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More than 110,000 Europeans died as a result of the record-breaking temperatures of 2022 and 2023. A new generation of impact-based early warning systems, using epidemiological models to transform weather forecasts into health forecasts for targeted population subgroups, is an essential adaptation strategy to increase resilience against climate change. Here, we assessed the skill of an operational continental heat-cold-health forecasting system. We used state-of-the-art temperature-lag-mortality epidemiological models to transform bias-corrected ensemble weather forecasts into daily temperature-related mortality forecasts. We found that temperature forecasts can be used to issue skillful forecasts of temperature-related mortality. However, the forecast skill varied by season and location, and it was different for temperature and temperature-related mortality due to the use of epidemiological models. Overall, our study demonstrates and quantifies the forecast skill horizon of heat-cold-health forecasting systems, which is a necessary step toward generating trust among public health authorities and end users. [ABSTRACT FROM AUTHOR]

Outdoor activities support children's active participation and contribute to their experiential learning. Furthermore, they engage all senses of the children. Outdoor activities are considered a necessity for children, particularly those diagnosed with Autism Spectrum Disorder (ASD). Limited eye contact, avoidance of physical contact, and difficulties in adhering to social norms often limit their participation in outdoor activities. However, this situation increases the need for outdoor activities among children with ASD and their primary caregivers, especially mothers. Therefore, this study aims to examine the opinions of mothers of children diagnosed with ASD regarding outdoor activities. A phenomenological approach, a qualitative research method, was employed in this study. The study group consisted of 13 mothers with children diagnosed with ASD, enrolled in a special education preschool in Adapazarı district of Sakarya province during the 2022-2023 academic year. Purposive sampling method was used to select the study group. Data were collected through a "Personal Information Form" and a "Semi-Structured Parent Interview Form" prepared by the researchers and validated by experts. Content analysis was used to analyze the data. According to the analysis, mothers with higher education levels expressed the importance of dressing their children appropriately for outdoor activities in all weather conditions, while mothers with lower education levels expressed concerns about taking their children outdoors in bad weather due to health reasons. Additionally, they mentioned that shopping malls and parks were more effective outdoor environments for children to socialize, as these places were more crowded and conducive to socialization. Mothers with higher education levels did not see any problem in taking their children outside even when it was snowing. Families emphasized the significant effects of outdoor activities on children's social development, especially in school settings. Based on the data obtained from the study, it is recommended that the study could be conducted with a different sample group, and data collection tools could be diversified. [ABSTRACT FROM AUTHOR]

Background: It is widely known that the incidence rate and short-term mortality of acute myocardial infarctions (AMIs) are generally higher during the winter months. The goal of this study was to determine how the temperature of the environment influences fatal acute myocardial infarctions in Xuzhou. Methods: This observational study used the daily meteorological data and the data on the cause of death from acute myocardial infarction in Xuzhou from January 1, 2018, to December 31, 2020. After controlling meteorological variables and pollutants, the distributed nonlinear lag model (DLNM) was used to estimate the correlation between temperature and lethal AMI. Results: A total of 27,712 patients with fatal AMI were enrolled. 82.4% were over the age of 65, and 50.9% were men. Relative to the reference temperature (15 ℃), the 30-day cumulative RRs of the extremely cold temperature (− 2 ℃) for the general population, women, and people aged 65 years and above were 4.66 (95% CI: 1.76, 12.30), 15.29 (95% CI: 3.94, 59.36), and 7.13 (95% CI: 2.50, 20.35), respectively. The 30-day cumulative RRs of the cold temperature (2 ℃) for the general population, women, and people aged 65 years and above were 2.55 (1.37, 4.75), 12.78 (2.24, 5.36), and 3.15 (1.61, 6.16), respectively. No statistically significant association was observed between high temperatures and the risk of fatal AMI. The influence of the cold effect (1st and 10th) was at its peak on that day, and the entire cold effect persisted for 30 days. Temperature extremes had an effect on the lag patterns of distinct age and gender stratifications. Conclusion: According to this study, the risk of fatal AMI increases significantly in cold weather but not in hot weather. Women above the age of 65 are particularly sensitive to severe weather events. The influence of frigid weather on public health should also be considered. [ABSTRACT FROM AUTHOR]

Background: Institutional delivery has been considered one of the important strategies to improve maternal and child health and significantly reduce birth-related complications. However, it is still low in developing countries though there are some improvements. even among the community who has access to the health institutions weather health center and hospital including Somaliland. Hence, the aim of this study was to assess the level of institutional delivery service utilization and associated factors among women who gave birth in the last 12 months in Ga'an libah district, Marodijeh region, Somaliland. Methods: The community-based cross-sectional study was conducted among women who gave birth in the last 12 months from September to December 2022. A simple random sampling technique was employed to select study participants from a total of sample population. Data was collected using semi-structural administered questionnaire through interviewing women. Data was collected with online mobile data collection (Kobo collect). SPSS version 25.0 was used for data management, entering and analysis. Bivariate and multivariable logistic regression models were fitted to determine the presence of a statistically significant association between independent variables and the outcome variable with p-value < 0.05. Result: Level of Institutional delivery services utilization in Ga'an libah district was 53.9% [95% Cl 48.2–59.6] gave birth at health institutions. Women who can read and write local were (AOR 2.18, 95% CI 1.08–4.56, p<0.01), Women with their husband can be capable to read and write are [(AOR = 6.95, 95% Cl 2.82–21.58, p<0.002]). Additionally, ability to cost transportation for referral [AOR 5.21, 95% Cl 2.44–11.13, p<0.001]. not good services available [AOR 0.07, 95%Cl 0.01–0.10, p<0.02]. lack of maternal health and child knowledge [AOR 0.034, 95% Cl 0.02–0.57, p<0.01]. were observed associated with level of institutional deliver services utilization. Conclusion: The institutional delivery service utilization was relatively high compared to national demographic health services in the study area. A large proportion of women gave both at home without a skilled attendant. Therefore, this finding has important policy implications since changes in the cost of the health service and perceived quality would mean changes in client satisfaction as well as their choice, as well emphasize to expectant women can receive medical advice and ambulance for referrals. [ABSTRACT FROM AUTHOR]

