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When natural hazards interact in compound events, they may reinforce each other. This is a concern today and in light of climate change. In the case of coastal flooding, sea-level variability due to tides, seasonal to inter-annual salinity and temperature variations, or larger–scale wind conditions modify the development and ramifications of extreme sea levels. Here, we explore how various prior conditions could have influenced peak water levels for the devastating coastal flooding event in the western Baltic Sea in 1872. We design numerical experiments by imposing a range of precondition circumstances as boundary conditions to numerical ocean model simulations. This allows us to quantify the changes in peak water levels that arise due to alternative preconditioning of the sea level before the storm surge. Our results show that certain preconditioning could have generated even more catastrophic impacts. As an example, a simulated increase in the water level of 36 cm compared to the 1872 event occurred in Køge just south of Copenhagen (Denmark) and surrounding areas – a region that was already severely impacted. The increased water levels caused by the alternative sea-level patterns propagate as long waves until encountering shallow and narrow straits, and after that, the effect vastly decreases. Adding artificial increases in wind speeds to each study point location reveals a near-linear relationship with peak water levels for all western Baltic locations, highlighting the need for good assessments of future wind extremes. Our research indicates that a more hybrid approach to analysing compound events and readjusting our present warning system to a more contextualised framework might provide a firmer foundation for climate adaptation and disaster risk management. In particular, accentuating the importance of compound preconditioning effects on the outcome of natural hazards may avoid under- or overestimation of the associated risks.

In the future, shifts in wind storms across the North and Baltic Seas are highly unpredictable, challenging the projection of wave conditions for managing coastal hazards. Moreover, regional sea level rise (SLR), with very large uncertainty, complicates the situation for stakeholders seeking recommendations for climate adaptation plans. The purpose of this study is to examine the change of the storm surge and wind wave components of the water level due to climate change in a low tidal range Køge Bay near the entrance of the Baltic Sea. Under a high greenhouse gas emission scenario RCP8.5, we employed a regional climate model (HIRHAM) forced wave model (WAM) and focused on the wave model results during the “storm surge conditions” (exceeding 20 years storm surge events) and “stormy conditions” (exceeding 90th percentile of wave heights). We find that the change in both wave height and period in the future is negligible under “stormy conditions”. Nevertheless, under “storm surge conditions” when considering SLR, the simulated wave height is projected to double in the near future (mid-century) under RCP 8.5, and the wave period may also increase by about 1.5 seconds. This is because some high significant wave height events in the future are associated with the storm surge events when considering SLR. The findings suggest that the combined effects of mean sea level rise, storm surge and waves are likely to increase the risk to a bay with geography and exposure comparable to Køge Bay. As a result, the future plan for climate engineering protection should place a premium on the additional wave energy protection associated with storm surges.

OBJECTIVES To estimate whether school-based body mass index (BMI) reports impacted the accuracy of children’s self-reported weight category, for children overall and within subgroups. METHODS We analyzed existing data from the Fit Study, a randomized controlled trial of a BMI screening and reporting intervention conducted in California from 2014 to 2017. The sample included 4690 children in 27 schools randomized to receive BMI reports and 4975 children in 27 controls schools that received BMI screening only. To estimate how BMI reporting affected accuracy, we fit multinomial logistic regression models to our data. We calculated average marginal effects, which capture the change in probability that children more accurately reported their weight category because of BMI reporting. RESULTS We detected no impact of BMI reporting on children’s self-reported weight accuracy. Exploratory subgroup analyses show that for Black children, exposure to 1 round of BMI reporting was associated with a 10.0 percentage point increase in the probability of accurately reporting their weight category (95% confidence interval [CI]: 2.6 to 17.4). Two rounds of reporting were associated with an increase in the probability of accuracy for Asian children (6.6 percentage points; 95% CI: 0.4 to 12.8), 5th graders (11.1 percentage points; 95% CI: 1.6 to 20.5), and those with BMI CONCLUSIONS BMI reporting has limited efficacy in increasing children’s weight perception accuracy. Although exploratory analyses show that specific subpopulations became more accurate, future prospective studies should be designed to confirm these results.

Background While a 2021 federal commission recommended that the United States government levy a sugar-sweetened beverage (SSB) tax to improve diabetes prevention and control efforts, evidence is limited regarding the longer-term impacts of SSB taxes on SSB purchases, health outcomes, costs, and cost-effectiveness. This study estimates the impact and cost-effectiveness of an SSB tax levied in Oakland, California. Methods and findings An SSB tax ($0.01/oz) was implemented on July 1, 2017, in Oakland. The main sample of sales data included 11,627 beverage products, 316 stores, and 172,985,767 product-store-month observations. The main analysis, a longitudinal quasi-experimental difference-in-differences approach, compared changes in beverage purchases at stores in Oakland versus Richmond, California (a nontaxed comparator in the same market area) before and 30 months after tax implementation (through December 31, 2019). Additional estimates used synthetic control methods with comparator stores in Los Angeles, California. Estimates were inputted into a closed-cohort microsimulation model to estimate quality-adjusted life years (QALYs) and societal costs (in Oakland) from 6 SSB-associated disease outcomes. In the main analysis, SSB purchases declined by 26.8% (95% CI −39.0 to −14.7, p < 0.001) in Oakland after tax implementation, compared with Richmond. There were no detectable changes in purchases of untaxed beverages or sweet snacks or purchases in border areas surrounding cities. In the synthetic control analysis, declines in SSB purchases were similar to the main analysis (−22.4%, 95% CI −41.7% to −3.0%, p = 0.04). The estimated changes in SSB purchases, when translated into declines in consumption, would be expected to accrue QALYs (94 per 10,000 residents) and significant societal cost savings (>$100,000 per 10,000 residents) over 10 years, with greater gains over a lifetime horizon. Study limitations include a lack of SSB consumption data and use of sales data primarily from chain stores. Conclusions An SSB tax levied in Oakland was associated with a substantial decline in volume of SSBs purchased, an association that was sustained more than 2 years after tax implementation. Our study suggests that SSB taxes are effective policy instruments for improving health and generating significant cost savings for society.

Early life exposures have been associated with obesity later in life. We aim to assess the association between early life exposure to food insecurity and change in BMI throughout childhood and adolescents. Food security status and growth variables from 243 Mother–child dyads from the Center for the Health Assessment of Mothers and Children of Salinas study were assessed 7 times over a 12-year period. Generalized log linear models with Poisson distributions and linear regression models were implemented to assess the associations between early life food insecurity and obesity and growth. Early life food insecurity was associated with a 0.43 (0.01, 0.82) kg/m2 decrease in BMI from age 2 to 3.5, and a 0.92 kg/m2 (0.38, 1.46) increase in BMI among boys from ages 3.5 to 5, after adjusting for covariates. Sex and age modify the association between early life exposure to food insecurity and BMI.

Responding to the challenges of a changing climate requires information that is relevant and actionable at the local scale where adaptation actions take place. Here we describe the development of Klimaatlas, the Danish National Climate Atlas, a tool to provide information to ministries, regional authorities, businesses and citizens about climate change in Denmark. We focus in particular on the key decisions that needed to be made during development and the lessons learnt from doing so that are relevant to the development of similar tools in other jurisdictions. We describe the user groups that we involved in the development of the atlas, how their interactions shaped the final product, and the ongoing role of the user in the project. Communication and dissemination of results was approached on three different levels simultaneously, and we describe this approach, and its benefits, in detail. We detail some of the major technical challenges faced, particularly around the choice of bias-correction methods, and how these issues were overcome. The approach to quantifying and communicating uncertainty, and its importance, also receives particular attention. We assess the impact of Klimaatlas, and the challenges around quantifying its usefulness, together with the results of a recent user survey identifying the strengths and weaknesses. We also place Klimaatlas in the context of other comparable products, and particularly the recently developed IPCC Interactive Atlas. Finally, we discuss issues around future maintenance and possible expansions of Klimaatlas, including the use of convection permitting simulations, incorporation of compound events, updates between IPCC cycles and extensions to new sectors.

