The journal of climate change and health最新文献

Introduction

The nexus between carbon footprints and chronic kidney disease (CKD) progression have not been clarified, so it has not been possible to examine the prevention of disease severity as a potential countermeasure for decarbonization.

Material and methods

The study included 70,627 subjects aged 40–74 years and diagnosed with CKD stage by specific health checkups in 2014–2015. Greenhouse gas (GHG) emissions in Japan were formulated with the 2015 environmental input–output model. The carbon footprints by CKD stage were calculated with annual treatment cost according to renal function indicators, namely estimated glomerular filtration rate (eGFR) and proteinuria.

Results

The annual carbon footprint per patient with induction of dialysis due to CKD was estimated to be 3.9 tCO₂e, in contrast to 0.31 tCO₂e in subjects without dialysis. Highlighting the relationship between the carbon footprint and the slope of eGFR as the CKD stage advances, the carbon footprint of care for patients with a stable eGFR in CKD stage G2 or better was 300 kgCO₂e in males and 280 kgCO₂e in females. Yet, in CKD stages G3a and G3b or worse, the carbon footprint for a rapid decrease in eGFR (30 % or greater per year) was 620 kgCO₂e and 1440 kgCO₂e in males and 430 kgCO₂e and 1270 kgCO₂e in females, respectively.

Conclusion

Effective interventional treatments to prevent disease severity in CKD contribute to both the health of the patient and the mitigation of GHG emissions.

Introduction

Despite the potential of school-based programs targeting climate awareness and action to support students in addressing the climate crisis and to improve their mental health and well-being, there is limited evidence for their effectiveness. In preparation for a cluster-randomized controlled trial, we assessed the feasibility of evaluating the Public Climate School (PCS), a one-week school program in Germany, and its effects on theory-based behavioral and psychological outcomes.

Material and methods

We enrolled 158 students from 11 classes (grades 7–13) into a cluster-controlled pilot study. Four classes were allocated to the waitlist control group and 7 to the intervention group participating in the PCS in November 2021. Using online surveys, we assessed theory-based behavioral and psychological outcomes at baseline and follow-up. Two-level models were used to investigate changes in outcomes.

Results

125 students completed the baseline and follow-up survey (dropout rate: 21 %). For most outcomes we observed no between-group differences, except for pro-environmental communication and engagement (e.g., posting on social media; p=.040) and perceptions of environmental norms (p=.001) in the anticipated direction.

Conclusion

This study confirmed the feasibility of evaluating the PCS and provides parameter estimates to guide sample size calculations and study design decisions for future research. Together with recent work on the association between collective action and mental health, the effect of the PCS on pro-environmental communication and engagement highlights the value of examining effects of education for sustainable development programs on student health and linking them to collective action in future work.

Background

Climate change is one of the most significant threats to human and planetary health. As trusted sources, health professionals have a unique opportunity to help protect society from the impacts of climate change by educating key publics including policymakers about solutions to climate change, as well as reducing their sector's contribution to climate change by promoting sustainable practices in the workplace. Developing methods to activate health professionals as climate educators and advocates is an important step in activating this opportunity. Drawing on the practice of behavioral journalism, this study tests the effectiveness of role model stories at increasing attitudinal and behavioral engagement of health professionals with sustainability.

Methods

Participants in this study (n = 39) were employees of a network of U.S. hospitals and urgent care centers that were subscribed to a sustainability e-newsletter published by the healthcare system. Participants were randomly assigned to a control group that only received the regular newsletter, or a treatment group that received an additional series of emails featuring stories about sustainability role models in their healthcare system.

Results

We found that receiving the role model stories increased participant's belief that health professionals have a responsibility to support sustainability efforts and their willingness to receive more information about joining a climate and health advocacy organization, although there were no between-group differences on other dependent variables.

Conclusion

This study although limited by a small sample size provides evidence that role model stories can play a role in activating healthcare professionals to participate in sustainability initiatives and advocate for climate and health solutions.

Background

Climate change threatens human existence and is caused by increasing carbon emissions. Healthcare systems generate about 5% of global net CO2 emissions, further contributing to the crisis. Green healthcare practices could be implemented and nurses, as the largest workforce group, could potentially drive these practices. This review explored nurses’ awareness, perceptions, attitudes and perspectives towards sustainable nursing and healthcare practices concerning climate change.

Methods

The Joanna Briggs Institute [JBI] methodology for conducting mixed methods systematic reviews was applied and results were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. CINAHL, PsycINFO, SCOPUS, and PUBMED databases were searched. JBI and Mixed Method Appraisal Tool [MMAT] critical appraisal tools were used for the data appraisal. Data synthesis and integration followed the JBI convergent integrated approach and thematic analysis was performed. https://doi.org/10.17605/OSF.IO/8H3TC.