Background: The impact of weather on human health has been proven, but the impact of extreme weather events on cardiometabolic multimorbidity (CMM) needs to be urgently explored. Objectives: Investigating the impact of extreme temperature, relative humidity (RH), and laboratory testing parameters at admission on adverse events in CMM hospitalizations. Designs: Time-stratified case-crossover design. Methods: A distributional lag nonlinear model with a time-stratified case-crossover design was used to explore the nonlinear lagged association between environmental factors and CMM. Subsequently, unbalanced data were processed by 1:2 propensity score matching (PSM) and conditional logistic regression was employed to analyze the association between laboratory indicators and unplanned readmissions for CMM. Finally, the previously identified environmental factors and relevant laboratory indicators were incorporated into different machine learning models to predict the risk of unplanned readmission for CMM. Results: There are nonlinear associations and hysteresis effects between temperature, RH and hospital admissions for a variety of CMM. In addition, the risk of admission is higher under low temperature and high RH conditions with the addition of particulate matter (PM, PM2.5 and PM10) and O3_8h. The risk is greater for females and adults aged 65 and older. Compared with first quartile (Q1), the fourth quartile (Q4) had a higher association between serum calcium (HR = 1.3632, 95% CI: 1.0732 ~ 1.7334), serum creatinine (HR = 1.7987, 95% CI: 1.3528 ~ 2.3958), fasting plasma glucose (HR = 1.2579, 95% CI: 1.0839 ~ 1.4770), aspartate aminotransferase/ alanine aminotransferase ratio (HR = 2.3131, 95% CI: 1.9844 ~ 2.6418), alanine aminotransferase (HR = 1.7687, 95% CI: 1.2388 ~ 2.2986), and gamma-glutamyltransferase (HR = 1.4951, 95% CI: 1.2551 ~ 1.7351) were independently and positively associated with unplanned readmission for CMM. However, serum total bilirubin and High-Density Lipoprotein (HDL) showed negative correlations. After incorporating environmental factors and their lagged terms, eXtreme Gradient Boosting (XGBoost) demonstrated a more prominent predictive performance for unplanned readmission of CMM patients, with an average area under the receiver operating characteristic curve (AUC) of 0.767 (95% CI:0.7486 ~ 0.7854). Conclusions: Extreme cold or wet weather is linked to worsened adverse health effects in female patients with CMM and in individuals aged 65 years and older. Moreover, meteorologic factors and environmental pollutants may elevate the likelihood of unplanned readmissions for CMM. [ABSTRACT FROM AUTHOR]

Extreme weather events such as floods, bushfires, cyclones, and drought, are projected to increase in eastern Australia. Understanding how these events influence the combined, sustainable well-being of humans, animals, and ecosystems - that is One Health - will enable development of transdisciplinary and ultimately more effective interventions. A scoping review was conducted to explore the research associated with the effects of extreme weather events in eastern Australia using a One Health lens, specifically identifying the type of extreme weather events studied, the research conducted in the context of One Health, and gaps to inform improved One Health implementation. The review followed JBI guidelines (based on PRISMA). Eligible research was peer-reviewed, in English, and published since 2007, in which primary research studies investigated the impact of extreme weather events in eastern Australia on at least two of ecosystems, human health, and animal health. Using structured search terms, six databases were searched. Following removal of duplicates, 870 records were screened by two reviewers. Eleven records were eligible for data extraction and charting. The scope of extreme weather events studied was relatively limited, with studies in flood and bushfire settings predominating, but relatively little research on cyclones. Major health themes included more than the impact of extreme weather events on physical health (zoonotic and vector-borne diseases) through investigation of social well-being and mental health in the context of the human-animal bond in evacuation behaviors and drought. Research gaps include studies across a broader range of extreme weather events and health topics, as well as a more comprehensive approach to including the impacts of extreme weather events on all three domains of One Health. The limited research focus inevitably translates to limited recommendations for policy, planning and response to manage extreme weather event emergencies. Given the expected increase in frequency of these events, there is a critical need for more comprehensive primary research to better identify strategies and facilitate implementation of One Health promotion for improved outcomes in extreme weather event emergencies. [ABSTRACT FROM AUTHOR]

With the climate continually changing, the interaction between weather and mental health is expected to grow. Weather anxiety and its associated safety behaviors are common experiences that can reach distressing, debilitating, and clinically significant levels. Models of anxiety disorders suggest that cognitive and perceptual biases related to threat probability often contribute to and maintain anxiety, yet this has not been investigated within weather anxiety or its associated safety behaviors. The current study aimed to investigate the effects of severe weather probabilities across visual and written modalities on anxiety, worry, and safety behaviors in those with elevated weather anxiety and safety behavior use. Participants were shown three images and three texts that displayed lower, medium, and higher risk probabilities for severe weather and were asked to rate anxiety, worry, and safety behaviors in response to each level of probability. Results suggested that those with increased weather-related anxiety and safety behaviors displayed less flexibility in anxiety and expected safety behavior use across varying levels of threat probability, relative to those lower in anxiety and safety behavior use. These results support the application of cognitive biases as potential maintenance factors of weather anxiety, a condition that has a significant lack of investigation. Clinical implications and limitations are discussed. [ABSTRACT FROM AUTHOR]

