tbuckley/cabot-search huggingface dataset:
How are health systems in sub-Saharan Africa adapting to protect human health from climate change threats? A scoping review and case study
Authors: Hashim Hounkpatin, Claudia Nieto-Sanchez, Virginia Castellano Pleguezuelo, Katja Polman, Bruno Marchal
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> Sub-Saharan Africa stands out as one of the regions most affected by the climate crisis, while it has contributed to the problem only marginally. The foreseen negative effect on health adds great stress to the already overburdened health systems. Health systems' adaptation to climate change is, therefore, urgently needed to better protect human health. There is, however, scant evidence on how adaption is being planned and implemented in Africa. The aim of this study was to review the literature on health system adaptation in sub-Saharan Africa. <h3>Methods</h3> In this scoping review and case study, we first carried out the scoping review, searching for publications on adaptation measures using the PubMed, Science Direct, and Web of Science databases on July 1, 2023. We included papers in English and French that addressed the adaptation of health systems in countries in sub-Saharan Africa without time limit. Second, we did a case study of the design and implementation of the National Adaptation Plan of Benin, with a specific focus on the policy-making process underlying the plan, whereby we used the health policy triangle as a policy analysis framework. Data were collected through a document review of national policy plans, reports, and evaluations. <h3>Findings</h3> A total of 14 papers met the inclusion criteria, showing that climate change adaptation remains a niche in the literature for sub-Saharan Africa. Most included papers were authored by individuals from high-income countries. Health system adaptation measures cover seven domains: health systems strengthening; policy and planning; financing and implementation; information and capacity building; societal resilience; disaster risk prevention, preparedness, response, and recovery; and mitigation. The review found that the dominant role of global agencies in supporting or steering health system adaptation planning contributes to policy mimicry across countries, as confirmed by the case study of the adaptation plan in Benin. Benin's National Adaptation Plan prioritised three climate hazards: heat, drought, and flooding. Although the financial and technical inputs of international agencies effectively support Benin's adaptation planning, these inputs might induce a more narrow focus that does not fully respond to Benin's needs in terms of climate shocks and adaptation priorities. <h3>Interpretation</h3> Health systems in sub-Saharan Africa are already adapting to climate change. Future research could focus on how national governments could develop adaptation plans that are responsive to local needs by making the needs analysis and priority-setting processes more inclusive of local stakeholders. <h3>Funding</h3> The Belgian Directorate-General for Development Cooperation and Humanitarian Aid.
Pre–post evaluation of the emotions and motivations for transformative action of medical students in Germany after two different planetary health educational interventions
Authors: Eva-Maria Schwienhorst-Stich, Clara Schlittenhardt, Tobias Leutritz, Sandra Parisi, Henrike Kleuser, Sarah König, Anne Simmenroth
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> Climate change is the greatest threat to human health. Medical students, as future health-care workers, are important in promoting sustainable behaviours, which are strongly associated with individuals' emotional responses to climate change. At Würzburg University Hospital (Würzburg, Germany), a one-term optional course (40 learning units) about planetary health and two lectures within the curricular course Environmental Medicine were introduced in 2021. We aimed to examine the effects of these courses on the emotions and motivations of students in acting against climate change. <h3>Methods</h3> We surveyed medical students from both courses during four consecutive terms during 2021–23 with a pre–post design using an anonymous online questionnaire on EvaSys. The survey consisted of 20 closed questions based on a 5-point Likert scale and six open questions. Quantitative data were analysed with SPSS version 28.0.1.1. Qualitative data were analysed with Kuckartz' qualitative content analysis. <h3>Findings</h3> 458 students were initially involved (349 [76%] in the lectures and 109 [24%] in the optional course) and 396 students were involved until the final date (288 [73%] in the lectures and 108 [27%] in the optional course). Mean response rate was 389 (85%) of 458 students pre-survey and 315 (80%) of 396 post-survey. The most frequently reported initial emotions of medical students from both cohorts were "helplessness" (220 [57%] of 389), "fear" (197 [51%]), and "disappointment" (171 [44%]). Only 82 (21%) of 389 students reported having "motivation to act" and 45 (12%) reported having "confidence". When comparing 176 matched pre-lecture and post-lecture Likert scale values of reported emotions, we observed a significant decrease in "helplessness" (mean difference –0·37, 95% CI –0·2 to –0·53; p<0·0001; <i>d</i>=0·34) and "disappointment" (–0·35, –0·2 to –0·49; p<0·0001; <i>d</i>=0·36) and a significant increase in "confidence" (0·67, 0·82 to 0·51; p<0·0001; <i>d</i>=0·65 and "motivation to act" (0·4, 0·53 to 0·27; p<0·0001; <i>d</i>=0·46). Students associated these changes with options for action offered in the lecture. <h3>Interpretation</h3> This pre–post evaluation provides evidence for a positive effect of planetary health education at the university level. Educators should focus on options for action and create space for improving emotional resilience within courses. <h3>Funding</h3> None.
