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Health professionals are well placed to play a key role in educating people about climate and health. This article maps existing climate change education in medical as well as public health programs, identifies gaps and proposes possible improvements. It is essential that climate and health education enter the broader curriculum as this will also be a foundational part of education and help build the next generation of global expertise needed to create a healthier and more sustainable future.

Soil organic carbon (SOC) content and the water holding capacity of soils are two properties which link the carbon and hydrological cycles. Hydrological model inputs seldom include soil carbon as a parameter even though soil carbon content is known to influence soil water retention capacities. This study is a sensitivity analysis of changes in hydrological responses when the model inputs include different soil carbon percentages for the topsoil horizon. Sensitivities of hydrological responses such as transpiration, runoff volumes, the stormflow component of runoff and extreme runoff events to SOC content were quantified under various climatic conditions in South Africa. The soil water holding capacities at the drained upper limit (i.e. field capacity), permanent wilting point and saturation were calculated for the topsoil horizon, using SOC dependent pedo (soil)-transfer functions for different soil carbon scenarios and locations in South Africa. These variables, together with other pre-determined soil- and locationrelated inputs, as well as 50 years of daily climate, were then used as inputs in a process-based hydrological model. Overall, it was found that increased SOC content in the topsoil horizon leads to an increase in transpiration, a reduction in runoff, especially in its stormflow component, and a reduction of extreme runoff events. However, these changes are relatively small compared to the influence of climate, particularly of rainfall amount and distribution.Significance: Organic carbon content of the soil and the water holding capacity of soils link the carbon and hydrological cycles. Management interventions that increase SOC lead to win-win situations because, in addition to climate change mitigation, plant water availability improves, and overall surface runoff ‘flashiness’ becomes more regulated. While rainfall amount and distribution over space and time remain the most critical determinants of hydrological responses, increased SOC in the topsoil horizon leads to increases in transpiration and thus plant growth, and to a reduction in runoff, especially in its stormflow component, and hence to a small reduction of severe flooding events.

IntroductionAs part of the PIONEER (Prostate Cancer Diagnosis and Treatment Enhancement Through the Power of Big Data in Europe) Consortium, we will explore which diagnostic and prognostic factors (DPFs) are currently being researched to previously defined clinical and patient-reported outcomes for prostate cancer (PCa).Methods and analysisThis research project will follow the following four steps: (1) a broad systematic literature review of DPFs for all stages of PCa, covering evidence from 2014 onwards; (2) discussion of systematic review findings by a multidisciplinary expert panel; (3) risk of bias assessment and applicability with Prediction model Risk Of Bias Assessment Tool criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) and the Quality In Prognosis Studies tool (QUIPS) and (4) additional quantitative assessments if required.Ethics and disseminationWe aim to develop an online tool to present the DPFs identified in this research and make them available across all stakeholders. There are no ethical implications.

The negative implications of climate change for human health are now well-established. Yet these have not been fully considered into climate change communication strategies. Research suggests that reorienting climate change communication with a health frame could be a useful communication strategy. We conducted a long-term and broad overview of existing scientific literature in order to summarize the state of research activity in this area, by extent and by nature. The methodology is based on a scoping review of scientific articles published on climate change communication and health between 1990 and mid-2016 indexed in the PubMed, ScienceDirect, and Web of Science databases. The screened citations were reviewed for inclusion and data were extracted and coded in order to conduct quantitative (e.g. frequencies) and qualitative (i.e. content analysis) analyses.Out of 2,866 identified published papers, only 24 articles were eligible for analyses. The main themes identified were effective communication of climate change (n=10, 41.7%), the role of health professionals (n=10, 41.7%) and the perception of climate change (n=4, 16.7%). We identified a large proportion of secondary research articles (n= 15, 62.5%) including reviews (n=5, 20.8%) and opinion articles (n=10, 41.7%). A significant share - 37.57% (n=9) - of the identified articles were classified as original research articles, suggesting that the number of publications in this area - particularly original research - has not grown rapidly.This scoping review identified several themes including effective communication of climate change, the role of health professionals, and the perception of climate change in the selected articles on the subject. The research literature on the communication of climate change and health is relatively recent and emerging: the first articles on the subject were published from 2008 onward only.