Findings

Eighteen papers were included that represented nine different countries across five continents. One study was found in Africa, no studies in South America, and three in Asia. Five key themes were identified: i) knowledge and awareness of climate change, ii) link between nursing and climate change, iii) environmental sustainability, iv) barriers to environmentally responsible healthcare, and v) routes to environmentally sustainable nursing practices.

Interpretation

The review indicates the need to raise awareness regarding climate change and sustainable practices among nurses. It is vital policy makers, and healthcare leaders ensure criteria relating to environmental sustainability and carbon reduction are included in decisions about procurement and service delivery. Nurses’ engagement could drive forward a net-zero agenda.

With climate change accelerated at a worrisome rate, global warming also will have implications for surgery and surgical practice. The goal of this current study was to systematically survey the literature and better understand how climate change has affected surgical disease burden, surgical care delivery, and surgical outcomes. We performed a comprehensive scoping review, screening 3334 unique citations from three databases – 1766 from Embase, 1329 from Pubmed and 239 from Scopus – to identify studies that had associated climate change with surgery. After systematic searching, quality appraisal, and data extraction, we synthesized findings from qualitative and quantitative studies. Twenty-six studies that met the inclusion criteria were included in the review. The studies associating climate change with surgery spanned all surgical subspecialties, although most notable examples came from urology, trauma surgery, and burns and reconstructive surgery. Although there is increasingly strong evidence for how climate change might affect surgery, there is a paucity of research attempting to establish a more direct correlation or causal link between the two. Additionally, we identified several studies that did not directly address climate change but instead focused on chronobiology and its effects on surgery, highlighting directions for future research. The existing evidence, despite its limitations, generates hypotheses for future work, implicating climate change as an independent contributor towards increased surgical disease burden, decreased surgical care delivery, and worsened surgical outcomes.

Humanity is currently confronted with simultaneous complex environmental crises of unprecedented scale. These include, but are not limited to, the ongoing sixth mass extinction and the depletion of biodiversity, and ongoing anthropogenic greenhouse gas emissions which are causing changes in the climate that humanity has never before witnessed. As these ecological crises continue to progress, there is increasing recognition of the impact this has on mental health. Within this context, the notion of ecoanxiety has gained traction, primarily from the perspective of psychology, with the view to elevate suffering. However, in our view, the risk of considering ecoanxiety, and other ecological emotions, solely from a medicalized perspective as a mental disorder is that it places too much responsibility on individuals, decontextualizes ecological emotions from their social and political settings, and detaches these emotions from their ethical and moral dimensions. This article proposes to reconsider ecological emotions from the perspective of moral distress. Environmental moral distress resituates ecological emotions within their social and political contexts, and sheds light on their entanglement with ethical realms that medicalized conceptions of ecoanxiety fail to recognize. We argue that responding to environmental moral distress requires a shift to an ethics of care and ecofeminist paradigm which enables us to consider ecological emotions as contextualized indicators of the experience of morally questionable actions. This approach opens the door to collective responses aiming to empower and build moral agency in the face of the shared moral and political struggles which characterize the ecological crisis.

Introduction

Climate change is a health emergency and healthcare professionals represent critical and trusted points of contact between communities and the health effects of climate change.  However, healthcare professionals require training in the complex dynamics governing the interaction between climate and health as this education is not a part of traditional healthcare oriented curricula.

Methods

From February-April 2022, a free, live-virtual, 8-session climate and health course was offered in a collaboration between the Global Consortium on Climate and Health Education (GCCHE), Project ECHO and the United States National Oceanic and Atmospheric Administration (NOAA). The goal of the course was to increase health professionals’ knowledge, self-efficacy, and communication skills related to the climate crisis. Participants were invited to complete pre-, post- and 6-month post surveys to assess their readiness to lead climate and health education and programmatic development at their own institutions or within their own communities.

Results

Between February-April 2022, 1,047 unique attendees participated in the Climate and Health Responder ECHO series. The primary outcome measured of communication regarding climate change trended toward increased communication. Survey respondents reported increased motivation to teach climate and health topics and confidence in training others following completion of the course.

Conclusion

Live-virtual, evidence, and competency-based courses have the potential to change health professional behaviors towards addressing the climate impacts on health and equip health professionals with the knowledge and skills needed to implement climate and health programs in their own work in order to scale-up climate and health knowledge, self-efficacy, and communication skills.