There is growing evidence that weather alters SARS-CoV-2 transmission, but it remains unclear what drives the phenomenon. One prevailing hypothesis is that people spend more time indoors in cooler weather, leading to increased spread of SARS-CoV-2 related to time spent in confined spaces and close contact with others. However, the evidence in support of that hypothesis is limited and, at times, conflicting. We use a mediation framework, and combine daily weather, COVID-19 hospital surveillance, cellphone-based mobility data and building footprints to estimate the relationship between daily indoor and outdoor weather conditions, mobility, and COVID-19 hospitalizations. We quantify the direct health impacts of weather on COVID-19 hospitalizations and the indirect effects of weather via time spent indoors away-from-home on COVID-19 hospitalizations within five Colorado counties between March 4th 2020 and January 31st 2021. We also evaluated the evidence for seasonal effect modification by comparing the results of all-season (using season as a covariate) to season-stratified models. Four weather conditions were associated with both time spent indoors away-from-home and 12-day lagged COVID-19 hospital admissions in one or more season: high minimum temperature (all-season), low maximum temperature (spring), low minimum absolute humidity (winter), and high solar radiation (all-season & winter). In our mediation analyses, we found evidence that changes in 12-day lagged hospital admissions were primarily via the direct effects of weather conditions, rather than via indirect effects by which weather changes time spent indoors away-from-home. Our findings do not support the hypothesis that weather impacted SARS-CoV-2 transmission via changes in mobility patterns during the first year of the pandemic. Rather, weather appears to have impacted SARS-CoV-2 transmission primarily via mechanisms other than human movement. We recommend further analysis of this phenomenon to determine whether these findings generalize to current SARS-CoV-2 transmission dynamics, as well as other seasonal respiratory pathogens. [ABSTRACT FROM AUTHOR]

As global warming became a cause of concern in the 1980s, researchers and climate activists initially paid little attention to the possible health effects of a warmer world. This changed quickly between 1985 and 1989, when scientists working on contracts with the US Department of Energy and the Environmental Protection Agency extrapolated from existing knowledge about the impact of weather on health to speculate about how global warming would impact health. However, they downplayed the impact of their contributions by highlighting the uncertainty in their models and the adaptability of human societies. Since that time, physicians and other health scientists have maintained a steady drumbeat of warnings about the health effects of global warming. They have published widely in the medical literature and participated actively in international scientific collaborations. Their research has significantly increased the breadth and depth of climate-health science and shown that measurable impacts of global warming have already begun. But as the many climate crises of 2023 show, action against global warming remains inadequate. Is it still reasonable to hope that health advocacy will incite communities and politicians to act? The history of climate and health advocacy reveals many obstacles that must be overcome. [ABSTRACT FROM AUTHOR]

• Health Canada's Fixed Point Surveillance network can respond to cosmic radiation. • Forbush decrease events and the GLE69 event have been observed in the network. • The network response to these events is similar to the global muon/neutron detectors. • The network is readily available for real-time space weather monitoring. This work presents a feasibility study of utilizing Health Canada's terrestrial radiation monitoring network, the Fixed Point Surveillance (FPS) network, for space weather monitoring through demonstrating detections of Forbush decrease and ground level enhancement events. The network is currently comprised of more than eighty sodium iodide spectrometers distributed across Canada. It was designed for terrestrial radiation monitoring but is also capable of registering cosmic radiation in a high-energy channel. Data from fourteen FPS stations for the period from 2003 to 2018 were analyzed and compared with data obtained by other ground-level cosmic radiation monitoring systems. The level of atmospheric impacts on measurements can be well explained, and signatures of both long-term solar cycle variations and sporadic solar events have been detected in the FPS network. The Forbush decrease amplitudes in FPS were found to be comparable to those obtained in the global muon detector network but about 2–3 times lower than those recorded by the global neutron monitoring network. This study suggests that the 20 years of cosmic ray data from the FPS network can be used for climatological space weather studies. In addition, the network can be readily available for real-time space weather monitoring. [ABSTRACT FROM AUTHOR]

Ozone pollution in 2019 in China is particularly severe posing a tremendous threat to the health of Chinese inhabitants. In this study, we constructed a more reliable and accurate 1-km gridded dataset for 2019 with as many sites as possible using the inverse distance weight interpolation method to analyze spatiotemporal ozone pollution characteristics and health burden attributed to ozone exposure from the perspective of different diseases and weather influence. The accuracy of this new dataset is higher than other public datasets, with the coefficient of determination of 0.84 and root-mean-square error of 8.77 ppb through the validation of 300 external sites which were never used for establishing retrieval methods by the datasets mentioned-above. The averaged MDA8 (the daily maximum 8 h average) ozone concentrations over China was 43.5 ppb, and during April–July, 83.9% of total grids occurred peak-month ozone concentrations. Overall, the highest averaged exceedance days (60 days) and population-weighted ozone concentrations (55.0 ppb) both concentrated in central-eastern China including 9 provinces (only 11.4% of the national territory); meanwhile, all-cause premature deaths attributable to ozone exposure reached up to 142,000 (54.9% of national total deaths) with higher deaths for cardiovascular and respiratory, and the provincial per capita premature mortality was 0.27~0.44‰. The six most polluted weather types in the central-eastern China are in order as follows: westerly (SW and W), cyclonic, northerly, and southerly (NW, N, and S) types, which accounts for approximately 73.2% of health burden attributed to daily ozone exposure and poses the greatest public health risk with mean daily premature deaths ranging from 466 to 610. Our findings could provide an effective support for regional ozone pollution control and public health management in China. [ABSTRACT FROM AUTHOR]