An umbrella review of health co-benefits from actions to reduce greenhouse gas emissions
Authors: Tamzin Reynolds, Sarah Whitmee, Rosemary Green, Blanca Anton, Andy Haines
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> There have been many modelled studies of potential health co-benefits from actions to reduce greenhouse gas emissions, but so far there have been no large-scale attempts to compare the magnitude of health and climate effects across sectors, countries, and study designs. <h3>Methods</h3> As part of the Pathfinder Initiative project an umbrella review of studies was done, and 26 previous reviews were identified with 57 primary studies included. Studies included in the review were required to have quantified changes in greenhouse gas emissions and health effects (or risk factors) from defined actions to reduce climate effects. Study data were extracted and harmonised by standardising impact measures per 100 000 of the national population (or urban population for city-level actions), averaging effects over a 1-year period and aggregating actions into their respective sectors by use of a predefined framework. <h3>Findings</h3> From 200 mitigation actions, the majority were in the agriculture, forestry, and land use sector (103 actions [52%]), followed by the transport sector (43 actions [22%]). The largest effects on greenhouse gas emissions were seen from actions in the energy sector, and these actions also had substantial health co-benefits in lower middle-income countries, although benefits were smaller in high-income settings. The greatest health benefits were seen from actions to change diets and introduce clean cookstoves. The major pathways to health were through reduced air pollution, healthier diets, and increased physical activity from switching to active travel modes. Effect sizes tended to be larger from national modelling studies and smaller from localised or implemented actions. <h3>Interpretation</h3> The potential co-benefits to health from actions to reduce climate change are large, but most evidence still comes from modelling studies and from high-income and middle-income countries. There are also major context-dependent differences in the magnitude of effects found, so actions need to be tailored to the local context and careful attention needs to be paid to potential trade-offs and spillover effects. <h3>Funding</h3> The Wellcome Trust and the Oak Foundation.
Biodiversity or ultra-processed food: an analysis of school meals offered in a riverside school in the Brazilian Amazon
Authors: Paula Regina Humbelino de Melo, Pericles Vale Alves, Tatiana Souza de Camargo
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> Rural schools in Amazonas, Brazil, often offer ultra-processed foods in school meals for students, which can lead to health problems and loss of regional food culture. We show an analysis of the menu offered in a riverside school in the Brazilian Amazon and the acceptability of students regarding the consumption of the food they are served with. <h3>Methods</h3> Data were collected in situ, in a riverside school in southern Amazonas, through the analysis of the school menu and the application of an investigative questionnaire to 37 students in the 9th grade of Junior High School. <h3>Findings</h3> The research revealed that the foods most consumed by students in school meals are canned beef, canned meatballs, canned sardines, sausage, biscuits, juice, rice porridge, corn porridge, pasta, meat soup, and rice with beans. In the questionnaire that was applied to students, there is a wide variation in the acceptability of the foods offered. However, 57% of students reported not liking the lunch offered at the educational institution. <h3>Interpretation</h3> To tackle this problem, it is essential that, local food culture and biodiversity food can be more valued, elements that are often excluded from school menus. This work showed that is also essential to fully adhere to the National School Meal Program (PNAE) in Brazil, which recommends that at least 30% of food intended for school meals must come from family farming, highlighting that quality food is crucial for cognitive development of students. Therefore, the meals offered in the chosen riverside school not only do not meet the PNAE guidelines but are also not well accepted by students. This study shows a significant need to consider the direct relationship between planetary health, school meals food security, and food sovereignty, given the various negative effects of foods that are rich in fat, sodium, preservatives, and other substances. Furthermore, it is imperative to integrate food into the students' context, valuing regional products from the Amazon region. <h3>Funding</h3> FAPEAM (Amazonas State Research Foundation).