Day-to-day variations in surface air temperature affect society in many ways, but daily surface air temperature measurements are not available everywhere. Therefore, a global daily picture cannot be achieved with measurements made in situ alone and needs to incorporate estimates from satellite retrievals. This article presents the science developed in the EU Horizon 2020–funded EUSTACE project (2015–19, www.eustaceproject.org) to produce global and European multidecadal ensembles of daily analyses of surface air temperature complementary to those from dynamical reanalyses, integrating different ground-based and satellite-borne data types. Relationships between surface air temperature measurements and satellite-based estimates of surface skin temperature over all surfaces of Earth (land, ocean, ice, and lakes) are quantified. Information contained in the satellite retrievals then helps to estimate air temperature and create global fields in the past, using statistical models of how surface air temperature varies in a connected way from place to place; this needs efficient statistical analysis methods to cope with the considerable data volumes. Daily fields are presented as ensembles to enable propagation of uncertainties through applications. Estimated temperatures and their uncertainties are evaluated against independent measurements and other surface temperature datasets. Achievements in the EUSTACE project have also included fundamental preparatory work useful to others, for example, gathering user requirements, identifying inhomogeneities in daily surface air temperature measurement series from weather stations, carefully quantifying uncertainties in satellite skin and air temperature estimates, exploring the interaction between air temperature and lakes, developing statistical models relevant to non-Gaussian variables, and methods for efficient computation.

Objectives. To identify lessons learned from implementation of the nation’s first sugar-sweetened beverage (SSB) excise tax in 2015 in Berkeley, California. Methods. We interviewed city stakeholders and SSB distributors and retailers (n = 48) from June 2015 to April 2017 and analyzed records through January 2019. Results. Lessons included the importance of thorough and timely communications with distributors and retailers, adequate lead time for implementation, advisory commissions for revenue allocations, and funding of staff, communications, and evaluation before tax collection begins. Early and robust outreach about the tax and programs funded can promote and sustain public support, reduce friction, and facilitate beverage price increases on SSBs only. No retailer reported raising food prices, indicating that Berkeley’s SSB tax did not function as a “grocery tax,” as industry claimed. Revenue allocations totaled more than $9 million for public health, nutrition, and health equity through 2021. Conclusions. The policy package, context, and implementation process facilitated translating policy into public health outcomes. Further research is needed to understand long-term facilitators and barriers to sustaining public health benefits of Berkeley’s tax and how those differ from facilitators and barriers in jurisdictions facing significant industry-funded repeal efforts.

BACKGROUND The National School Lunch and Breakfast Programs help to reduce food insecurity and improve nutrition. The Community Eligibility Provision (CEP) enables high-poverty schools to offer breakfast and lunch at no cost to all students. This study examines associations between CEP and participation among students eligible for free or reduced-price meals ("FRPM"), possibly eligible ("near-cutoff"), or ineligible ("full-price"). METHODS Using data from the 2013-2015 Healthy Communities Study, we compared school breakfast and lunch participation between 842 students in K-8 at 80 CEP schools and 1463 students at 118 schools without CEP. Cross-sectional difference-in-difference (DID) models compared meal participation among near-cutoff and full-price groups to that in the FRPM group. RESULTS Overall, FRPM students had high participation in school lunch and breakfast at both types of schools. In adjusted DID models, lunch participation among near-cutoff students was 12 points higher in CEP versus comparison schools (p

Wind patterns projected for the region, together with sea level rise and land rise, call into question our current understanding of extreme storm surges in the Danish coastal area. The Danish Meteorological Institute (DMI) will research changes in the extreme statistics of sea level in the twenty-first century through the 'Danish Climate Atlas,' a new national climate service initiative. The study will make use of multi-scenarios, multi-models and multi-parameters approach to focus on the uncertainty of the projected change in extreme statistics of sea level. Historical sea level records suggest that the relative sea level (RSL) along the Danish North Sea coast south of Skagerrak has been increasing with the global mean sea level (GMSL) rise. However, RSL has been absent in the central Skagerrak-Kattegat Seas, owing to the Fennoscandian post-glacial land-uplift offsetting the GMSL rise. According to the recent IPCC Special Report on the Ocean and Cryosphere in a Changing Climate (SROCC), due to Antarctic ice sheet dynamics, GMSL would grow more than previously estimated in the IPCC Fifth Assessment Report (AR5) by the end of the twenty-first century under RCP8.5. We regionalized the SROCC sea level forecasts for the "Danish Climate Atlas" dataset. Our findings indicate that sea level projections under RCP8.5 result in a > 40 cm RSL rise in the Skagerrak-Kattegat Seas by the end of the twenty-first century, which may necessitate a new adaptation strategy in this region. Under the RCP8.5 scenario, the rate of mean sea level rise will exceed the rate of land rise earlier than previously estimated by AR5. We emphasize, in particular, the impact of these new predictions on future severe sea levels in this region. Our findings suggest that this more current GMSL prediction should be factored into coastal risk assessments in the Skagerrak-Kattegat Seas in this century.

Public schools in the U.S. generate about 14,500 tons of municipal solid waste daily, and approximately 42% of that is food packaging generated by school foodservice, contributing significantly to the global packaging waste crisis. This literature review summarizes methods used to evaluate food packaging waste in school foodservice. This review has two objectives: first, to understand which methodologies currently exist to evaluate food packaging waste generation and disposal in school foodservice; and second, to describe the creation of and share a practical standardized instrument to evaluate food packaging waste generation and disposal in school foodservice. A systematic review was conducted using the following search terms: solid waste, school, cafeteria and food packaging, waste, and school. The final review included 24 studies conducted in school environments (kindergarten through twelfth grade or college/university), 16 of which took place in the U.S. Food packaging waste evaluations included objective methods of waste audits, models, and secondary data as well as subjective methods of qualitative observations, questionnaires, interviews, and focus groups. Large variation exists in the settings, participants, designs, and methodologies for evaluating school foodservice packaging waste. Lack of standardization was observed even within each methodology (e.g., waste audit). A new instrument is proposed to support comprehensive and replicable data collection, to further the understanding of school foodservice food packaging waste in the U.S., and to reduce environmental harms.

Highlights • 7 U.S. cities have a sugar-sweetened-beverage tax, raising $134 million annually. • Early childhood programs received the largest investment of tax revenues ($58M). • Community improvements (e.g., rec centers & libraries) were second largest ($21M). • Increasing healthy food and beverage access (e.g., produce subsidies) received $17M. • 85% of revenues supported projects and programs in impacted communities., We sought to describe how revenues from sugar-sweetened beverage (SSB) excise taxes in 7 U.S. cities are being allocated, who is benefiting from these investments, and whether allocations are consistent with the original intent of tax legislation. We collected information from public documents and key informants about allocations in the most recent fiscal year available (ranging from 2018 to 2021). Across the 7 U.S. cities with taxes, the average annual revenue from SSB taxes totaled $133.9 M. In the fiscal year studied, cities allocated a total of $133.2 M in SSB tax revenues. Human and community capital investments totaled $89.6 M (67% of all allocations) funding early childhood development, community infrastructure improvements, and youth and workforce development. Health-related investments totaled $36.9 M (28% of total allocations), funding access to healthy foods and beverages; support for physical activity opportunities; promotion of overall physical, mental or social health and wellbeing; health and nutrition education; chronic-disease prevention and management; and reducing SSB consumption. In the 3 cities that specified how tax revenues would be spent, allocations were consistent with promised uses of revenues. In addition, 85% of aggregated revenues ($112.9 M) were targeted to support work and programs in impacted communities (communities that experience health inequities, discrimination and exclusion). SSB tax revenues are supporting initiatives to improve community health, develop human and community capital, and advance equity. These investments may yield additional health benefits beyond those resulting from lower SSB consumption. Consistent tracking and public reporting on revenue allocations would increase transparency and accountability.