It is now clear that anthropogenic climate change is having a negative impact on human health. In this paper, we provide the first comprehensive assessment of the impact of climatic stressors on child health in Burkina Faso. We undertake a rigorous empirical analysis of the impact of climate and weather shocks on mortality, stunting (height‐for‐age Z‐score) and wasting (weight‐for‐age Z‐score), using Demographic and Health Surveys, combined with high‐resolution meteorological data, controlling for household and individual covariates. We find robust evidence that both lifetime and short‐term exposure to high temperatures and droughts have a negative impact on child health, as do increased temperature anomalies during crop seasons, suggesting a link between climate and health through domestic food production. Income and household wealth, access to electricity, sanitation and a health facility for childbirth negate some adverse impacts of climate change. Combining our econometric estimates with updated CMIP6 scenarios, we compute policy‐relevant projections of future child health. Our results show that future warming is projected to significantly increase child mortality, and share of underweight and stunted children, in all but the Paris Agreement scenario. Given the links between health, a key element of human capital, and economic growth, our findings and projections provide yet more evidence of the importance of a rapid reduction in global emissions combined with adaptation funding, if lower‐income countries are to achieve poverty reduction and increasing prosperity. [ABSTRACT FROM AUTHOR]

Background: The correlation between stable geomagnetic fields and unstable geomagnetic activities with mortality, incidence, and prevalence of cardiovascular diseases (CVDs) remains ambiguous. Method: To investigate the correlations between geomagnetic field (GMF) intensity and geomagnetic disturbance (GMD) and CVDs events in global, long-period scale, global and 204 countries and territories were included on the base of 2019 Global Burden of Disease study (GBD 2019). Data of GMF intensity, GMD frequency, CVDs events, weather and health economic indicators from 1996 to 2019 of included locations were collected. Linear regression and panel data modelling were conducted to identify the correlations between GMF intensity and CVDs events, multi-factor panel data analysis was also generated to adjust the effect of confounding factors. Results: For the average data during 1996–2019, linear regression model revealed consistent positive correlations between total GMF (tGMF) intensity and mortality of total CVDs [coef = 0.009, (0.006,0.011 95%CI)], whereas negative correlations were found between horizonal GMF (hGMF) intensity and total CVD mortality [coef = -0.010 (-0.013, -0.007 95%CI)]. When considering the time trend, panel data analysis still demonstrated positive correlation between tGMF and total CVDs mortality [coef = 0.009, (0.008,0.009 95%CI)]. Concurrently, the hGMF negatively correlated with total CVDs mortality [coef = -0.008, (-0.009, -0.007 95%CI)]. When the panel models were adjusted for confounding factors, no reverse of correlation tendency was found between tGMF, hGMF and CVDs events. In high-income territories, positive correlation was found between geomagnetic storm (GMS) frequency and mortality of total CVDs [coef = 14.007,(2.785, 25.229 95%CI)], however, this positive trend faded away gradually with the latitude decreasing from polar to equator. Conclusions: Stable and long-term horizontal component of GMF may be beneficial to cardiac health. Unstable and short-term GMF called GMD could be a hazard to cardiac health. Our results suggest the importance of regular GMF in maintaining cardio-health state and the adverse impacts of GMD on cardiac health. [ABSTRACT FROM AUTHOR]

To investigate the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia.Methods: An online cross-sectional survey was carried out in Najran region, Saudi Arabia. A self-administered questionnaire was distributed among a random sample of the general population, aged 18 or above between March and December 2022. The survey instrument included questions regarding history and exposure, physician diagnosed-disorders, respiratory symptoms, allergy, use of medications and possible risk-related factors.Results: This research had a total of 712 individuals. Nearly one-third of the participants in the survey (n = 218; 30.6%) said that they or a member of their family suffer from respiratory ailments. The majority of research participants (n = 167; 76.8%) identified asthma as their primary respiratory condition. A total of 32.0% of participants (n = 70) reported dealing with dust or chemicals such as paints, fertilizers, and cleaning products on a daily basis at work or at home. Around 62.0% of the participants (n = 134) said that exposure to gases, fragrances, and other such substances negatively impacts their health. Almost 78.0% (n = 169) of them indicated that summer weather affects their health, whereas 63.0% (n = 138) reported that winter cold affects their health. Participants aged 41– 50 years were 38.0% less likely to have CRDs compared to others (p < 0.05).Conclusion: This study is among the first few studies that explored the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. In the southern area of Najran, respiratory symptoms are frequent among the inhabitants of Saudi Arabia. More research is required to discover avoidable risk factors and create countermeasures for them. It is recommended that healthcare personnel increase their efforts to educate their patients about respiratory illness prevention methods. [ABSTRACT FROM AUTHOR]

Cities in the global south face dire climate impacts. It is in socioeconomically marginalized urban communities of the global south that the effects of climate change are felt most deeply. Santiago de Chile, a major mid-latitude Andean city of 7.7 million inhabitants, is already undergoing the so-called "climate penalty" as rising temperatures worsen the effects of endemic ground-level ozone pollution. As many cities in the global south, Santiago is highly segregated along socioeconomic lines, which offers an opportunity for studying the effects of concurrent heatwaves and ozone episodes on distinct zones of affluence and deprivation. Here, we combine existing datasets of social indicators and climate-sensitive health risks with weather and air quality observations to study the response to compound heat-ozone extremes of different socioeconomic strata. Attributable to spatial variations in the ground-level ozone burden (heavier for wealthy communities), we found that the mortality response to extreme heat (and the associated further ozone pollution) is stronger in affluent dwellers, regardless of comorbidities and lack of access to health care affecting disadvantaged population. These unexpected findings underline the need of a site-specific hazard assessment and a community-based risk management. [ABSTRACT FROM AUTHOR]