Examining the mental health impacts of climate change on young people in Canada: a national cross-sectional survey
Authors: Breanne Aylward, Ashlee Cunsolo, Susan Clayton, Kelton Minor, Madison Cooper, Susan Chatwood, Sherilee Harper
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> Climate change poses a substantial threat to the mental wellbeing of young people. Population-level research is urgently needed to help inform policies and interventions to ensure that young people are not burdened by long-term mental health impacts from climate change. We sought to identify the prevalence, distribution, and factors associated with climate change-related mental and emotional health outcomes among young people (aged 13–34 years) in Canada. <h3>Methods</h3> This study is part of a larger cross-sectional survey, which examined mental and emotional health responses to climate change among individuals aged 13 years or older from across Canada. We used a multi-stage, multi-stratified random probability sampling procedure. Participants were randomly recruited through either an addressed letter or a telephone call. Online and telephone questionnaires were used to interview individuals in English, French, or Inuktitut between April 1, 2022, and March 31, 2023. Data were weighted by age and province using population estimates from Statistics Canada and analysed using descriptive statistics, factor analyses, and multivariable regression analyses. <h3>Findings</h3> The full survey included 2476 participants, with a subgroup of 409 young people. Of the 401 respondents who provided their gender identity, 215 (54%) identified as cisgender women, 167 (42%) identified as cisgender men, and 19 (5%) identified as non-binary. Preliminary results suggest that young people in Canada experience a wide range of climate-related emotional and mental health outcomes. More than 70% of respondents in the young people subgroup reported having at least mild levels of sadness, anger, worry, anxiety, concern, helplessness, hopelessness, or powerlessness related to climate change. The severity of climate-related emotional responses differed by gender, with non-binary respondents and cisgender women reporting higher average levels of distress than cisgender men. Regional differences were also observed, with northern regions and urban locations reporting more severe reactions. <h3>Interpretation</h3> This study builds on the understanding of the burden of climate change on the mental health of young people. If unaddressed, the impact of this burden could have long-standing and wide-reaching public health and related socioeconomic effects. <h3>Funding</h3> Canadian Institutes of Health Research, ArcticNet, Social Sciences and Humanities Research Council Doctoral Fellowship, Izaak Walton Killam Memorial Scholarship, and Alberta Innovates Graduate Student Scholarship.
Social interactions and heat stress mitigation among elderly people in a healthy city
Authors: Kaoruko Seino, Keiko Nakamura, Sharifullah Alemi
Journal: The Lancet Planetary Health (2024)

BackgroundIncreased frequencies and duration of extreme heat events have caused severe heat stress, especially among elderly people. Despite its obvious cause and universally known preventive measures, heat stress preventive measures have not been implemented effectively at community levels. This study examined heat coping practices among elderly people and their associations with living conditions, social interactions, and community involvement.MethodsA self-administered questionnaire was done to assess heat-coping practices to mitigate heat stress, living conditions, and interactions with family, friends, and neighbours. Participants were 3000 randomly selected elderly people aged 65 years and older living in Owariasahi, Japan, a city that applies the 2004 Healthy City Approach. A generalised linear regression model was applied with binominal distribution to examine the association between social interactions and application of heat-coping practices. Sex and ages were adjusted in the model.FindingsAmong the 2127 elderly people who completed the survey, 745 (35·0%) had heat stress during the summer of the survey year. The presence of heat stress was higher in male participants living alone and having less interaction with friends and neighbours; only interaction with friends and relatives showed difference in the occurrence of the heat-related illness in female participants. The use of ice packs, air conditioners, and the opening of windows or doors were associated with the presence of heat stress. The odds of not applying relevant preventive practices were higher in participants disconnected from relatives and friends (odds ratio 1·52 [95% CI 1·12–2·04]). Participants living alone and disconnected from their neighbours showed similar trends to the connection with relatives and friends but not significantly.InterpretationThe findings of the study indicated that heat stress mitigative measures were underused in elderly people who are socially disconnected. Heat illness prevention programmes need to focus on outreach to the disadvantaged population.FundingJapan Society for the Promotion of Science.
A study on analysing sociospatial distribution and equity in access to urban parks in Bengaluru, India
Authors: Nilanjan Bhor, Dhananjayan Mayavel
Journal: The Lancet Planetary Health (2024)

<h2>Abstract</h2><h3>Background</h3> Given the effect of urbanisation on land use, allocation, and implementation of urban green spaces, we attempt to analyse the sociospatial distribution and equity in access to urban parks in Bengaluru, India, also known as the garden city of India. <h3>Methods</h3> Geospatial method was used for mapping the park's distribution and measuring the accessibility using road network data. To understand equitable access to the parks, four socioeconomic parameters from 2011 census (ie, population density, children aged 6 years or younger, proxy wealth index, and the Scheduled Caste population) were correlated with the parks' accessibility. <h3>Findings</h3> The spatial distribution revealed that 19 of 198 wards did not have a single park and 36 wards only had one park. About 25–29% of wards did not have accessibility to neighbourhood-level and community-level parks within a 400–800 m distance. These parks must be accessible within walking distance of 400–800 m but were found to most likely be inaccessible in the periphery where population density was low and children population was high in comparison to the central part of the city. Similarly, parks found inaccessible in the eastern part of the city where the scheduled caste population is high, and also found inaccessible to the low-income neighbourhoods residing in the western part and southern periphery of the city, indicating the uneven distribution and inequitable access to public parks. <h3>Interpretation</h3> Our study proposes reshaping of both neighbourhood parks and community parks, an attempt to look beyond biodiversity. The affirmative actions in terms of availability of public parks with adequate area requirement and essential services at a neighbourhood scale is required to redress the inequity of access. In addition, accessibility to parks must be considered important in urban planning. <h3>Funding</h3> None.
Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort
Authors: Nathan D. Wong, Wenjun Fan, Xingdi Hu, Christie Ballantyne, Ron C. Hoodgeveen, Michael Y. Tsai, Auris Browne, Matthew J. Budoff
Journal: Journal of the American College of Cardiology (2024)

Lipoprotein(a) (Lp[a]) is a causal genetic risk factor for atherosclerotic cardiovascular disease (ASCVD). There are limited long-term follow-up data from large U.S. population cohorts. This study examined the relationship of Lp(a) with ASCVD outcomes in a large, pooled, multi-ethnic U.S. cohort. The study included data on Lp(a) and ASCVD outcomes from 5 U.S. prospective studies: MESA (Multi-Ethnic Study of Atherosclerosis), CARDIA (Coronary Artery Risk Development in Young Adults), JHS (Jackson Heart Study), FHS-OS (Framingham Heart Study-Offspring), and ARIC (Atherosclerosis Risk In Communities). Lp(a) levels were classified on the basis of cohort-specific percentiles. Multivariable Cox regression related Lp(a) with composite incident ASCVD events by risk group and diabetes status. The study included 27,756 persons without previous ASCVD who were aged 20 to 79 years, including 55.0% women, 35.6% Black participants, and 7.6% patients with diabetes, with mean follow-up of 21.1 years. Compared with Lp(a) levels <50th percentile, Lp(a) levels in the 50th to <75th, 75th to <90th, and ≥90th percentiles had adjusted HRs of 1.06 (95% CI: 0.99-1.14), 1.18 (95% CI: 1.09-1.28), and 1.46 (95% CI: 1.33-1.59), respectively for ASCVD events. Elevated Lp(a) predicted incident ASCVD events similarly by risk group, sex, and race or ethnic groups, but more strongly in patients with vs without diabetes (interaction P = 0.0056), with HRs for Lp(a) levels ≥90th percentile of 1.92 (95% CI: 1.50-2.45) and 1.41 (95% CI: 1.28-1.55), respectively. Lp(a) also individually predicted myocardial infarction, revascularization, stroke, and coronary heart disease death, but not total mortality. The study shows, in a large U.S. pooled cohort, that higher Lp(a) levels are associated with an increased ASCVD risk, including in patients with diabetes.
Facilitating the development of urgently required combination vaccines
Authors: William P Hausdorff, Shabir A Madhi, Gagandeep Kang, Lassané Kaboré, Marta Tufet Bayona, Birgitte K Giersing
Journal: The Lancet Global Health (2024)

The essence of a vaccine lies in its ability to elicit a set of immune responses specifically directed at a particular pathogen. Accordingly, vaccines were historically designed, developed, registered, recommended, procured, and administered as monopathogen formulations. Nonetheless, the control and elimination of an astonishing number of diseases was realised only after several once-separate vaccines were provided as combinations. Unfortunately, the current superabundance of recommended and pipeline vaccines is now at odds with the number of acceptable vaccine administrations and feasible health-care visits for vaccine recipients and health-care providers. Yet, few new combinations are in development because, in addition to the scientific and manufacturing hurdles intrinsic to coformulation, developers face a gauntlet of regulatory, policy, and commercialisation obstacles in a milieu still largely designed for monopathogen vaccines. We argue here that national policy makers and public health agencies should prospectively identify and advocate for the development of new multipathogen combination vaccines, and suggest ways to accelerate the regulatory pathways to licensure of combinations and other concrete, innovative steps to mitigate current obstacles.
Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity
Authors: Hadil Zureigat, Michael T. Osborne, Shady Abohashem, Kenechukwu Mezue, Charbel Gharios, Simran Grewal, Alex Cardeiro, Nicki Naddaf, Giovanni Civieri, Taimur Abbasi, Azar Radfar, Wesam Aldosoky, Antonia V. Seligowski, Meagan M. Wasfy, James Sawalla Guseh, Timothy W. Churchill, Rachel P. Rosovsky, Zahi Fayad, Anthony Rosenzweig, Aaron Baggish, Roger K. Pitman, Karmel W. Choi, Jordan Smoller, Lisa M. Shin, Ahmed Tawakol
Journal: Journal of the American College of Cardiology (2024)