Advertising exerts a powerful influence over consumer decision-making, and disproportionate marketing for unhealthy products may contribute to health inequities. The objective of this study was to examine socioeconomic and racial and ethnic disparities in outdoor branded advertising for products harmful to health in San Francisco and Oakland, CA. We collected cross-sectional data on outdoor advertising from 372 blocks with≥1 residential or mixed-residential parcel in SF and Oakland in 2018-2019. Blocks were randomly sampled by city, land use, majority vs. non-majority Black and/or Hispanic composition, and upper and lower tertiles of household income. Advertisements were coded by product, healthfulness, and branding. Exposure variables were neighborhood household median income and percent of residents who were Hispanic of any race, non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White. The primary outcome variable was block-level dichotomous presence of any unhealthy branded advertisement for food, beverage, alcohol, or tobacco. Analyses were unadjusted and adjusted for land use and number of total advertisements on each block. Each additional $10,000 in neighborhood household median income was associated with an 11% lower adjusted odds of having any unhealthy branded advertisements on the block (95%CI: 0.80-0.99; P=0.03). There were no significant associations between neighborhood racial and ethnic composition and presence of unhealthy branded advertisements, but with each 10% higher neighborhood composition of Hispanic residents, there was a borderline significant higher presence of unhealthy branded advertisements (OR=1.23; 95%CI: 1.00-1.51; P=0.05). Results indicate that low-income neighborhoods were disproportionately exposed to outdoor branded advertisements for unhealthy products.

BACKGROUND: Food insecurity affects 13 million children in the United States. Body dissatisfaction is also prevalent, affecting up to 46% of children. Both food insecurity and body dissatisfaction are associated with poor health outcomes, and both are associated with body weight and racial/ethnic disparities. The association between food insecurity and body dissatisfaction among children has not been examined. OBJECTIVE: The purpose of this study was twofold: to examine, in a sample of children in grades 4 through 8, the relationship of child food insecurity with body dissatisfaction and to gain an understanding of the interactive roles of body mass index (BMI), race/ethnicity, and sex in the relationship between food insecurity and body dissatisfaction. DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: This study examined data obtained from 14,768 children in grades 4 through 8 from 54 public schools in California between 2014 and 2016. MAIN OUTCOME MEASURES: The primary outcome of interest was body dissatisfaction (five items converted to a binary indicator), and the exposure of interest was child-reported food insecurity (three items converted to a binary indicator). Subsets of validated questionnaires were used to assess body dissatisfaction and food insecurity. STATISTICAL ANALYSES PERFORMED: Data were analyzed using multivariable logistic regression, and effect modification was examined by BMI category (underweight, normal, overweight, obese), race/ethnicity, and sex. RESULTS: In this large and diverse sample, after adjusting for cofounders, children experiencing food insecurity, in all BMI categories and from all racial/ethnic backgrounds, had higher odds of body dissatisfaction than their food-secure counterparts. The strength of the relationship differed by BMI and race/ethnicity, with the strongest associations observed for African-American children (odds ratio=2.32; P

Sugar-sweetened beverages (SSBs) increase risk of cardiometabolic disease. Young people consume the largest amounts of SSBs and have experienced the greatest relative gains in obesity in the past several decades. There is evidence of addictive properties of both caffeine and sugar, the primary ingredients in SSBs, but little research into such properties of SSBs in naturally occurring consumption patterns. Thus, in this exploratory study, we sought to examine potentially addictive properties of SSBs during a 3-day SSB cessation intervention in overweight and obese adolescents who typically consume ≥3 SSBs daily. Participants (n = 25) were aged 13-18 years, mostly female (72%), and African American (56%) or Hispanic (16%) with a BMI≥95th percenttile (76%). Withdrawal symptoms and SSB craving were assessed approximately 1-week apart, during both regular SSB consumption and a 3-day period of SSB cessation in which participants were instructed to drink only plain milk and water. During SSB cessation, adolescents reported increased SSB cravings and headache and decreased motivation, contentment, ability to concentrate, and overall well-being (uncorrected Ps

While school meals are often the healthiest option for students, lunch participation remains relatively low. Few approaches for increasing participation have leveraged teachers’ potential social influence. We determined if a teacher intervention about the benefits of school lunch could improve teachers’ perceptions of, and participation in, school lunch, and encouragement of students to eat school lunch. This repeated cross-sectional study included teacher/student survey administration in spring of 2016 and 2018 in 19 public secondary schools (9 intervention, 10 comparison) educating students of ages ≈ 11–18. Intervention teachers received monthly newsletters; lunch taste tests; and a promotional video and website. Mixed effects models with a random effect for school showed the proportion of teachers that reported eating with students increased in intervention schools relative to control schools (difference-in-change: 7.6%; 95% CI: 3.578%, 14.861%), as did student agreement that adults at their schools encouraged them to eat school lunch (difference-in-change: 0.15 on a 5-point scale; 95% CI: 0.061, 0.244). There were no between-group differences in teachers’ perceptions of school meals or teachers’ lunch participation. These findings suggest that teachers’ perceptions of school meals do not necessarily need to improve to promote the school lunch program to students. However, to see meaningful change in teacher lunch participation, the taste of school meals likely needs improving.

Denmark has a long, complex coastline, connecting the North Sea in the west to the semi-enclosed Baltic Sea in the east, via the Skagerrak-Kattegat Seas. Historical sea level records indicate that relative sea level (RSL) has been increasing along the Danish North Sea coast, south of Skagerrak, following the global mean sea level (GMSL) rise. In the central Skagerrak-Kattegat Seas, RSL rise has been practically absent, due to the GMSL rise being off-set by the Fennoscandian post-glacial land-uplift. The new IPCC Special Report on the Ocean and Cryosphere in a Changing Climate (SROCC) reported that under RCP8.5 GMSL will increase more than the previous estimates in the IPCC Fifth Assessment Report (AR5) at the end of twenty-first century due to Antarctic ice sheet dynamics. We performed a regionalization of the SROCC sea level projections for the “Danish Climate Atlas” dataset, a nation-wide climate adaptation dataset based on IPCC and various national and international databases. In these complementary datasets, important local data have been considered, which have not been included in the IPCC SROCC GMSL rise estimates, i.e., more precise national-wide land-rise prediction and sets of sea level fingerprints. Our results indicate that sea level projections under RCP8.5 results in a > 40 cm RSL rise at the end of the twenty-first century in the Skagerrak-Kattegat Seas, which might call for a new adaptation strategy in this region. The rate of mean sea level rise will exceed the rate of the land-rise earlier than the previous estimates by AR5 under the RCP8.5 scenario. In particular, we stress how these new estimates will affect future extreme sea levels in this region. Based on our results, we suggest this more recent GMSL projection needs to be considered in coastal risk assessments in the Skagerrak-Kattegat Seas also in this century.

Background Prior research suggests a relationship between overall diet quality and breast cancer survival, although few studies have reported on this topic. We evaluated whether 4 dietary quality indices consistent with healthy eating recommendations around the time of breast cancer diagnosis were associated with risk of recurrence, cause-specific, and all-cause mortality. Methods A total of 3660 women diagnosed with invasive breast cancer were included. Diet was assessed an average of 2.3 (range = 0.7-18.7) months after diagnosis, from which 4 dietary quality indices were derived: the American Cancer Society guidelines (ACS), the alternate Mediterranean Diet Index (aMED), the Dietary Approaches to Stop Hypertension (DASH), and the 2015 Healthy Eating Index (HEI). Over 40 888 person-years of follow-up, 461 breast cancer recurrences, and 655 deaths were ascertained. Cox models were used to estimate hazards ratios (HRs) and 95% confidence intervals (CIs). Results Adjusted comparisons between extreme quintiles showed all 4 dietary quality indices to be inversely associated with all-cause mortality, suggesting a 21%-27% lower risk (ACS HR = 0.73, 95% CI = 0.56 to 0.95; aMED HR = 0.79, 95% CI = 0.61 to 1.03; DASH HR = 0.76, 95% CI = 0.58 to 1.00; HEI HR = 0.77, 95% CI = 0.60 to 1.01). Similar patterns were noted for non-breast cancer mortality (ACS HR = 0.69, 95% CI = 0.48 to 0.98; aMED HR = 0.73, 95% CI = 0.50 to 1.05; DASH HR = 0.55, 95% CI = 0.38 to 0.79; HEI HR = 0.67, 95% CI = 0.48 to 0.94). None of the dietary quality indices were associated with recurrence or breast cancer–specific mortality. Conclusion Food intake patterns concordant with dietary quality indices consistent with recommendations for healthy eating may be beneficial for women with breast cancer.