The health impacts of the diurnal temperature range (DTR), which may be affected by climate change, have received little attention. The objectives of this study were (1) to evaluate the association of DTR and cardiopulmonary outcomes, (2) to select the proper thresholds for a DTR warning system, and (3) to identify vulnerable groups. The weather and health records in Taiwan from 2000 to 2019, with a maximum DTR of 12.8 °C, were analyzed using generalized additive models. The health outcomes included cardiovascular (CVD) and respiratory disease (RD) categories and several sub-categories, such as ischemic heart disease, stroke, pneumonia, asthma, and chronic obstructive pulmonary disease. The results showed that the associations of DTR and cardiopulmonary outcomes were as significant as, and sometimes even stronger than, those of the daily maximum temperature and daily minimum apparent temperature in the warm and cold seasons, respectively. The significant association began at DTR of 6 °C, lower than previously reported. The identified DTR warning thresholds were 8.5 and 11 °C for the warm and cold seasons, respectively. DTR is statistically significantly associated with a 5–36% and a 9–20% increase in cardiopulmonary emergency and hospitalized cases in the warm season with a 1 °C increase above 8.5 °C, respectively. In the cold season, DTR is significantly associated with 7–41%, 4–30%, and 36–100% increases in cardiopulmonary emergency, hospitalized, and mortality with a 1 °C increase above 11 °C, respectively. People with hypertension, hyperglycemia, and hyperlipidemia had even higher risks. Vulnerable age and sex groups were identified if they had a lower DTR–health threshold than the general population, which can be integrated into a warning system. In conclusion, DTR may be increased on a local or city scale under climate change; a DTR warning system and vulnerable group identification may be warranted in most countries for health risk reduction. • Ignored health impacts of diurnal temperature range (DTR) warrant more evaluation. • Unlike regional scales, DTR in cities may be increased under climate change. • Significant cardiopulmonary impacts were associated with DTR as low as 6 °C. • The threshold method provides additional aspect in identifying vulnerable groups. • Methodology of identifying thresholds for a DTR warning system was demonstrated. [ABSTRACT FROM AUTHOR]

The aim is to assess the association between mental health and extreme weather events related to climate change and identify resilience-based interventions to support mental health for those affected by extreme weather events related to climate change. Methods In November 2022, we undertook a scoping review following standard guidelines, searching databases MEDLINE, EMBASE, SCOPUS, CINAHL, Cochrane, and Web of Science. We reported study demographics, climate change-related exposures, mental health-related outcomes, and resilience outcomes. The methodological quality of included studies was not assessed as this is not a requirement for scoping reviews. Twenty-seven studies published between 2011–22 (three on the overall impact of climate change, 11 on ambient temperature, nine on hurricanes, three on flooding, and one on wildfire) were included that assessed the association between extreme weather events related to climate change and mental health. Studies included cross-sectional surveys (n=14), secondary data analysis (n=12, with 8 studies based on clinic or hospital record data), and longitudinal data collection (n=1). Mental health-related outcomes included depression, anxiety, post-traumatic stress disorder (PTSD)/ related stress disorders, schizophrenia, and other mental health conditions. Eight studies reported resilience outcomes. We reported which extreme weather events related to climate change are more likely to be associated with which kind of mental health problem. Ambient temperature showed an association with mental health-related hospital or emergency department visits or hospital admissions in both new cases and people with existing mental health conditions. Extreme weather events such as hurricanes and floods showed associations with depression, anxiety, and/or PTSD. Apart from one longitudinal study evaluating a psycho-social support program, we did not identify any interventions to support people's mental health when faced with extreme weather events. Though all included studies reported an association between extreme weather events related to climate change and mental health conditions, there is a lack of related interventions. As specific extreme weather events seem to be associated with specific kinds of mental health problems, there is a need for interventions that will be tailored both to the specific nature of extreme weather events, the kinds of impact they create, and the needs and circumstances of those who are impacted and should be culturally adapted to make them acceptable, engaging, and effective. None. [ABSTRACT FROM AUTHOR]

Adverse pregnancy outcomes (APOs) include stillbirth, preterm birth, and low birthweight (LBW). Studies exploring the impact of weather factors and air pollution on APOs are scarce in Nepal. We examined the impacts of prenatal exposure to temperature, precipitation, and air pollution (PM 2.5) on APOs among women living in Kavre, Nepal. We conducted a hospital and rural health centers-based historical cohort study that included health facility birth records (n = 1716) from the Nepali fiscal year 2017/18 through 2019/20. We linked health records to temperature, precipitation, and PM 2.5 data for Kavre for the six months preceding each birth. A random intercept model was used to analyze birthweight, while a composite APO variable, was analyzed using multivariable logistic regression in relation to environmental exposures. The proportion of LBW (<2500 gm), preterm birth (babies born alive before 37 weeks of gestation), and stillbirth was 13%, 4.3%, and 1.5%, respectively, in this study. Overall, around 16% of the study participants had one or more APOs. Total precipitation (β: 0.17, 95% CI 0.01 to 0.33, p = 0.03) had a positive effect on birthweight in the wetter season. Negative effects for mean maximum (β: 33.37, 95% CI -56.68 to −10.06, p = 0.005), mean (β: 32.35, 95% CI -54.44 to −10.27, p = 0.004), and mean minimum temperature (β: 29.28, 95% CI -49.58 to −8.98, p = 0.005) on birthweight was also observed in the wetter season. A positive effect of temperature (mean maximum, mean, and mean minimum) and total precipitation on birthweight was found in the wetter season. This study emphasizes the need for future research using larger cohorts to elucidate these complex relationships in Nepal. • Temperature, precipitation, and PM 2.5 were statistically non-significant in terms of birthweight in the pooled analysis. • Total precipitation had a positive effect on birthweight in the wetter season. • Mean maximum, mean and mean minimum temperature negatively affected birthweight in the wetter season. [ABSTRACT FROM AUTHOR]