The Lancet Countdown: tracking progress on health and climate change was established to provide an independent, global monitoring system dedicated to tracking the health dimensions of the impacts of, and the response to, climate change. The Lancet Countdown tracks 41 indicators across five domains: climate change impacts, exposures, and vulnerability; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; finance and economics; and public and political engagement. This report is the product of a collaboration of 27 leading academic institutions, the UN, and intergovernmental agencies from every continent. The report draws on world-class expertise from climate scientists, ecologists, mathematicians, geographers, engineers, energy, food, livestock, and transport experts, economists, social and political scientists, public health professionals, and. doctors. The Lancet Countdown’s work builds on decades of research in this field, and was first proposed in the 2015 Lancet Commission on health and climate change,1 which documented the human impacts of climate change and provided ten global recommendations to respond to this public health emergency and secure the public health benefits available (panel 1).

Technological advances during the last decade have provided novel opportunities for development of health and medical education. Education of health care professionals by massive open online courses (MOOCs) has been suggested in order to improve care and treatment of patients and the health literacy of the public. This article discusses the strengths, weaknesses, opportunities and threats of MOOCs in health and medical education by taking a special focus on low and middle-income countries.

Background : Climate change has been recognized as both one of the biggest threats and the biggest opportunities for global health in the 21st century. This trend review seeks to assess and characterize the amount and type of scientific literature on the link between climate change and human health. Design : We tracked the use of climate-related terms and their co-occurrence with health terms during the 25 years since the first Intergovernmental Panel on Climate Change (IPCC) report, from 1990 to 2014, in two scientific databases and in the IPCC reports. We investigated the trends in the number of publications about health and climate change through time, by nature of the health impact under study, and by geographic area. We compared the scientific production in the health field with that of other sectors on which climate change has an impact. Results : The number of publications was extremely low in both databases from 1990 (325 and 1,004, respectively) until around 2006 (1,332 and 4,319, respectively), which has since then increased exponentially in recent years (6,079 and 17,395, respectively, in 2014). However, the number of climate change papers regarding health is still about half that of other sectors. Certain health impacts, particularly malnutrition and non-communicable diseases (NCDs), remain substantially understudied. Approximately two-thirds of all published studies were carried out in OECD countries (Organization for Economic Cooperation and Development), predominantly in Europe and North America. Conclusions : There is a clear need for further research on the links between climate change and health. This pertains particularly to research in and by those countries in which health will be mostly affected and capacity to adapt is least. Specific undertreated topics such as NCDs, malnutrition, and mental health should gain the priority they deserve. Funding agencies are invited to take note of and establish calls for proposals accordingly. Raising the interest in this research area in young scientists remains a challenge and should lead to innovative courses for large audiences, such as Massive Open Online Courses. Keywords : literature review; IPCC; NCDs; infectious diseases; malnutrition; respiratory diseases (Published: 21 June 2016) Citation: Glob Health Action 2016, 9 : 30723 - http://dx.doi.org/10.3402/gha.v9.30723 Supplementary material: To access the supplementary material for this article, please see Supplementary files under ‘Article Tools’

The objective of this paper is to map soil organic carbon content (%) across South Africa in detail and at high spatial resolution. Several existing datasets, namely the Soil Profile Database, the Terrain Unit Database and the Binomial Soil Series Database were used, but had to be enhanced to be able to combine some information to produce detailed soil carbon maps for South Africa at a resolution of terrain units. A distinction was made between soil samples taken under assumed pristine conditions with a natural vegetation cover and those of soils that had been modified by agricultural activities. The results were maps of areas with soil organic carbon content across South Africa at a spatial detail not previously achieved. The methodology did not allow for SOC mapping of stony or rocky soils, so these areas were omitted, but these are likely to be low in SOC. The results show that generally a higher SOC content is found in topsoil horizons than in subsoil horizons, in areas of natural vegetation versus those with agricultural land uses and in the higher rainfall areas compared to drier areas.