The potential impacts of extreme sea level events are becoming more apparent to the public and policy makers alike. As the magnitude of these events are expected to increase due to climate change, and increased coastal urbanization results in ever increasing stakes in the coastal zones, the need for risk assessments is growing too.The physical conditions that generate extreme sea levels are highly dependent on site specific conditions, such as bathymetry, tidal regime, wind fetch and the shape of the coastline. For a low-lying country like Denmark, which consists of a peninsula and islands that partition off the semi-enclosed Baltic Sea from the North Sea, a better understanding of how the local sea level responds to wind forcing is urgently called for.We here present a map for Denmark that shows the most efficient wind directions for generating extreme sea levels, for a total of 70 locations distributed all over the country’s coastlines. The maps are produced by conducting simulations with a high resolution, 3D-ocean model, which is used for operational storm surge modelling at the Danish Meteorological Institute. We force the model with idealized wind fields that maintain a fixed wind speed and wind direction over the entire model domain. Simulations are conducted for one wind speed and one wind direction at a time, generating ensembles of a set of wind directions for a fixed wind speed, as well as a set of wind speeds for a fixed wind direction, respectively.For each wind direction, we find that the maximum water level at a given location increases linearly with the wind speed, and the slope values show clear spatial patterns, for example distinguishing the Danish southern North Sea coast from the central or northern North Sea Coast. The slope values are highest along the southwestern North Sea coast, where the passage of North Atlantic low pressure systems over the shallow North Sea, as well as the large tidal range, result in a much larger range of variability than in the more sheltered Inner Danish Waters. However, in our simulations the large fetch of the Baltic Sea, in combination with the funneling effect of the Danish Straits, result in almost as high water levels as along the North Sea coast.Although the wind forcing is completely synthetic with no spatial and temporal structure of a real storm, this idealized approach allows us to systematically investigate the sea level response at the boundaries of what is physically plausible. We evaluate the results from these simulations by comparison to peak water levels from a 58 year long, high resolution ocean hindcast, with promising agreement.

Objective This paper identifies implementation leadership characteristics in the school nutrition setting and places findings in the context of implementation leadership literature. Methods Fourteen interviews were conducted with school district leadership/staff in an urban school district. Modified grounded theory was employed. Results Four themes emerged: (1) understanding of technical/operational intervention details; (2) ability to proactively develop and communicate plans; (3) supervisory oversight; and (4) intervention framing. Themes were consistent with 4 of the 5 dimensions comprising the Implementation Leadership Scale: knowledgeable, proactive, perseverant, and distributed leadership. The supportive domain was not a major finding. An additional domain, how leaders message the intervention to staff, was identified. Conclusions and Implications Implementation leadership in school nutrition appears similar, but not identical, to leader behaviors present in the Implementation Leadership Scale. School nutrition leaders might consider involving staff early in implementation planning, incorporating technical expertise, and clearly communicating the intervention purpose to support successful implementation. Future research might explore the interplay between leadership and implementation outcomes.

The rise and fall of the sea surface in the coastal region is observed closely by two different sources: tide gauges measure the relative sea level anomaly at the coast at high temporal resolution (minutes or hours) and satellite altimeters measure the absolute sea surface height of the open ocean along tracks multiple times a day. However, these daily tracks are scattered across the Baltic Sea with each track being repeated at a lower temporal resolution (days). Due to the inverse relationship between spatial and temporal coverage of the satellite altimetry data, gridded satellite altimetry products often prioritize spatial coverage over temporal resolution, thus filtering out the high sea level variability. In other words, the satellite data, and especially averaged products, often miss the daily sea level variability, such as storm surges, which is most important for all societies in the coastal region. To compensate for the sparse spatial coverage from satellite altimetry, we here present an experimental product developed as part of the ESA project Baltic+SEAL: on a 3-day scale, the DMI Optimal Interpolation (DMI-OI) method is combined with error statistics from a storm surge model as well as 3-day averages from both tide gauge observations and satellite altimetry tracks to generate a gridded sea level anomaly product for the Baltic Sea for year 2017. The product captures the overall temporal evolution of the sea level changes well for most areas with an average RMSE wrt. tide gauge observations of 17.2 cm and a maximum of 34.2 cm. Thus, the 3-day mean gridded product shows potential as an alternative to monthly altimetry products, although further work is needed.

Importance Annually, US schools screen millions of students’ body mass index (BMI) and report the results to parents, with little experimental evidence on potential benefits and harms. Objective To determine the impact of school-based BMI reporting on weight status and adverse outcomes (weight stigmatization and weight-related perceptions and behaviors) among a diverse student population. Design, Setting, and Participants Cluster randomized clinical trial. The Fit Study (2014-2017) randomized 79 California schools to BMI screening and reporting (group 1), BMI screening only (group 2), or control (no BMI screening or reporting [group 3]) in grades 3 to 8. The setting was California elementary and middle schools. Students in grades 3 to 7 at baseline participated for up to 3 years. A modified intent-to-treat protocol was used. Data analysis was conducted from April 13, 2017, to March 26, 2020. Interventions School staff assessed BMI each spring among students in groups 1 and 2. Parents of students in group 1 were sent a BMI report each fall for up to 2 years. Main Outcomes and Measures Changes in BMIzscore and in adverse outcomes (based on surveys conducted each fall among students in grades 4 to 8) from baseline to 1 and 2 years of follow-up. Results A total of 28 641 students (14 645 [51.1%] male) in grades 3 to 7 at baseline participated in the study for up to 3 years. Among 6534 of 16 622 students with a baseline BMI in the 85th percentile or higher (39.3%), BMI reporting had no effect on BMIzscore change (−0.003; 95% CI, −0.02 to 0.01 at 1 year and 0.01; 95% CI, −0.02 to 0.03 at 2 years). Weight dissatisfaction increased more among students having BMI screened at school (8694 students in groups 1 and 2) than among control participants (5674 students in group 3). Results of the effect of BMI reporting on other adverse outcomes were mixed: compared with the control (group 3), among students weighed at school (groups 1 and 2), weight satisfaction declined more after 2 years (−0.11; 95% CI, −0.18 to −0.05), and peer weight talk increased more after 1 year (0.05; 95% CI, 0.01-0.09); however, concerning weight control behaviors declined more after 1 year (−0.06; 95% CI, −0.10 to −0.02). Conclusions and Relevance Body mass index reports alone do not improve children’s weight status and may decrease weight satisfaction. To improve student health, schools should consider investing resources in evidence-based interventions. Trial Registration ClinicalTrials.gov Identifier:NCT02088086

Consumption of sugar-sweetened beverages (SSBs) contributes to adverse health outcomes and excess health care spending. To provide context for ongoing work assessing the impact of public health strategies, including SSB excise taxes, we used data from the California Health Interview Survey from 2011-2018 to estimate trends in beverage consumption among adults, teens, and children overall and by education, race/ethnicity, and family income. We found reductions in the annual prevalence and frequency of soda consumption across all age groups and heterogeneous increases in the consumption of fruit drinks among adults and children. Surveillance of beverage consumption trends will continue to strengthen and improve the ability of researchers and policy makers to effectively improve population health.

