with erosive reflux esophagitis. The healing dose of omeprazole used was that with which the duration of acid reflux was <6% of a 24-hour intraesophageal pH study. Follow-up endoscopy was performed after 3 months of treatment with the healing dose.

RESULTS

At entry, two thirds of 57 patients who completed the study had esophagitis grade 3 or 4 (scale 0-4); some 50% had neurologic impairment or repaired esophageal atresia. Of the 57 patients, 54 healed; 3 did not heal and left the study, and 3 healed with a second course. Doses required for healing were 0.7 to 3.5 mg/kg/d: 0.7 mg/kg/d in 44% of patients and 1.4 mg/kg/d in another 28%. Healing dose correlated with grade of esophagitis but not with age or underlying disease. Reflux symptoms improved dramatically in almost all of the 57 patients, including the unhealed patients.

CONCLUSIONS

Omeprazole is well tolerated, highly effective, and safe for treatment of erosive esophagitis and symptoms of gastroesophageal reflux in children, including children in whom antireflux surgery or other medical therapy has failed. On a per-kilogram basis, the doses of omeprazole required to heal erosive esophagitis are much greater than those required for adults.

Facial profile and dental changes before, during and after treatment with Hansaplate/Headgear

In this prospective study the changes of facial profile and dentition in 19 boys and 19 girls treated for 1 year with Hansaplate/Headgear were analyzed yearly over a 4-year period. On average the boys were 10.2 and the girls 9.2 years old at the first recording, i.e., 1 year pretreatment. The actual values are compared with standard growth data presented by Bathia and Leighton (1993). Irrespective of the initial face morphology, the Hansaplate/Headgear appliance straightened the facial hard and soft tissue profiles favorably. The upper lip became more retruded while the lower lip was unaffected by therapy. During the 2-year post-treatment period these changes continued, probably as a consequence of growth. The overjet was reduced by 5 mm during treatment and was found to be quite stable 2 years after treatment.

Treatment of adolescents with Hansaplate/headgear. Influence on face in profile and on dentition

The treatment effects of Hansaplate/headgear in the course of 1 year were analyzed. Twenty-one girls and 19 boys, 10 and 11 years old, respectively, with postnormal occlusion and an average overjet of 8 mm, made up the treatment group. Forty untreated patients with the same type of malocclusion and dentofacial morphology as the treated children, and paired and matched for sex and age, made up the controls. Measurements were obtained from cephalometric headfilms. Matched-intrapairs analysis of control versus treatment changes after 1 year of treatment was done. This showed that the treatment resulted in inhibited sagittal growth of the maxilla, increased anterior face height and a flattened soft tissue profile with a less protrusive upper lip and a less pronounced sulcus mentolabialis. The overjet decreased by 5 mm on average. Only slight retroclination of the upper incisors without extrusion and retroclination of lower incisors to the mandibular plane occurred. No significant anterior positioning of the mandible as compared with the controls was recorded in this study.