Background The 2014-2016 Ebola outbreak across West Africa was devastating, acting not only as a wake-up call for the global health community, but also as a catalyst for innovative change and global action. Improved infectious disease monitoring is the stepping-stone toward better disease prevention and control efforts, and recent research has revealed the potential of digital technologies to transform the field of global health. This scoping review aimed to identify which digital technologies may improve disease prevention and control, with regard to the 2014-2016 Ebola outbreak in West Africa. Methods A search was conducted on PubMed, EBSCOhost and Web of Science, with search dates ranging from 2013 (01/01/2013) - 2017 (13/06/2017). Data was extracted into a summative table and data synthesized through grouping digital technology domains, using narrative and graphical methods. Findings The scoping review identified 82 full-text articles, and revealed big data (48%, n = 39) and modeling (26%, n = 21) technologies to be the most utilized within the Ebola outbreak. Digital technologies were mainly used for surveillance purposes (90%, n = 74), and key challenges were related to scalability and misinformation from social media platforms. Interpretation Digital technologies demonstrated their potential during the Ebola outbreak through: more rapid diagnostics, more precise predictions and estimations, increased knowledge transfer, and raising situational awareness through mHealth and social media platforms such as Twitter and Weibo. However, better integration into both citizen and health professionals' communities is necessary to maximise the potential of digital technologies.

Despite the greatly increased numbers of migrants and refugees worldwide in recent years, insufficient attention has been paid to addressing their health needs. While a variety of international instruments assert the right to health, in practice, migrants and refugees—especially those awaiting clarification of their status, such as asylum seekers and those without documentation—often fall in cracks between service providers and humanitarian relief programmes at national and regional levels. This report provides a summary of the current state of knowledge regarding the health issues of migrants and refugees and of the extent to which they are being met. It highlights, through a series of case studies, the diverse approaches to policies, entitlements and services provided in different jurisdictions, ranging from regional (Europe) and country (Germany, Iran, Italy, Turkey, South Africa) levels to provinces and cities (Quebec/Montreal, Berlin). These provide evidence of successes and challenges and highlight areas requiring further effort, including in the domains of policy, service design and delivery, education and training, research and communication. They also underscore the challenges of highly neglected aspects such as mental health and the critical importance of developing cultural/transnational competence in the health professional individuals and institutions working with migrants and refugees. Results from discussions taking place in an M8 Alliance Expert Group Meeting (Rome, 23–24 June 2017) and from the literature are synthesised to develop an ‘agenda of solutions’. This agenda aims to provide a comprehensive framework, which bridges humanitarian, ethical and rights-based imperatives to provide a framework for action to tackle this crucial area.

Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed.

Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed.

Lung cancer remains the leading cause of cancer mortality worldwide. A number of screening trials for early detection of lung cancer exist, using chest X-ray, low-dose computed tomography, or both. However, little is known about the socio-demographic characteristics of participants in lung cancer screening programs. As gender and socio-economic determinants are important variables to consider for successful program implementation, this review aims to characterize the participants in such programs and to investigate whether differences in representation exist across screening programs. Systematic methods were used to identify relevant studies. A search was undertaken to locate all studies published up to August 2017 assessing the socio-demographic profile of participants in lung cancer screening programs. A search strategy was developed, refined, and implemented to search in two different online databases (MEDLINE and Web of Sciences). A total of 1588 references were retrieved of which 14 were eligible for review. The results highlight differences in gender and social characteristics of participants across programs, while noting that differences may be partly explained by the various epidemiological contexts, program inclusion criteria, and socio-economic status (SES) measures collected. Most importantly, despite a well-recognized predominance of low SES among heavy smokers, people with high SES are seemingly over-represented among participants. Male participants also seem to be over-represented. These findings are important to help inform the development and implementation processes of future lung cancer screening programs, which should likely include strategies for engaging women as well as individuals with low SES and, of course, those most at risk for developing lung cancer.