Background Persistent household food insecurity may have a greater adverse effect on children's health outcomes than experiencing household food insecurity for a shorter duration. Objectives Examine how changing household food security status and prolonged exposure to household marginal food security or food insecurity are associated with changes in children's growth from age 5 to 12. Methods We analyzed 204 mother-child dyads from the Center for Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal birth cohort study of Latino households. Generalized estimating equations assessed how changing household food security status and persistent exposure to marginal food security or food insecurity were associated with growth throughout childhood. Results Living in a marginally food secure of food insecure household compared to highly food secure household was associated with a decrease in BMI z-score of 0.18 (0.09, 0.26) between age 9 and 10.5. Changing from a highly food secure household to a marginally food secure or food insecure household was associated with a 0.10 (0.01, 0.20) decrease in body mass index z-score compared to those who persistently lived in highly food secure households. Conclusions Changes in food security status and duration of food insecurity were associated with changes in children's growth.

The sugar-sweetened beverage (SSB) industry has claimed that food and beverage retailers are opposed to SSB taxes. In 2018 and 2019, we formally evaluated retailers' perceptions of SSB taxes using semi-structured interviews (including open- and closed-ended questions) with 103 randomly selected retailers (50 corner and liquor stores; 28 chain convenience, drug, and mass-merchandise stores; 18 chain supermarkets and discount supermarkets; and 7 independent supermarkets) across 3 cities with SSB taxes (Berkeley, Oakland, and San Francisco); interviews occurred in 2018 and 2019 (approximately 3years, 1year and 6months post tax-implementation, respectively). A majority of both small and large retailers reported the tax had only a minimal effect on their business (70%). About half of retailers believed that other cities should adopt SSB taxes (53%), and were supportive of a statewide SSB tax (53%), noting it would level the playing field and better support health in their communities. Retailers' responses did not differ based on neighborhood income, and only 2 responses differed significantly between large and small retailers. Only 2 of 103 retailers reported raising the price of a non-beverage product in response to the tax, specifically raising the price of snack foods of low nutritional quality and alcoholic beverages. A majority of retailers in 3 California cities with SSB taxes have no concerns regarding the tax, endorse the health goals of SSB taxes and support statewide expansion of SSB tax policies.

Author(s): Thompson, Hannah R; Ritchie, Lorrene; Park, Esther; Madsen, Kristine A; Gosliner, Wendi | Abstract: IntroductionSchools across the United States have removed sweetened, flavored milk from cafeterias to reduce students' sugar consumption and improve their health. However, evidence on the impact of the removal is limited. We examined the effect of a policy that removed chocolate milk from secondary schools on students' milk consumption and estimated milk-related nutrient intake.MethodsWe collected data on milk selection and consumption during 1 lunch period in 24 California public secondary schools pre-policy (N = 3,158 students in 2016) and post-policy (N = 2,966 students in 2018). Schools had a student population that was 38% Asian and 29% Latino, with 63% qualifying for free or reduced-price meals. We used linear mixed effects models to assess changes in milk selection and waste, and we estimated related changes in added sugars, calcium, protein, and vitamin D consumed from milk.ResultsThe proportion of students selecting milk declined 13.6%, from 89.5% pre-policy to 75.9% post-policy (95% CI for difference, 10.8% tο 16.4%), but the proportion of milk wasted remained stable (37.1% vs 39.3%; 95% CI for difference, -0.2% to 4.6%). Although average per-student milk consumption declined by less than 1 ounce per student (from 4.8 oz to 3.8 oz; 95% CI for difference, -1.1 oz to -0.7 oz), we observed no significant reductions in average per-student intake of calcium, protein, or vitamin D from milk. Estimated added sugars from milk declined significantly, by 3.1 grams per student (95% CI, -3.2 g to -2.9 g).ConclusionRemoving chocolate milk modestly reduced student milk consumption without compromising average intake of key milk-related nutrients, and consumption of added sugars from milk declined significantly. Secondary schools should consider removing chocolate milk to support healthy beverage consumption.

Objectives. To examine how much sugar-sweetened beverage (SSB) excise taxes increased SSB retail prices in Oakland and San Francisco, California. Methods. We collected pretax (April–May 2017) and posttax (April–May 2018) retail prices of SSBs and non-SSBs from 155 stores in Oakland, San Francisco, and comparison cities. We analyzed data using difference-in-differences high-dimensional fixed-effects regressions, weighted by regional beverage sales. Results. Across all beverage sizes, the weighted average price of SSBs increased by 0.92 cents per ounce (95% confidence interval [CI] = 0.28, 1.56) in Oakland and 1.00 cents per ounce (95% CI = 0.35, 1.65) in San Francisco, compared with prices in untaxed cities. The tax did not significantly alter prices of water, 100% juice, or milk of any size examined. Diet soda only, among non-SSBs, exhibited a higher price increase for some sizes in taxed cities. Conclusions. Within 4 to 10 months of implementation, Oakland’s and San Francisco’s SSB excise taxes significantly increased SSB retail prices by approximately the amount of the taxes, a key mechanism for reducing consumption.

Extreme water levels in the micro-tidal transition zone between the North Sea and the semi-enclosed Baltic sea are predominantly determined by wind forcing associated with synoptic-scale weather systems. This connection between the two seas is partly blocked by low-lying islands, and the bathymetry comprises a complex mixture of narrow, deep channels and shallow sills. Coastlines in the Southern Kattegat and the Western Baltic Sea are therefore exposed to wind forcing from a large range of directions, and the extent of water build-up varies strongly between locations.In the present study, we aim to determine the most critical wind direction for most of the Danish coastlines by employing numerical modelling experiments. The simulations are conducted with two different regional 3D ocean models to enable model inter-comparison. The DMI-HBM model implements a structured grid with fully dynamic 2-way nesting, while the MIKE 3 FM invokes an unstructured mesh. Both models have grid resolutions of ~0.5–1 km within the Danish Straits and 4–6 km in the offshore Baltic Sea. The models are forced by synthetic wind fields, where both wind speed and wind direction are maintained at fixed levels over the entire model domains. Pairs of model simulations are then obtained by varying the angle from which the wind is blowing.From the model outputs, we describe the temporal evolution of the water level by the site-specific peak water level, and the time required for the response to reach its peak value. Our results show a steady rise of the water level up until the peak value. The peak water level significantly overshoots the final equilibrium water level, which develops further into the simulations. Our study facilitates a better understanding of the sea level's response to extreme and persistent winds in a region with highly complex geometry.

Climate change will lead to increases in the flood risk in low-lying coastal areas. Understanding the magnitude and impact of such changes is vital to design adaptive strategies and create awareness. In the context of the CoDEC project (Coastal Dataset for Evaluation of Climate impact), we developed a consistent European dataset of extreme sea levels, including climatic changes from 1979 to 2100. To simulate extreme sea levels, we apply the Global Tide and Surge Model v3.0 (GTSMv3.0), a 2D hydrodynamic model with global coverage. GTSM has a coastal resolution of 2.5 km globally and 1.25 km in Europe, and incorporates dynamic interactions between sea-level rise, tides and storm surges. Validation of the dataset shows a good performance with a mean bias of 0-.04 m for the 1 in 10-year water levels. When analyzing changes in extreme sea levels for the future climate scenarios, it is projected that by the end of the century the 1 in 10-year water levels are likely to increase up to 0.5 m. This change is largely driven by the increase in mean sea levels, although locally changes in storms surge and interaction with tides can amplify the impacts of sea-level rise with changes up to 0.2 m in the 1 in 10-year water level.The CoDEC dataset will be made accessible through a web portal on Copernicus Climate Data Store (C3S). The dataset includes a set of Climate Impact Indicators (CII’s) and new tools designed to evaluate the impacts of climate change on different sectors and industries. This data service will support European coastal sectors to adapt to changes in sea levels associated with climate change. In this presentation we will also demonstrate how the C3S coastal service can be used to enhance the understanding of local climate impacts.

