In response to emerging challenges that intersect humans, animals, and environments, there is growing international exigent need to adopt 'One Health' approaches. While One Health efforts are emerging in British Columbia in Canada, there are still challenges to overcome in the adoption of a One Health approach in policymaking. We conducted a comparative analysis of One Health policies in Asia, specifically, Singapore, Hong Kong, Bangladesh, and Thailand, which have well-established and sophisticated One Health approaches, to determine good practices in the implementation of One Health that could be considered for adoption in British Columbia. We conducted a literature review and scan of public-facing One Health websites, strategic action plans, and health databases, complemented by 13 semi-structured interviews with researchers, educators, service providers, human and animal health experts, and policymakers in our chosen Asian jurisdictions and British Columbia. While there was diversity in the One Health approaches taken by four jurisdictions, three key characteristics were present in policymaking processes in all of them: a national One Health strategic action plan, inter-ministerial coordination, and flexibility in the working relationships of public servants. One Health presents an opportunity for British Columbia to take a novel approach to public health policymaking, the one that is more holistic and effective at addressing shared health challenges.

This discussion paper proposes a framework of four indicators of transformational adaptation – the breadth and depth of change, the intention to achieve transformation, scale and sustainability – and provides a framework to apply these indicators to four types of interventions in agri-food systems. The paper was co-commissioned with Catholic Relief Services.

This paper shares stories from six countries—Bangladesh, Nepal, Kenya, Somalia, Syria, and Iraq—highlighting the challenges communities face in accessing water. It seeks to bring forward the unique perspectives of communities from diverse backgrounds, each experiencing water crises in distinct ways. While climate change intensifies their crises, many communities also face marginalization due to exclusionary water governance. The impacts are further compounded by factors such as gender, poverty, ethnicity, and race. However, the voices and perspectives of these communities are often overlooked in global climate discussions.The paper aims to highlight these diverse community experiences and advocate for the inclusion of local voices and leadership in climate actions and interventions to ensure fairer access to water. As global climate events like COP-29 unfold, it calls on governments to create inclusive climate policies, integrate water issues into loss and damage discussions, actively involve women and local voices, and urge rich, polluting nations to compensate those most affected by historic and ongoing carbon emissions.

Aim: Amidst the mounting challenges posed by climate change, the healthcare sector emerges as a vital frontliner, with nurses standing as its linchpins. This review delves into the pivotal role of nurses in combatting the health consequences of climatic alterations, particularly within the nuanced environment of Saudi Arabia. Design: A rapid literature review. Method: Drawing from a rigorous analysis of 53 studies, our exploration revolves around the preparedness strategies formulated in response to Saudi Arabia's changing climate. The variables analysed included study design, sample size, focus area, geographical coverage and key findings related to nurse competencies. Data were collected using a structured data extraction form and analysed using thematic content analysis. Employing content analysis, we discerned essential domains: from grasping the health impacts of climate change to customizing care for the most susceptible populations and championing advocacy initiatives. Findings: Salient findings highlight nurses' profound understanding of both direct and secondary health implications of climate shifts. Additionally, the results emphasize the tailored interventions needed for vulnerable groups, capacity building and disaster readiness. Crucially, our findings spotlight the significance of weaving cultural, ethical and regional threads into nursing strategies. By painting a comprehensive picture, we showcase the delicate balance of environmental evolution, healthcare dynamics and the unique socio-cultural tapestry of Saudi Arabia. Conclusion: The results of our analysis revealed key competencies required for nurses, including the ability to address immediate health impacts, provide tailored care for vulnerable populations and engage in advocacy and policy formulation. In summation, nurses' multifaceted roles-from immediate medical care to research, advocacy and strategizing-underscore their invaluable contribution to confronting the health adversities sparked by climate change. Our review accentuates the essential contributions of nurses in tackling climate-related health hurdles and calls for more nuanced research, policy adjustments and proactive measures attuned to Saudi Arabia's distinct backdrop.

Climate change is a pressing issue that has a negative impact on the planet but also on public health. The healthcare sector contributes to environmental pollution, while it aims to improve health. Therefore, its environmental sustainability should be improved. This study focuses on the governance of sustainability in hospitals, since hospitals are the largest operational units in the healthcare system and can therefore make a large impact. To successfully implement and embed sustainable development through the hospital, the right governance approach is needed. This systematic literature review aims to give an overview of governance related factors that influence the implementation of sustainable development in hospitals in Europe. Following PRISMA guidelines, 2426 papers were identified and screened of which 30 were included in the analysis. In these papers, four governance related factors were identified to be important for the implementation of sustainable development in the hospital: knowledge, involvement from management, commitment from healthcare professionals, and technology use. These factors currently mostly form barriers in the implementation process. Future research is recommended on how to practically deploy these factors as facilitators for implementation. Since both involvement from management and commitment from healthcare professionals are crucial factors, further research should look into combining the input of these stakeholders in policy development.