Rising temperatures exacerbated by climate change are a growing concern in the UK. This paper assesses the state of heat risk governance in the country through an analysis of the Adverse Weather and Health Plan (AWHP) launched in 2023, which replaces the former Heatwave Plan (HWP) for England — the prominent policy for addressing heatwaves in the UK. Through 17 semi-structured interviews with key stakeholders, the paper assesses the perceived effectiveness of the new plan in addressing heat risk. The findings demonstrate that AWHP has been positively received and is considered to have well-functioning institutional arrangements and strategies tailored to manage immediate heat risks. However, areas for improvement are identified: the need to enhance public communication and broaden the cross-sectoral understanding of heat impacts beyond the domain of 'health'. Further, the research reveals gaps in leadership, institutional structure, delineation of roles and responsibilities, and funding and resources for addressing long-term heat risk and preparedness in the UK. The paper explores these and highlights the need for strengthening governance and capacity to tackle the multi-dimensional climate risk, i.e., heat, effectively. • UK heat policy lacks consideration for long-term risks. • Understanding heat impacts beyond health is crucial for effective risk mitigation. • Establishing an institutional structure with clear leadership is essential. [ABSTRACT FROM AUTHOR]

Background: Current findings on the impact of weather conditions on osteoarthritis (OA) and rheumatoid arthritis (RA) are sparse and not conclusive. This study aimed to investigate the relationship between temperature change and OA/RA admission.Methods: Daily OA/RA admission, meteorological data and pollutants from 1 January 2014 to 31 December 2017 in Hefei, China, were collected. We quantified the relationship between ambient temperature and OA/RA admission using a distributed lag nonlinear model (DLNM). Stratified analyses by gender and age were also examined.Results: Temperature decrease was significantly associated with RA admission (25th percentile of temperature versus 50th percentile of temperature), with the acute and largest effect at current days lag (RR: 1.057, 95%CI: 1.005-1.111). However, no significant association between temperature and OA admission was observed. When conducting subgroup analyses by individual characteristics, we found that females and patients aged 41-65 years were more vulnerable to temperature decrease than males, patients aged 0-40 and ≧66 years, respectively.Conclusions: This study suggested that temperature decrease was a risk factor for increases in RA admission. Females and patients aged 41-65 years were particularly vulnerable to the effect of temperature decrease. [ABSTRACT FROM AUTHOR]

The health management of weather radar plays a key role in achieving timely and accurate weather forecasting. The current practice mainly exploits a fixed threshold prespecified for some monitoring parameters for fault detection. This causes abundant false alarms due to the evolving working environments, increasing complexity of the modern weather radar, and the ignorance of the dependencies among monitoring parameters. To address the above issues, we propose a deep learning-based health monitoring framework for weather radar. First, we develop a two-stage approach for problem formulation that address issues of fault scarcity and abundant false fault alarms in processing the databases of monitoring data, fault alarm record, and maintenance records. The temporal evolution of weather radar under healthy conditions is represented by a long short-term memory network (LSTM) model. As such, any anomaly can be identified according to the deviation between the LSTM-based prediction and the actual measurement. Then, construct a health indicator based on the portion of the occurrence of deviation beyond a user-specified threshold within a time window. The proposed framework is demonstrated by a real case study for the Chinese S-band weather radar (CINRAD-SA). The results validate the effectiveness of the proposed framework in providing early fault warnings. [ABSTRACT FROM AUTHOR]

As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population's burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables—as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs—in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events. [ABSTRACT FROM AUTHOR]

Background: Hot weather leads to increased illness and deaths. The Heatwave Plan for England (HWP) aims to protect the population by raising awareness of the dangers of hot weather, especially for those most vulnerable. Individuals at increased risk to the effects of heat include older adults, particularly 75+, and those with specific chronic conditions, such as diabetes, respiratory and heart conditions. The HWP recommends specific protective actions which relate to five heat-health alert levels (levels 0-4). This study examines the attitudes to hot weather of adults in England, and the protective measures taken during a heatwave.Methods: As part of a wider evaluation of the implementation and effects of the HWP, a survey (n = 3153) and focus groups, a form of group interview facilitated by a researcher, were carried out after the June 2017 level 3 heat-health alert. Survey respondents were categorised into three groups based on their age and health status: 'vulnerable' (aged 75+), 'potentially vulnerable' (aged 18-74 in poor health) and 'not vulnerable' (rest of the adult population) to hot weather. Multivariable logistic regression models identified factors associated with these groups taking protective measures. In-person group discussion, focused on heat-health, were carried out with 25 people, mostly aged 75 + .Results: Most vulnerable and potentially vulnerable adults do not consider themselves at risk of hot weather and are unaware of the effectiveness of important protective behaviours. Only one-quarter of (potentially) vulnerable adults reported changing their behaviour as a result of hearing hot weather-related health advice during the level 3 alert period. Focus group findings showed many vulnerable adults were more concerned about the effects of the sun's ultra-violet radiation on the skin than on the effects of hot temperatures on health.Conclusions: Current public health messages appear to be insufficient, given the low level of (potentially) vulnerable adults changing their behaviour during hot weather. In the context of increasingly warmer summers in England due to climate change, public health messaging needs to convince (potentially) vulnerable adults of all the risks of hot weather (not just effects of sunlight on the skin) and of the importance of heat protective measures. [ABSTRACT FROM AUTHOR]

Phenotypic and genetic diversity are mandatory aspects to allow future breeding in fruit trees. This work was aimed to study the genetic diversity and heritability of important phenological traits in several almond genotypes. The seedlings were planted in randomized complete block design with 3 replications (two trees in each replication). Phenological traits including flower size, petal length, petal width, sepal length, sepal width, pistil length, pistil thickness were evaluated. Furthermore, number of stamens, first flowering, 10% flowering, 50% flowering, 90% flowering, date of flowering among 33 selected almond cultivars and genotypes were also evaluated using almond descriptors during 27 February to 29 March 2017. The results showed the existence of genetic variation among the studied cultivars and genotypes. A great phenotypic variation was observed for pistil length, petal width and flowering time. The exact and extended characterizations of all the new materials of almond could provide breeders new opportunities to develop future crosses and to obtain more resistant seedlings that can be better adapted to extreme and changing weather conditions in this area and in other regions of the world. [ABSTRACT FROM AUTHOR]