The use of satellite altimetry at high latitudes and coastal regions is currently limited by the presence of seasonal sea ice coverage, and the proximity to the coast. The semi-enclosed Baltic Sea features seasonal coverage of sea-ice in the northern and coastal regions, and complex jagged coastlines with a huge number of small islands. However, as a semi-enclosed sea with a considerable extent, the Baltic Sea features a much-reduced tidal signal, both open- and coastal- waters, and an extensive multi-national network of tide-gauges. These factors maximise opportunities to drive improvements in sea-level estimations for coastal, and seasonal-ice regions.The ESA Baltic SEAL project, launched in April 2019, aims to exploit these opportunities. It is generating and validating a suite of enhanced multi-mission sea level products. Processing is developed specifically for coastal regions, with the objective of achieving a consistent description of the sea-level variability in terms of long-term trends, seasonal variations and a mean sea-surface. These will advance knowledge on adapting processing algorithms, to account for seasonal ice, and complex coastlines. Best practice approaches will be available to update current state-of-the-art datasets.In order to fulfill these goals, a novel altimeter re-tracking strategy has been developed. This enables the homogeneous determination of sea-surface heights for open-ocean, coastal and sea-ice conditions (ALES+). An unsupervised classification algorithm based on artificial intelligence routines has been developed and tailored to ingest data from all current and past satellite altimetry missions. This identifies radar echoes, reflected by narrow cracks within the sea-ice domain. Finally, the improved altimetry observations are gridded onto a triangulated surface mesh, featuring a spatial resolution greater than 1/4 degree. This is more suitable for utility for coastal areas, and use by coastal stakeholders.In addition to utilizing a wide range of altimetry data (Delay-Doppler and Pulse-Limited systems), the Baltic SEAL initiative harnesses the Baltic Seas unique characteristics to test novel geophysical corrections (e.g. wet troposphere correction), use the latest generation of regional altimetry datasets, and evaluate the benefits of the newest satellite altimetry missions. This presentation outlines the methodology and results achieved to date. These include estimations of a new regional mean sea surface, and insights into the trends of the sea level along the altimetry tracks with the longest records. The transfer of advances to other regions and sea-level initiatives are also highlighted.

Background Community initiatives to promote physical activity in children are common, but evidence supporting their effectiveness is limited. Objectives The objective of this study is to examine the relationships between community programmes and policies and children's physical activity in a large and diverse sample of US communities. Methods Programmes and policies to promote children's physical activity were assessed in 130 communities by key informant interviews, and physical activity behaviours were measured by self-report and parental report in samples of children in each community (total n = 5138). Associations between composite indices of community programmes and policies and indicators of total and moderate-to-vigorous physical activity were examined without and with adjustment for demographic factors. Results An index reflecting the 6-year history of the number of behaviour change strategies used in community programmes and policies was positively associated with children's moderate-to-vigorous physical activity. This association was attenuated with adjustment for demographic factors. Effect modification analyses found that the association was positive among non-Hispanic children but was negative for Hispanic children. Conclusions Community initiatives to promote physical activity in children were positively associated with children's physical activity in non-Hispanic children. Such initiatives were negatively associated with physical activity in Hispanic children, suggesting that future research should consider unique cultural factors when designing community initiatives to promote activity in this population sub-group.

We establish a methodology for assimilating satellite observations of ice surface temperature (IST) into a coupled ocean and sea-ice model. The method corrects the 2 meter air temperature based on the difference between the modelled and the observed IST. Thus the correction includes biases in the surface forcing and the ability of the model to convert incoming parameters at the surface to a net heat flux. A multi-sensor, daily, gap-free surface temperature analysis has been constructed over the Arctic region. This study revealed challenges estimating the ground truth based on buoys measuring IST, as the quality of the measurement varied from buoy to buoy. With these precautions we find a cold temperature bias in the remotely sensed data, and a warm bias in the modelled data relative to ice mounted buoy temperatures, prior to assimilation. As a consequence, this study weighted the modelled IST and the observed IST equally in the correction. The impact of IST was determined for experiments with and without the assimilation of IST and sea-ice concentration. We find that assimilation of remotely sensed data results in a cooling of IST, which improves the timing of the snow melt onset. The improved snow cover in spring is only based on observations from one buoy, thus additional good quality observations could strengthen the conclusions. The ice cover and the sea-ice thickness are increased, primarily in the experiment without sea-ice concentration assimilation.

Objectives. To evaluate a mass media campaign to reduce the consumption of sugar-sweetened beverages (SSBs). Methods. We disseminated messages emphasizing the health risks of SSBs through television, digital channels, and local organizations over 15 weeks in 2015–2016 in the Tri-Cities region of northeast Tennessee, southwest Virginia, and southeast Kentucky. We evaluated the campaign with pre- and post-telephone surveys of adults aged 18 to 45 years in the intervention area and by examining changes in beverage sales in the intervention and a matched comparison area in western Virginia. Results. Fifty-four percent of postcampaign respondents recalled seeing a campaign advertisement. After the campaign, 53% of respondents believed SSBs were a cause of heart disease, and respondents were more likely postcampaign to consider SSBs a “big cause of diabetes” (75% vs 60%; P

[ ]public health may be able to engage a broader coalition in fighting other preventable but deadly diseases, perhaps even obesity and diabetes [ ]sales taxes on soft drinks in Maine and Ohio, where 5 5% and 5 0% taxes, respectively, were added at the register, had no effect on sales 4 By contrast, a similarly sized excise tax in Washington State, which led to a 6% increase in shelf prices, was associated with a 5% decline in soft drink sales 5 Although Chriqui et al explain that Cook County used a sales tax because of existing restrictions, the tax size (equivalent to a 26% price increase) was five times larger than those in Maine and Ohio and led to a 21% net decline in sales while it was in place 2 FOCUS ON HEALTH Although excise taxes increase the cost of doing business for SSB manufacturers, and thereby lead to higher SSB prices and reduced consumption,1 it remains important to frame SSB taxes as a remedy to SSB-related disease and the tax revenues as a source of funding for health promotion By contrast, highlighting taxes as a means of reducing SSB consumption plays into the beverage industry's faulty but repeated claims that excise taxes restrict personal choice 3 Further, focusing on individual behaviors aligns with industry's talking points about personal responsibility;such talking points minimize the role inequitable environments across economic strata, including SSB advertising, play in shaping individual behaviors 1 NEXT STEPS Although Cook County's tax failed, it does pose an elegant natural experiment that could augment the science on SSB taxes, if the repeal's effect is consistent with evidence from Washington State and Denmark

Objectives. To examine the impact of physical education (PE) litigation on changes in cardio–respiratory fitness among racially/ethnically and socioeconomically diverse students. Methods. We used annual school-level data for all California schools with measures of fifth graders’ cardio–respiratory fitness spanning 2007–2008 through 2017–2018. A difference-in-difference design assessed changes before and after lawsuits in the proportion of students meeting fitness standards in schools in districts that were parties to PE lawsuits (n = 2715) versus in schools in districts not involved (n = 3152). We ran separate models with the proportion of students meeting fitness standards by sex, race/ethnicity, and low-income status as outcomes. Results. PE litigation led to a 1-percentage-point increase in the proportion of fifth-grade students meeting cardio–respiratory fitness standards (95% confidence interval [CI] = 0.03%, 2.0%). Effects were especially pronounced for female (1.3-percentage-point increase; 95% CI = 0.1%, 2.5%), African American (3.4-percentage-point increase; 95% CI = 0.5%, 6.2%), and low-income (2.8-percentage-point increase; 95% CI = 0.5%, 6.0%) students. Conclusions. Schools in districts subject to PE litigation showed greater improvements in student fitness, particularly among students typically at higher risk for inactivity and low fitness. Litigation may be an impactful tool for enforcing PE provision in accordance with the law.