Context: Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking. Objectives: This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategies for purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature. Data sources: Five peer-reviewed databases and grey literature sources were rigorously searched for publications. Data extraction: Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted. Data analysis: Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016-2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies. Conclusion: If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Operating theatres consume large amounts of energy and consumables and produce large amounts of waste. There is an increasing evidence base for reducing the climate impacts of healthcare that could be enacted into routine practice; yet, healthcare-associated emissions increase annually. Implementation science aims to improve the systematic uptake of evidence-based care into practice and could, therefore, assist in addressing the environmental impacts of healthcare. The aim of this systematic search with narrative synthesis was to explore what implementation approaches have been applied to reduce the environmental impact of operating theatre activities, described by implementation phases and methodologies. A search was conducted in EMBASE, PubMed, and CINAHL, limited to English and publication since 2010. In total, 3886 articles were retrieved and 11 were included. All were in the exploratory phase (seven of 11) or initial implementation phase (four of 11), but none were in the installation or full implementation phase. Three studies utilised a recognised implementation theory, model, or framework in the design. Four studies used interprofessional education to influence individuals' behaviour to reduce waste, improve waste segregation, or reduce anaesthetic gases. Of those that utilised behaviour change interventions, all were qualitatively successful in achieving environmental improvement. There was an absence of evidence for sustained effects in the intervention studies and little follow-up from studies that explored barriers to innovation. This review demonstrates a gap between evidence for reducing environmental impacts and uptake of proposed practice changes to deliver low-carbon healthcare. Future research into 'greening' healthcare should use implementation research methods to establish a solid implementation evidence base. SYSTEMATIC REVIEW PROTOCOL: PROSPERO CRD42022342786.

Climate change is a pressing issue that has a negative impact on the planet but also on public health. The healthcare sector contributes to environmental pollution, while it aims to improve health. Therefore, its environmental sustainability should be improved. This study focuses on the governance of sustainability in hospitals, since hospitals are the largest operational units in the healthcare system and can therefore make a large impact. To successfully implement and embed sustainable development through the hospital, the right governance approach is needed. This systematic literature review aims to give an overview of governance related factors that influence the implementation of sustainable development in hospitals in Europe. Following PRISMA guidelines, 2426 papers were identified and screened of which 30 were included in the analysis. In these papers, four governance related factors were identified to be important for the implementation of sustainable development in the hospital: knowledge, involvement from management, commitment from healthcare professionals, and technology use. These factors currently mostly form barriers in the implementation process. Future research is recommended on how to practically deploy these factors as facilitators for implementation. Since both involvement from management and commitment from healthcare professionals are crucial factors, further research should look into combining the input of these stakeholders in policy development.

How climate change is uniquely affecting Indigenous health remains a very less explored area in the existing research literature. The imperative of inclusive climate action to protect indigenous health multiplies manifolds due to their unique vulnerabilities owing to predominant dependence on natural resources and multiple disadvantages faced. The current article attempted to add to the evidence pool regarding climate change impacts on the indigenous population by systematically collecting, processing, and interpreting data as a scoping literature review for effective and inclusive climate policymaking. Twenty-Nine articles of varied study designs were identified employing a systematically organized search strategy using PubMed (Field, MeSH, and advanced search) and Google scholar; relevant data were extracted for further analysis. The Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews (PRISMA-ScR) guidelines were followed. Changing climate scenarios had both direct and indirect health-related impacts on indigenous health, and altered the epidemiological triad for various health-related events, causing the emergence and re-emergence of infectious diseases, and increased prevalence of chronic diseases and mental disorders. An expanded framework was developed showcasing the variability of climate change events, multiple disadvantages, and its impacts on indigenous populations. Few studies also reported a wide range of adaptation responses of indigenous peoples towards climate change. It was substantiated that any climate-change mitigation policy must take into account the trials and tribulations of indigenous communities. Also, due to the complexity and large variability of the impacts and differences in mitigation capabilities, policies should be contextualized locally and tailored to meet the climate need of the indigenous community.