Background: Given that low income worsens health outcomes, income differences may affect health disparities in weather-related illnesses. The aim of this study was to investigate the association between income levels and prevalence of heat- and cold-related illnesses among Korean adults.Methods: The current study comprised 535,186 participants with all variables on income and health behaviors. Patients with temperature-related illnesses were defined as individuals with outpatient medical code of heat- and cold-related illnesses. We categorized individual income into three levels: "low" for the fourth quartile (0-25%), "middle" for the second and the third quartiles (25-75%), and "high" for the first quartile (75-100%). To examine income-related health disparities, Cox proportional hazard regression was performed. Hazard ratios (HRs) and 95% CI (confidence interval) for heat- and cold-related illnesses were provided. The model adjusted for age, sex, smoking status, alcohol drinking, exercise, body mass index, hypertension, hyperglycemia, and local income per capita.Results: A total of 5066 (0.95%) and 3302 (0.62%) cases identified patients with heat- and cold-related illnesses, respectively. Compared with high income patients, the adjusted HR for heat-related illnesses was significantly increased in the low income (adjusted HR = 1.103; 95% CI: 1.022-1.191). For cold-related illnesses, participants with low income were likely to have 1.217 times greater likelihood than those with high income (95% CI: 1.107-1.338), after adjusting for other covariates. In the stratified analysis of age (20-64 years and over 65 years) and sex, there was no difference in the likelihood of heat-related illnesses according to income levels. On the other hand, an HR for cold-related illnesses was higher in patients aged 20 to 64 years than in those aged over 65 years. Male with low income had also a higher HR for cold-related illnesses than female with low income.Conclusions: Our results showed that heat- or cold-related illnesses were more prevalent in Koreans with low income than those with high income. Strategies for low-income subgroups were needed to reduce greater damage due to the influence of extreme temperature events and to implement effective adaptation. [ABSTRACT FROM AUTHOR]

Insufficient information on the novel coronavirus (COVID-19) has made it more difficult for the world to tackle its continuous implosion. Meteorological and environmental factors, in both laboratory and epidemiological studies, have been reported to affect the survival and transmission of the virus. In this study, the possible effects of location-specific meteorological parameters in a tropical climate on new daily COVID-19 infection (NDI) are investigated in Kuala Lumpur from 14 March 2020 to 31 August 2020. A generalized additive model (GAM) was imposed on ambient temperature (T) and absolute humidity (AH) to explore their nonlinear relationship with NDI. Piecewise linear regression was then used to further discern the relationships below and above the threshold values of both T and AH. The relationship between T and NDI, which was linear and statistically significant for T > 29.7°C, showed that each unit rise in temperature increases NDI by about 3.210% (CI: 1.372–7.976). AH had a more pronounced linear association with NDI for AH ≤ 22.6 g/m3 but tended to flatten the exposure-response curve above this value. A 1 g/m3 increase in AH increases NDI by 3.807% (CI: 2.064–5.732). Generally, the results indicated a positive association between T and NDI, particularly above 29.7°C, while the association with AH showed a stronger positive relationship below 22.6 g/m3. The implication of this is that COVID-19 could not be suppressed on account of warmer weather as such public health interventions remain imperative. [ABSTRACT FROM AUTHOR]

Background: Exposure to extremely or moderate low temperatures is associated with increased morbidity and mortality risk. Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. Given that cold temperature causes constriction of the small arteries and veins in the skin, patients who suffer from peripheral circulation problems, like PVD, may be vulnerable to cold injuries. This study aimed to investigate the association between PVD and cold-induced injuries in the winter among Korean adults. We further analyzed the association stratified by body mass index (BMI) classification. Methods: We used the 2002–2015 National Health Insurance Service-National Sample Cohort data and included a total of 535,186 adults as the study population. Patients with underlying PVD were identified by ICD-10 code I73. Cold-related illnesses were defined by ICD-10 codes (T690, T691, T698, T699, T330 ~ T339, T340 ~ T349, and T350 ~ T357). Body mass index (BMI) was categorized into underweight, normal weight, overweight, and obese. Results: A total of 23.21% (n = 124,224) were PVD patients, and 0.59% (n = 3154) had cold-induced injuries. PVD patients were more likely to be diagnosed with cold injuries, but it was valid only in the underweight or normal weight groups. After adjusting for age, sex, income, cigarette smoking, alcohol consumption, regular exercise, high blood pressure, and hyperglycemia, PVD patients had a significantly increased odds ratio (OR) for cold injuries [adjusted OR = 1.11; 95% confidence intervals (95% CI): 1.01–1.21]. Increased OR for cold injuries in PVD patients was also observed in adults (adjusted OR = 1.14; 95% CI: 1.03–1.25 in Model 2), but not in the elderly. When we classified study subjects into the four BMI groups, the adjusted OR of cold injuries in PVD patients was significant in the underweight group (OR = 1.83; 95% CI, 1.26–2.66) and normal weight group (OR = 1.15; 95% CI, 1.03–1.27), not in those with overweight and obese. In adults, a consistent result was found in adults in the underweight group (OR = 1.63; 95% CI, 1.08–2.47 in Model 2) and normal weight group (OR = 1.19; 95% CI, 1.07–1.33 in Model 2). In the elderly, the adjusted OR for cold injuries was only significant in the underweight group (OR = 3.37; 95% CI, 1.08–10.53 in Model 2). Conclusions: We found a significant association between PVD and cold-induced injuries in the general population. BMI modified the association. Thus, the association observed appears to be clinically applicable to PVD patients being low to normal BMI. [ABSTRACT FROM AUTHOR]