Background Existing health systems all over the world are different due to the different combinations of components that can be considered for their establishment. The ranking of health systems has been a focal points for many years especially the issue of performance. In 2000 the World Health Organization (WHO) performed a ranking to compare the Performance of the health system of the member countries. Since then other health system rankings have been performed and it became an issue of public discussion. A point of contention regarding these rankings is the methodology employed by each of them, since no gold standard exists. Therefore, this review focuses on evaluating the methodologies of each existing health system performance ranking to assess their reproducibility and transparency. Methods A search was conducted to identify existing health system rankings, and a questionnaire was developed for the comparison of the methodologies based on the following indicators: (1) General information, (2) Statistical methods, (3) Data (4) Indicators. Overall nine rankings were identified whereas six of them focused rather on the measurement of population health without any financial component and were therefore excluded. Finally, three health system rankings were selected for this review: "Health Systems: Improving Performance" by the WHO, "Mirror, Mirror on the wall: How the Performance of the US Health Care System Compares Internationally" by the Commonwealth Fund and "the Most efficient Health Care" by Bloomberg. Results After the completion of the comparison of the rankings by giving them scores according to the indicators, the ranking performed the WHO was considered the most complete regarding the ability of reproducibility and transparency of the methodology. Conclusions This review and comparison could help in establishing consensus in the field of health system research. This may also help giving recommendations for future health rankings and evaluating the current gap in the literature.

The Lancet Countdown: Tracking Progress on Health and Climate Change is an international, multi-disciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be “the greatest global health opportunity of the 21st century”. The Lancet Countdown aims to track the health effects of climate change; health resilience and adaptation; health co-benefits of mitigation; climate economics and finance; and political and broader engagement. These focus areas form the five thematic working groups of the Lancet Countdown and represent different aspects of the complex relationships between health and climate change. These thematic groups will provide indicators for a global overview of health and climate change; national case studies highlighting countries leading the way or going against the trend; and engagement with a range of stakeholders. The Lancet Countdown ultimately aims to report annually on a series of indicators across these five working groups. This paper outlines these potential indicators and indicator domains to be tracked by the collaboration, with suggestions on the methodologies, and data sets available to achieve this end. The proposed indicator domains require further refinement, and mark the beginning of an ongoing consultation process – from November 2016 to early 2017 – to develop these domains, identify key areas not currently covered, and change indicators where necessary. It will actively seek to engage with existing monitoring processes, such as the UN Sustainable Development Goals, and the World Health Organization’s Climate and Health Country Profiles. Additionally, the indicators will evolve throughout their lifetime through ongoing collaboration with experts and a range of stakeholders, and dependent on the emergence of new evidence and knowledge. During the course of its work, the Lancet Countdown will adopt a collaborative and iterative process, which aims to complement existing initiatives, welcome engagement with new partners, and be open to developing new research projects on health and climate change.

In 2009, scientists argued that climate change was the ‘biggest global health threat of the 21st century’,1 and 6 years later ‘the greatest global health opportunity of the 21st century’.2 While a minority of populations may experience health benefits (mostly due to a reduction in diseases related to cold weather), the global burden of disease and premature death is expected to increase progressively.3 For instance, one study showed that heat-related deaths would be expected to rise by around 257% by the 2050s from a current annual baseline of approximately 2000 deaths.4 Much of the policy development on climate change comes from the negotiations between the 195 parties to the United Nations Framework Convention on Climate Change (UNFCCC), working towards a common long-term vision of limiting global warming. The 21th Conference of the Parties (COP21) in Paris in December 2015 was one milestone in the fight against climate change, as all countries agreed to take action by curbing greenhouse gas emissions (GHGE) and keep global warming well below 2°C. The agreement also included a regular review of national commitments every 5 years to check progress. Moreover, it represented an important step to protect and promote health in the face of climate change: for the first time ‘the right to health’ was mentioned in the global agreement on climate change. The WHO referred to the COP21 as ‘a historic win for human health’, and this climate treaty might actually become a public health treaty as countries take action to develop adaptation plans that will protect human health from the worst impacts of climate change.5 This opinion article seeks to present the role of health concerns in the scientific debates on climate change, but also in actual climate policies and international negotiations. ### Climate change-related health concerns in scientific debates Awareness of the health risks caused by …