Background: Current evidence demonstrates that, while a widely used tool for childhood obesity prevention, school-based BMI reports do not effectively reduce pediatric obesity. The purpose of this study was to examine the presumed mechanisms by which BMI reporting might impact child weight by assessing parents': (1) recall of BMI reports, (2) accuracy in recalling child overweight status, and (3) reactions to BMI reports. Methods: Mailed surveys were completed by 2205 racially/ethnically diverse parents of third- to seventh-grade students participating in the Fit Study who had either been exposed to 1 year of child BMI reporting (one report) or 2 years (two reports). Results: After 1 year of BMI reporting, parents of children with overweight were less likely [odds ratio (OR) = 0.7, 95% confidence interval (CI): 0.5-0.9] to recall receiving a BMI report and less likely (OR = 0.2, 95% CI: 0.1-0.3) to accurately recall their child's weight status from the BMI report, compared with parents of children with healthy weight. Differences in accuracy of child weight status recall persisted after 2 years of BMI reporting exposure. Only 22% of parents of children at risk for overweight and with overweight reported being surprised by the results. Conclusions: Parents' recall of receiving a school-based BMI report is low, as is the accuracy of recall of child's overweight status. Additionally, parents' surprise at, and concern for, BMI results is limited. Current BMI reports may be ineffective at reducing pediatric obesity due to their lack of salience and ability to compel meaningful behavior change among parents.

Author(s): Thompson, Hannah R; Linchey, Jennifer K; King, Benjamin; Himes, John H; Madsen, Kristine A | Abstract: BackgroundThe accuracy of students' heights and weights measured by school staff for body mass index (BMI) screening/reporting has not been established. This study examined school staffs' measurement accuracy, comparing accuracy by staff- and student-level characteristics.MethodsSchool staff and researchers measured the height and weight of 1008 4th-8th grade students, within 1 month of each other. Bland-Altman plots, mean differences, and intraclass correlation coefficients (ICCs) were calculated to examine measurement accuracy. Linear mixed effects models assessed accuracy by staff- and student-level characteristics.ResultsBland-Altman plots revealed no appreciable bias in differences between researcher and staff measurements. The mean absolute difference between researcher and school staff measurements were 1.0 ± 1.6ncm (height), 0.7 ± 1.8nkg (weight), and 0.4 ± 0.8nkg/m2 (BMI). Inter-rater ICC values were ≥0.97, demonstrating "excellent" reliability. Categorical weight status was correctly classified for 94% of students (kappa 0.90), and for 96% with a BMI ≥95th% (kappa 0.94). Physical education (PE) teachers were slightly less accurate than school nurses in measuring height (0.4ncm less accurate; pn=n.045) and weight (0.4nkg; pn=n.015).ConclusionsSchool staff conducted height/weight measurements on 4th-8th grade students with high accuracy. Resultant school-based BMI reports using similar protocols should validly reflect weight status for almost all students.

The Arctic region is responding heavily to climate change, and yet, the air temperature of Arctic, ice covered areas is heavily under-sampled when it comes to in situ measurements, and large uncertainties exist in weather- and reanalysis products. This paper presents a method for estimating daily mean 2 meter air temperatures (T2m) in the Arctic from satellite observations of skin temperature, using the Arctic and Antarctic ice Surface Temperatures from thermal Infrared (AASTI) satellite dataset, providing spatially detailed observations of the Arctic. The method is based on a linear regression model which has been developed using in situ observations and daily mean satellite ice surface skin temperatures combined with a seasonal variation to estimate daily T2m. The satellite derived T2m product including estimated uncertainties covers clear sky snow and ice surfaces in the Arctic region during the period 2000–2009. Comparison with independent in situ measured T2m gives average correlations of 95.5 % and 96.5 % and average root mean square errors of 3.47 °C and 3.19 °C for land ice and sea ice, respectively. The reconstruction provides a much better spatial coverage than the sparse in situ observations of T2m in the Arctic, is independent of numerical weather prediction model input and it therefore provides an important alternative to simulated air temperatures to be used for assimilation or global surface temperature reconstructions. A comparison between in situ T2m versus T2m from satellite and ERA-Interim shows that the T2m derived from satellite observations validate similar or better than ERA-Interim estimates in the Arctic.

Coastal zones are highly dynamical systems affected by a variety of natural and anthropogenic forcing factors that include sea level rise, extreme events, local oceanic and atmospheric processes, ground subsidence, etc. However, so far, they remain poorly monitored on a global scale. To better understand changes affecting world coastal zones and to provide crucial information to decision-makers involved in adaptation to and mitigation of environmental risks, coastal observations of various types need to be collected and analyzed. In this white paper, we first discuss the main forcing agents acting on coastal regions (e.g., sea level, winds, waves and currents, river runoff, sediment supply and transport, vertical land motions, land use) and the induced coastal response (e.g., shoreline position, estuaries morphology, land topography at the land-sea interface and coastal bathymetry). We identify a number of space-based observational needs that have to be addressed in the near future to understand coastal zone evolution. Among these, improved monitoring of coastal sea level by satellite altimetry techniques is recognized as high priority. Classical altimeter data in the coastal zone are adversely affected by land contamination with degraded range and geophysical corrections. However, recent progress in coastal altimetry data processing and multi-sensor data synergy, offers new perspective to measure sea level change very close to the coast. This issue is discussed in much detail in this paper, including the development of a global coastal sea-level and sea state climate record with mission consistent coastal processing and products dedicated to coastal regimes. Finally, we present a new promising technology based on the use of Signals of Opportunity (SoOp), i.e., communication satellite transmissions that are reutilized as illumination sources in a bistatic radar configuration, for measuring coastal sea level. Since SoOp technology requires only receiver technology to be placed in orbit, small satellite platforms could be used, enabling a constellation to achieve high spatio-temporal resolutions of sea level in coastal zones., Part of this work has been carried out with the financial support of the following research projects: Spanish research grant ESP2015-70014-C2-2-R (MINECO/FEDER) and Spanish Ministry of Science, Innovation and Universities: RTI2018-099008-B-C22, ESA contract Sea_Level_cci (No. 4000126561/19/I-NB).

ObjectiveThe present study aimed to determine the store types from which people in low-income neighbourhoods purchase most sugar-sweetened beverages (SSB) and to identify associations between purchasing location and demographic characteristics.DesignStreet-intercept surveys of passers-by near high foot-traffic intersections in 2016. Participants completed a beverage frequency questionnaire and identified the type of store (e.g. corner store, chain grocery) from which they purchased most SSB.SettingEight low-income neighbourhoods in four Bay Area cities, California, USA.ParticipantsSample of 1132 individuals who reported consuming SSB, aged 18–88 years, who identified as African-American (41 %), Latino (29 %), White (17 %) and Asian (6 %).ResultsBased on surveys in low-income neighbourhoods, corner stores were the primary source from which most SSB were purchased (28 %), followed by discount stores (18 %) and chain groceries (16 %). In fully adjusted models, those with lower education were more likely to purchase from corner stores or discount groceries than all other store types. Compared with White participants, African-Americans purchased more frequently from corner stores, discount groceries and chain groceries while Latinos purchased more frequently from discount groceries.ConclusionsThe wide range of store types from which SSB were purchased and demographic differences in purchasing patterns suggest that broader methodological approaches are needed to adequately capture the impact of SSB taxes and other interventions aimed at reducing SSB consumption, particularly in low-income neighbourhoods.

Consumption of sugar-sweetened carbonated beverages (including soda) has declined nationally, but trends by state are unknown. We used data from the California Health Interview Survey to assess overall changes in soda consumption among adults aged 18 or older from 2011 through 2016 and identified differences by education and income level. Frequency of soda consumption (times per week) declined from 2011 through 2014 by 16.5% but returned to 2011 levels in 2015 and 2016; trends did not differ by education or income. The proportion of the population that consumed soda did not change among adults with less than a high school diploma or equivalent, but declined significantly among those with at least a high school diploma. Our findings suggest that soda consumption remains a pressing public health problem in California.

