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With a few exceptions, most studies on tropospheric ozone (O 3) variability during and following the COrona VIrus Disease (COVID-19) economic downturn focused on high-emission regions or urban environments. In this work, we investigated the impact of the societal restriction measures during the COVID-19 pandemic on surface O 3 at several high-elevation sites across North America and western Europe. Monthly O 3 anomalies were calculated for 2020 and 2021, with respect to the baseline period 2000–2019, to explore the impact of the economic downturn initiated in 2020 and its recovery in 2021. In total, 41 high-elevation sites were analyzed: 5 rural or mountaintop stations in western Europe, 19 rural sites in the western US, 4 sites in the western US downwind of highly polluted source regions, and 4 rural sites in the eastern US, plus 9 mountaintop or high-elevation sites outside Europe and the United States to provide a "global" reference. In 2020, the European high-elevation sites showed persistent negative surface O 3 anomalies during spring (March–May, i.e., MAM) and summer (June–August, i.e., JJA), except for April. The pattern was similar in 2021, except for June. The rural sites in the western US showed similar behavior, with negative anomalies in MAM and JJA 2020 (except for August) and MAM 2021. The JJA 2021 seasonal mean was influenced by strong positive anomalies in July due to large and widespread wildfires across the western US. The polluted sites in the western US showed negative O 3 anomalies during MAM 2020 and a slight recovery in 2021, resulting in a positive mean anomaly for MAM 2021 and a pronounced month-to-month variability in JJA 2021 anomalies. The eastern US sites were also characterized by below-mean O 3 for both MAM and JJA 2020, while in 2021 the negative values exhibited an opposite structure compared to the western US sites, which were influenced by wildfires. Concerning the rest of the world, a global picture could not be drawn, as the sites, spanning a range of different environments, did not show consistent anomalies, with a few sites not experiencing any notable variation. Moreover, we also compared our surface anomalies to the variability of mid-tropospheric O 3 detected by the IASI (Infrared Atmospheric Sounding Interferometer) satellite instrument. Negative anomalies were observed by IASI, consistent with published satellite and modeling studies, suggesting that the anomalies can be largely attributed to the reduction of O 3 precursor emissions in 2020. [ABSTRACT FROM AUTHOR]

Background: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC ("PAL-LIFE group"). Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development. Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented. Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world. [ABSTRACT FROM AUTHOR]