The Lancet Countdown: tracking progress on health and climate change is an international, multidisciplinary research collaboration between academic institutions and practitioners across the world. It follows on from the work of the 2015 Lancet Commission, which concluded that the response to climate change could be "the greatest global health opportunity of the 21st century". The Lancet Countdown aims to track the health impacts of climate hazards; health resilience and adaptation; health co-benefits of climate change mitigation; economics and finance; and political and broader engagement. These focus areas form the five thematic working groups of the Lancet Countdown and represent different aspects of the complex association between health and climate change. These thematic groups will provide indicators for a global overview of health and climate change; national case studies highlighting countries leading the way or going against the trend; and engagement with a range of stakeholders. The Lancet Countdown ultimately aims to report annually on a series of indicators across these five working groups. This paper outlines the potential indicators and indicator domains to be tracked by the collaboration, with suggestions on the methodologies and datasets available to achieve this end. The proposed indicator domains require further refinement, and mark the beginning of an ongoing consultation process-from November, 2016 to early 2017-to develop these domains, identify key areas not currently covered, and change indicators where necessary. This collaboration will actively seek to engage with existing monitoring processes, such as the UN Sustainable Development Goals and WHO's climate and health country profiles. The indicators will also evolve over time through ongoing collaboration with experts and a range of stakeholders, and be dependent on the emergence of new evidence and knowledge. During the course of its work, the Lancet Countdown will adopt a collaborative and iterative process, which aims to complement existing initiatives, welcome engagement with new partners, and be open to developing new research projects on health and climate change.

Background The aim of this study was to explore the associations between socio-demographic, psychosocial, material and occupational factors and self-reported health (SRH) in the European working population. Anotherobjective was to examine whether these associations varied according to occupation and country. Methods This study was based on data from the European quality of life survey 2007 including 17 005 workers from 31 European countries. SRH was measured using a single item. Factors were classified into four different groups: socio-demographic, psychosocial, material and occupational factors. The associations between these factors and SRH were examined using multilevel logistic regression analyses including interaction tests. Results When all four groups of factors were studied together, age, occupation, urbanization level, origin, trust level, social exclusion, material deprivation, financial and neighbourhood problems, access to medical services, quality of public services, psychological job demands, job reward, work‐life imbalance and dangerous/unhealthy working conditions were associated with poor SRH. Almost no differences were found in these associations according to occupation and country. Conclusion Various factors were associated with poor SRH. This study gave a first European overview of the associations between sociodemographic, psychosocial, material and occupational factors and SRH in Europe and could provide better advice to policy-makers at a European level.

Aims: The aim of this study was to examine educational differences in self-reported health (SRH) among men and women in Europe. Methods: The study was based on a sample of 15,362 men and 20,272 women from the nationally representative European Quality of Life Survey conducted in 31 European countries in 2007. SRH was measured using a single item and dichotomised into good (very good, good) and poor (fair, bad, very bad) health. Education was classified into seven categories according to the International Standard Classification of Education. Relative index of inequality, multilevel logistic regression analyses, and interaction tests were conducted. Results: Educational differences in SRH were found in almost all countries. After adjustment for covariates, no differences were found in Austria, Denmark, or the Netherlands. The highest differences were observed for both genders in Ireland and Macedonia. Women had significant larger educational differences in SRH than men in Portugal but significant lower differences in Czech Republic and Lithuania. Conclusions: The study underlined that the magnitude of educational differences in SRH varied according to gender and country.