Background: The aim of our study was to analyse the influence of air temperature and implemented veterinary measures on salmonellosis incidence in the Czech Republic (CZ).Methods: We conducted a descriptive analysis of salmonellosis as reported to the Czech national surveillance system during 1998-2017 and evaluated the influence of applied veterinary measures (started in January 2008) on salmonellosis incidence by comparing two 9-year periods (1998-2006, 2009-2017). Using a generalized additive model, we analysed association between monthly mean air temperature and log-transformed salmonellosis incidence over the entire twenty-year period.Results: A total of 410,533 salmonellosis cases were reported during the study period in the CZ. Annual mean incidences of salmonellosis were 313.0/100,000 inhabitants before and 99.0/100,000 inhabitants after implementation of the veterinary measures. The time course of incidence was non-linear, with a sharp decline during 2006-2010. Significant association was found between disease incidence and air temperature. On average, the data indicated that within a common temperature range every 1 °C rise in air temperature contributed to a significant 6.2% increase in salmonellosis cases.Conclusions: Significant non-linear effects of annual trend, within-year seasonality, and air temperature on the incidence of salmonellosis during 1998-2017 were found. Our study also demonstrates significant direct effect of preventive veterinary measures taken in poultry in reducing incidence of human salmonellosis in the CZ. The annual mean number of salmonellosis cases in the period after introducing the veterinary measures was only 32.5% of what it had been in the previous period. [ABSTRACT FROM AUTHOR]

There is substantial epidemiological evidence on the associations between cold weather and adverse health effects. Meteorological alarm systems are being developed globally, and generalized protective advice is given to the public based on outdoor exposure parameters. It is not clear how these shared outdoor exposure parameters relate to the individual-level thermal exposure indoors, where the majority of time is spent. We hypothesized a priori that there are opposite correlations between indoor and outdoor temperatures in residential apartments. Apartments were classified into 3 categories according to their response to declining outdoor temperature: under-controlled apartments cool down, controlled apartments maintain constant indoor temperature level, and over-controlled apartments warm up. Outdoor and indoor temperatures were measured in 30-min intervals in 417 residential apartments in 14 buildings in Kotka, Finland, between February and April 2018 with outdoor temperatures ranging from − 20.4 °C to + 14.0 °C. Different apartment types were present in all buildings. Floor and orientation did not explain the divergence. Indoor temperatures below the limit value + 20 °C by building code occurred in 26.2%, 7.9%, and 23.6% of the under-controlled, controlled, and over-controlled apartments, some in conjunction with increasing outdoor temperatures. Indoor temperatures above the limit + 25 °C occurred but were more rare. This proof-of-concept study demonstrates that while the home environment may be a source of thermal stress during cold weather, generalized advice for adjusting the heating may lead to paradoxical exposures in some cases. More elaborate conceptualizations of everyday thermal exposures are needed to safely reduce weather-related health risks using shared meteorological alarm systems. [ABSTRACT FROM AUTHOR]

Despite the frequent use of model averaging in many disciplines from weather forecasting to health outcomes, it is not yet an idea often considered in travel behaviour or choice modelling. The idea behind model averaging is that a single model can be created by calculating contribution weights for a set of candidate models, depending on their relative performance, thus creating an 'average'. There are different ways of doing this, with a clear distinction between looking at the overall performance of each model or by doing this at the level of individual agents or observations. In this paper, we demonstrate that a relatively straightforward adaptation of latent class models can be used for the latter approach and show how this can be an effective method for travel behaviour modelling. We identify two key opportunities for model averaging. The first is the situation where an analyst faces the difficult choice between a number of advanced models, all with some desirable properties. The second is the situation where advanced models cannot be used due to the size of the data and/or choice sets. Our tests demonstrate that in both cases, model averaging using a sequential latent class framework results in a consistent improvement in model fit for both estimation and in forecasting with subsets of validation samples. Additionally, we demonstrate that model averaging can be used to obtain more reliable elasticities and welfare measures by averaging across outputs obtained from the set of candidate models. In terms of actual implementation of model averaging, we present a simple expectation–maximisation (EM) algorithm which can deal with very large numbers of candidate models within the same model averaging structure, unlike the typical case with classical estimation approaches for latent class. [ABSTRACT FROM AUTHOR]

The needs of fragile and conflict-affected states (FCAS) are usually framed in terms of humanitarian or security aims. As a result, health security in FCAS is poor. Yet in the background of these competing forces is the approaching threat of climate change. This paper will evaluate the impact of climate change on health security related issues in FCAS. I will first assess how environmental trends may impact the health outcomes of the civilians in FCAS using state-level data. Next, I will describe the barriers that limit FCAS from addressing their health and climate change risks. Lastly, I will outline policies that can be undertaken in the absence of political settlement to protect civilian health security from the threats of climate change. [ABSTRACT FROM AUTHOR]

Access to high quality weather and climate data is crucial for a wide range of societal and economic issues. It allows optimising industrial processes, supports the identification of potential risks related to climate change or allows the development of corresponding adaptation and mitigation strategies. Although such data is freely available through Germany's national meteorological service DWD (Deutscher Wetterdienst) since 2017, the application potential in industry and society has certainly not yet been fully unlocked. Major obstacles are the complexity of the raw data, as well as missing tools for their simple integration into existing industrial applications. The goal of the research project FAIR is to simplify the information exchange between the DWD and economical players. In order to reach this goal a requirement analysis with end-users of weather data from three different sectors was conducted. A central requirement regarding the site assessment of wind plants is quick and easy access to historical wind-series at specific sites. Preferably downloadable in formats like CSV or via an API. Event planning partners are interested in a quick access to health relevant weather information at their event location, and the E-mobility sector in temperature data along planned routes. In this paper, we summarize the results of the requirement analysis and present the deduced technical architecture and FAIR services aiming at a user-friendly exchange of weather data. [ABSTRACT FROM AUTHOR]

We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices—Universal Thermal Climate Index and Excess Heat Factor (EHF)—were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May–September) during 1994–2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system. [ABSTRACT FROM AUTHOR]