Climate change will affect the coastline of the Baltic Sea through changes in sea level, storm surges and waves. In Denmark, a large part of the responsibility for climate adaptation lies with the local municipalities. The purpose of this study was to map the user needs for coastal climate change information of five municipalities in the Danish south western Baltic Sea and the Danish Coastal Authority in a cost-efficient way and to transform the mapping into local climate indicators. An interview template was customized to form the basis for telephone interviews of key stakeholders and systematic gathering of the results. The interest for the interviews was high, and response from the interviewed persons on the use of the template was very positive. During the interviews, it was clear that the municipalities have access to extensive information on the population and infrastructure, as well as detailed geographical information. The main interests were in very high quality storm surge warnings and present day and future extreme sea level and wave heights. This should be based on modeling of past storm surges and future changes, taking observations, and historical records into account. There was a big need for more detailed information than presently available, and for common scenarios, which will help the collaboration between municipalities. Within this study, the user requirements were used to define targeted climate indicators. Within the C3S CODEC project, the indicators will be provided for the municipalities, based on a downscaling of European scale storm surge, and wave simulations to local scale.

Author(s): Jeon, Diane; Chang, Emily G; McGing, Maggie; Hartman-Filson, Marlena; Sommers, Mathew; Lewis, Eula; Balmes, John R; Moisi, Daniela; Lederman, Michael M; Madsen, Kristine A; Woodruff, Prescott G; Hunt, Peter W; Huang, Laurence; Inflammation, Aging, Microbes and Obstructive Lung Disease (I AM OLD) Study | Abstract: BackgroundCOPD is a common HIV comorbidity, and HIV-infected individuals have a higher incidence and earlier onset of COPD compared to HIV-uninfected individuals. While the pathogenesis of HIV-associated COPD is largely unknown, chronic inflammation may contribute. Four pneumoproteins known to be markers of lung injury and inflammation have been associated with COPD in HIV-uninfected individuals: PARC/CCL-18, SP-D, CC-16, and sRAGE.ObjectiveTo determine whether these pneumoproteins are also associated with pulmonary function and COPD Assessment Test (CAT) scores in HIV-infected individuals.MethodsAssociations between plasma pneumoprotein levels and pulmonary function were determined in a cross-sectional study of otherwise healthy HIV-infected individuals enrolled between September 2016 and June 2017. Covariates included HIV-associated (antiretroviral therapy, CD4 count, and viral load) and COPD-associated (smoking and BMI) covariates.ResultsAmong 65 participants, 78.5% were male, 50.8% had undetectable viral load, and 76.9% were ever-smokers. Mean post-bronchodilator FEV1/FVC was 0.71, and mean DLco%predicted was 61%. Higher PARC/CCL-18 was associated with lower DLco%predicted and higher CAT score. Higher CC-16 was associated with lower DLco%predicted and lower FVC%predicted.ConclusionsThis exploratory analysis is the first to characterize associations between these four pneumoproteins and pulmonary function in an HIV-infected cohort. Our findings suggest the pathogenesis of HIV-associated COPD may differ from that of non-HIV-associated COPD due to HIV-specific inflammatory changes affecting DLco. PARC/CCL-18 is associated with structural and functional pulmonary abnormalities and may be an important COPD biomarker candidate in HIV infection. Our study is a preliminary step toward finding clinically relevant COPD biomarkers in high-risk populations.

Climate change and increased coastal urbanization are causing low-lying coastlines to become increasingly susceptible to the threat of extreme water levels and coastal flooding. Robust decision-making on adaptation in the coastal zone, based on reliable ocean-modelling tools, is therefore crucially contingent on accurate assessments of current and future storm surge hazards. This accuracy relies considerably on the quality of the wind forcing used in the ocean models. In this paper, we use a high-resolution, regional 3D ocean model (HBM) covering the North Sea and Baltic Sea to simulate extreme water levels during three extreme storm surge events with different dynamics and patterns, in order to assess their impacts along Denmark’s coastlines, which are of varying levels of complexity. We demonstrate that the model is able to reproduce the observed extreme high-water levels accurately, indicating that the system is well suited for producing simulations of present and future projections of extreme storm surges with high resulting impacts and damage potentials. Additionally, we quantify the level at which acknowledged deficiencies in the otherwise most suitable atmospheric forcing data set influence the results of the storm surge simulations. We found that reducing the temporal resolution of the forcing data – that is, replacing two out of every six time stamps with linearly interpolated values – is preferable to using the original forcing data set when recurring noise is present in these time stamps. As a result, for given storm surge events, and depending on the stage reached in the storm’s evolution, mean absolute errors can be reduced by 4.5 cm. This emphasizes the importance of considering such model fluctuations when coupling high-resolution atmosphere and ocean models.

Denmark has decided to reduce its GHG emissions by 70% compared to 1990 levels by 2030, which will imply changes to technologies, economic activities and behaviour. Here alongside, climate change remains a pressing issue, requiring climate information to be integrated into current and future planned activities in order to promote effective risk-coping strategies. This study maps the current use and future demands of data and services within climate and weather across spatiotemporal scales to understand how more targeted and thus more efficient data and climate services can be developed and employed, including upscaling and wider sectoral dissemination. A key to this process is a better understanding of the needs of current and new data and climate service-users. Based on a survey, we investigate how existing and potential data and climate service-users express their need for new data, products, services and tools within the Danish Realm, including Greenland, the Faroe Islands and the Danish Oceans. The survey was distributed to existing customers of the Danish Meteorological Institute (DMI) through personal networks and to 31,181 entry points in the Danish Business Register forming an extensive representation within Denmark. The focal sectors include agriculture, energy (including supply), and research and consultancy regarding climate issues. Key results indicate moderate differences in data characteristics between current users of data and climate services depending on their type of organization and sector, the low demand for future data and climate services compared to their current use by respondents and, finally and crucially, trust in suppliers’ reliability.

Regular physical activity improves academic performance in children, yet the short-term impact of activity on test scores and related behaviors, such as testing anxiety, is less established. Laboratory research demonstrates a positive relationship, but the impact of activity before testing in the school setting remains unstudied. We assessed the impact of a moderate-vigorous intensity physical education (PE) lesson directly before reading/math standardized tests on 5th grade student test-taking outcomes. A cluster RCT design was employed within a highly diverse public school district. Fifth grade classes (n = 29) were randomized to a standardized 40-min PE lesson immediately prior to testing or control condition. After testing, teacher ratings of students’ classroom behavior during math testing were 12% higher in intervention vs. control classes (p = 0.047; Cohen’s d = 0.79). There were no overall differences in student reported test-taking anxiety between groups, though differences by race/ethnicity and sex were present; intervention African American students reported a more positive physical state on math tests (11% higher, p = 0.012; Cohen’s d = 0.51) and on reading (10% higher, p = 0.040; Cohen’s d = 0.40) tests, and lower overall test anxiety during the math test (13% lower, p = 0.018; Cohen’s d = 0.48) than controls. However, intervention boys reported more off-task behavior (4% higher, p = 0.040; Cohen’s d = 0.03) than controls. There was no difference in test scores between groups. Teachers felt the PE lesson may have been too vigorous, as it left some students perspiring and thirsty during testing. Further research is necessary to better understand the conditions under which physical activity prior to testing impacts student’s testing anxiety and behaviors.

School lunch programs provide an opportunity to improve students&rsquo, diets. We sought to determine the impact of a multifaceted intervention (cafeteria redesigns, increased points-of-sale and teacher education) on secondary students&rsquo, perceptions of school-lunch quality and convenience and fruit and vegetable intake. Surveys (n = 12,827) from middle and high school students in 12 intervention and 11 control schools were analyzed. We investigated change in school-lunch perceptions and lunchtime and daily fruit and vegetable consumption from 2016 to 2018. Among 8th graders, perceptions that school lunch tastes good and that school lunch was enough to make students feel full increased 0.2 points (on a 5-point scale, p &lt, 0.01) in intervention schools relative to control schools. Among 10th graders, lunchtime fruit and vegetable consumption increased 6% in intervention relative to control schools (p &lt, 0.05 and p &lt, 0.01 respectively). Daily fruit intake increased 0.1 cups/day in intervention relative to control schools among 9th graders (p &lt, 0.01). This study provides important evidence on the limited effect of design approaches in the absence of meal changes. We observed only modest changes in school lunch perceptions and fruit and vegetable consumption that were not consistent across grades, suggesting that additional efforts are needed to improve school-lunch uptake.