Significant land use changes from natural/agricultural to urban land uses have been proposed within the Mpushini/Mkhondeni sub-catchments of the uMngeni Catchment in South Africa. A better understanding of the influences which such land use changes are likely to have on hydrological flows, is required, in order to make informed land use decisions for a sustainable future. As a point of departure, an overview of linkages between urbanisation and hydrological flow responses within this sub-humid study area is given. The urban characteristics of increased impervious areas and the potential return flows from transfers of potable water from outside the catchment were identified as being important in regard to hydrological flow responses. A methodology was developed to model urban response scenarios with urban characteristics as variables, using the daily time-step process based ACRU model. This is a hydrological multi-process model and not an urban hydraulic model and it addresses the landscape as well as the channel components of a catchment, and in addition to runoff components includes evaporation and transpiration losses as outputs. For the study area strong links between proposed urbanisation and hydrological resource flow responses were found, with increases in stormflows, together with increased and more regulated baseflows, and with impacts varying markedly between dry or wet years and by season. The impacts will depend on the fractions of impervious areas, whether or not these are connected to permeable areas, the amount of imported water and water system leaks. Furthermore, the urban hydrological impacts were found to be relatively greater in more arid than humid areas because of changes in the rainfall to runoff conversion. Flow changes due to urbanisation are considered to have important environmental impacts, requiring mitigation. The methodology used in this paper could be used for other urbanising areas.

Introduction For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been assessing the potential risks associated with anthropogenic climate change. Although interest in climate change and health is growing, the implications arising from their interaction remain understudied. Generating a greater understanding of the health impacts of climate change could be key step in inciting some of the changes necessary to decelerate global warming. A long-term and broad overview of the existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. In this paper we outline our methods to conduct a scoping review of the published peer-reviewed literature on climate change and health between 1990 and 2015. Methods and analysis A detailed search strategy will be used to search the PubMed and Web of Science databases. Specific inclusion and exclusion criteria will be applied in order to capture the most relevant literature in the time frame chosen. Data will be extracted, categorised and coded to allow for statistical analysis of the results. Ethics and dissemination No ethical approval was required for this study. A searchable database of climate change and health publications will be developed and a manuscript will be complied for publication and dissemination of the findings. We anticipate that this study will allow us to map the trends observed in publications over the 25-year time period in climate change and health research. It will also identify the research areas with the highest volume of publications as well as highlight the research trends in climate change and health.

Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking.The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries.The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing.When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country.Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.

www.thelancet.com Vol 385 June 13, 2015 e49 Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/ public health. If benefi ts of mitigation policies are often seen as long-term investments with many uncertainties, immediate cobenefi ts on health can be far more convincing arguments. In this regard, the upcoming conference “Climate, Health, Inequalities: solutions?” in Paris June 18–19, organised by the French Ministry of Health ahead of COP21, represents a huge opportunity. Importantly, COP21 is only one battlefi eld in the fi ght against climate change. Before and after December 2015, health professionals and researchers should commit to get informed on climate change, and mobilise their creativity to develop studies that will support decision making, both in the fi elds of adaptation and mitigation.

OBJECTIVE The aim was to assess the changes in psychosocial work factors among European employees between 2005 and 2010. METHODS The study samples came from the European Working Conditions Survey, involving 23,580 and 32,516 employees in 2005 and 2010, respectively, from 30 European countries. The psychosocial work factors studied were based on job strain and effort-reward imbalance models, and more recent factors. Multilevel linear and logistic regression models were used. Differences according to occupations and countries were tested. RESULTS Results were mixed with improvement for some factors and decline for other factors. Some countries and occupations were more likely to be affected by negative changes, especially low-skilled employees. CONCLUSION Prevention policies at the workplace should take into account that the degradation of some psychosocial work factors may be sharper for some countries and occupations.

The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country. The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests. When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong. A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.

The objective was to explore the educational differences in psychological well-being, measured using the WHO-5 Index, among 15,362 men and 20,272 women in 31 European countries. Relative Index of Inequality, multilevel logistic regression analyses and interaction tests were performed. Within Europe, large cross-national differences in the prevalence of poor well-being were observed. In almost all countries, the prevalence of poor well-being was higher in low educational groups, but the magnitude of these inequalities was much larger in some countries than in others. The highest social differences in well-being were observed in the European Union candidates countries among both genders. Future health promotion programs should consider strategies that target lower educational groups.