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Heat is a dangerous hazard that causes acute heat illness, chronic disease exacerbations, adverse pregnancy outcomes, and a range of injuries. Risks are highest during extreme heat events (EHEs), which challenge the capacity of health systems and other critical infrastructure. EHEs are becoming more frequent and severe, and climate change is driving an increasing proportion of heat-related mortality, necessitating more investment in health protection. Climate-resilient health systems are better positioned for EHEs, and EHE preparedness is a form of disaster risk reduction. Preparedness activities commonly take the form of heat action plans (HAPs), with many examples at various administrative scales. HAP activities can be divided into primary prevention, most important in the pre-event phase; secondary prevention, key to risk reduction early in an EHE;and tertiary prevention, important later in the event phase. After-action reports and other postevent evaluation activities are central to adaptive management of this climate-sensitive hazard. [ABSTRACT FROM AUTHOR]

To adaptively express inducible defenses, prey must gauge risk based on indirect cues of predation. However, the information contained in indirect cues that enable prey to fine-tune their phenotypes to variation in risk is still unclear. In aquatic systems, research has focused on cue concentration as the key variable driving threat-sensitive responses to risk. However, while risk is measured as individuals killed per time, cue concentration may vary with either the number or biomass killed. Alternatively, fine-grained variation in cue, that is, frequency of cue pulses irrespective of concentration, may provide a more reliable signal of risk. Here, we present results from laboratory experiments that examine the relationship between red-eyed treefrog tadpole growth and total cue, cue per pulse, and cue pulse frequency. We also reanalyze an earlier study that examined the effect of fine-grained variation in predator cues on wood frog tadpole growth. Both studies show growth declines with increasing cue pulse frequency, even though individual pulses in high-frequency treatments contained very little cue. This result suggests that counter to earlier conclusions, tadpoles are using fine-grained variation in cue arising from the number of predation events to assess and respond to predation risk, as predicted by consumer-resource theory. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: We have read and understood the BMJ policy on declaration of interests and have no relevant interests to declare. The BMJ has judged that there are no disqualifying financial ties to commercial companies.

Climate change is considered one of the greatest threats to humanity and the most significant global public health emergency of our lifetime. Millions of people from throughout the globe suffer and die each year from degraded air quality, extreme heat, water and vector-borne diseases as well as the mental health effects of climate change. Because clinicians are considered one of the most trusted sources of climate information, they have a unique opportunity to communicate the many health-related effects of climate change to their patients. It is important for clinicians to understand the most beneficial techniques to use when communicating with patients who may need more information regarding climate change and extreme weather events. These include 1) meeting patients where they are, 2) providing patient education, and 3) telling authentic stories. Developing and delivering effective communication strategies to our patients to prevent and prepare for climate-related health issues are paramount- if we are to make meaningful progress., Competing Interests: Conflict of interest: None., (© Copyright 2023 by the American Board of Family Medicine.)

Climate change causes and exacerbates disease, creates and worsens health disparities, disrupts health care delivery, and imposes a significant disease burden in the US and globally. Critical knowledge gaps hinder an evidence-based response and are perpetuated by scarce federal research funds. We identified and described extramural US federal research funding (that is, grants provided to organizations and institutions outside of federal agencies) that both addressed health outcomes associated with climate change and was awarded between 2010 and 2020. During this eleven-year period, 102 grants met our criteria, totaling approximately $58.7 million, or approximately $5.3 million per year (2020 adjusted US dollars). Federal investments in climate change and health research during this period failed to address the breadth of climate-sensitive exposures, health outcomes, and impacts on vulnerable populations. Moving forward, in addition to increasing investment in climate and health research across all known hazards, critical attention should be placed on vulnerable populations and health equity. To achieve this, increased federal research coordination and cooperation are needed, as well as a mechanism to track this funding.

Exposure to environmental variables including declining air quality and increasing temperatures can exert detrimental effects on human health including acute exacerbations of chronic diseases. We aim to investigate the association between these exposures and acute health outcomes in a rural community in Colorado. Meteorological and adult emergency department visit data were retrospectively collected (2013-2017); for asthma outcomes, additional data were available (2003-2017). Daily environmental exposure data included PM 10 , maximum daily temperature (MDT), and mean humidity and precipitation. Total daily counts of emergency department (ED) diagnoses for myocardial infarction, congestive heart failure, urolithiasis, and exacerbation of chronic obstructive pulmonary disease (COPD) and asthma, were calculated during the study period. Time series models using generalized estimating equations were fit for each disease and included all four environmental factors. Between 2013 and 2017, asthma and COPD exacerbation accounted for 30.8% and 25.4% of all ED visits (n=5,113), respectively. We found that for every 5˚C increase in MDT, the rate of urolithiasis visits increased by 13% (95% CI: 2%, 26%) and for every 10μg/m 3 increase in 3-day moving average PM 10 , the rate of urolithiasis visits increased by 7% (95% CI: 1%, 13%). The magnitude of association between 3-day moving average PM 10 and rate of urolithiasis visits increased with increasing MDT. The rate of asthma exacerbation significantly increased as 3-day, 7-day, and 21-day moving average PM 10 increased. This retrospective study on ED visits is one of the first to investigate the impact of several environmental exposures on adverse health outcomes in a rural community. Research into mitigating the negative impacts of these environmental exposures on health outcomes is needed., (Copyright ©2023, Yale Journal of Biology and Medicine.)

Climate change poses numerous near and long-term challenges for our society, and the human health consequences are increasingly recognized as unprecedented. Responding to these health hazards requires a healthcare workforce composed of climate-informed clinicians. As trusted messengers, physicians play a vital role in informing and preparing the public for health impacts of climate change. We describe an evolving graduate medical education fellowship for physicians from all specialties capable of training leaders in this field. Our program pairs fellows with federal and non-governmental partners to provide expertise in climate policy and empower them to be change agents. The accelerating response to climate change from the federal government coupled with an increased recognition of the impacts of climate hazards on health demands a climate-informed clinical workforce. The expansion of this fellowship to accommodate trainees from multiple specialties and its innovative structure leveraging local and national partnerships sets a standard for how similar programs can be developed in addressing the greatest public health threat and opportunity of the century., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wheat, Chekuri, Sorensen, Rochford and Lemery.)

Introduction: Climate change is a global public health crisis. Most clinicians and public health professionals do not receive adequate education to manage and communicate climate-related health impacts to their patients., Methods: From July 2021 to February 2022, the Project ECHO Climate Change and Human Health program completed 22 weekly trainings for health professionals. These virtual telementoring sessions were designed to improve both knowledge and self-efficacy about climate-related health impacts and climate change‒related communication skills., Results: Between July 2021 and February 2022, a total of 804 unique participants (from 44 states and 25 countries) attended the sessions. Participants were nurses (24.7%), physicians (16.8%), and public health professionals (8.5%). They completed weekly Zoom polls measuring their knowledge and self-efficacy. On average, participants strongly agreed or agreed that they had learned skills taught in each session (average percentage of those who strongly agreed or agreed=94.6%, range=66.7%-100.0%). Participants (31%) also completed a weekly postsession survey. A total of 91% rated the sessions as excellent or very good regarding evidenced-basis, and 89% rated sessions as excellent or very good regarding improved communication skills with patients and colleagues., Conclusions: Given the global climate crisis, the Climate Change and Human Health ECHO is successfully building resources and capacity for clinicians and public health professionals., Competing Interests: None., (© 2022 The Author(s).)