The global demand for plastic is expected to double in the next 20 years. The increasing demand for Single-Use Plastic Products (SUPPs) has become one of the main environmental problems in many developing countries, including Sri Lanka, through direct and indirect means, in the way of excessive consumption and the pollution of the environment through waste generation. In this way, there is a pressing need to accelerate the sustainability evaluation, comparison, impact mitigation, and policy recommendation of SUPPs to address environmental impacts and sustainable development. Therefore, this study aims to quantify and compare the environmental impacts of SUPPs for policy decision-making in Sri Lanka using life cycle assessment (LCA) techniques. Accordingly, the most popular and widely used single-use plastic products, which are under consideration for regulation in Sri Lanka, and their possible alternatives, are considered for this LCA study. The results reveal that SUPPs produced using polystyrene (PS), polypropylene (PP), low-density polyethylene (LDPE), high-density polyethylene (HDPE), and polyethylene terephthalate (PET) have a significant contribution in all life cycle stages, in terms of global warming potential (GWP) and endpoint impact categories. However, the outcomes of the study reveal that the net GWP impact of SUPPs that have recycling practices at the end of life shows better performance compared to incineration and landfill. In addition, the polylactic acid- (PLA)-based products also show a significant impact on mid- and end-point GWP impact categories. Remarkably, the midpoint analysis of PLA-based products and their alternatives emphasized that PLA production was the most impactful for most of the midpoint impact categories due to PLA resin production, which contributes significantly to all impact categories. In particular, for the pesticide bottles with the preferred end-of-life option of incineration, the HDPE indicates a 7.6% lower GWP compared to PET. For reusable steel cutlery, the largest GWP-associated life cycle stage is the user phase (97.5%), which includes cleaning the cutlery. However, the overall reduction in GWP in the use of steel, considering the best (PS with recycling) and worst (PS with incineration) case scenarios, with single-use items are 0.01 and 0.05 kg CO2 (eq), respectively. In the case of pesticide bottles, with the preferred end-of-life option being incineration, the HDPE indicates a 7.6% lower GWP compared to PET. the study reveals that conducting LCA will facilitate scientific decision-making for policy interventions related to SUPPs and their processes. Notably, the study shows that, at present, the capability of conducting LCA studies to evaluate the sustainability performance of SUPPs in Sri Lanka is limited due to the lack of life cycle inventory (LCI) data availability on SUPPs and relevant waste management practices in Sri Lanka.

There is an increasing number of studies focusing on extreme weather all over the world, but global trends and research topics related to extreme weather are still unclear. This study aimed to explore the current situation, research themes, and future trends in the field of extreme weather. Publications published from 1980 to 2019 were identified and retrieved from the Web of Science Core Collection databases by using keywords on May 5, 2020. Excel 2019, VOSviewer, R, and CiteSpace were used for scientific analysis. The results showed that (1) the number of publications on extreme weather research has rapidly increased and expanded continually, shifting from core disciplines to interdisciplinary fields; (2) the International Journal of Climatology was the most productive journal, and climate and environment were the most popular subject categories. Most studies were carried out in the USA, China, Germany, and other nations, and the Chinese Academy of Sciences was the most productive institution; (3) the main research topics were summarized as (a) climate change; (b) variability; (c) trends; (d) rainfall; (e) temperature; and (f) maximum. At the same time, (4) keyword bursts analysis showed that the domain focused on changes to atmospheric rivers, the impacts of global nitrogen content on extreme weather, and the relationship between water quality, soil moisture content, and extreme weather. Based on the in-depth analysis of extreme weather research, this paper developed a further understanding of the developments in this field over the past 39 years and also provided a reference for future research.

Background This systematic map principally sought to understand the different forms of effectiveness that existing studies evaluate in relation to Natural Flood Management (NFM) in the UK with a supplementary question of whether studies engaged with climate change and future flood risk. NFM measures seek to protect, enhance, emulate, or restore the natural function of rivers as part of approaches to flood risk management (FRM). While there is agreement in both academic and practice/policy literature that NFM should be part of a holistic FRM strategy to address current and future flood risk, the specifics of how to expand the application of and consistently implement NFM successfully in practice are less well known. A core focus of this study is on how the effectiveness of NFM measures is evaluated in different studies based on approaches drawn from the Environmental Impact Assessment (EIA) literature: procedural, substantive, transactive and normative. The systematic map also examines how studies account for climate change, which is a crucial issue given the connections between NFM and climate change adaptation and resilience. Methods We searched 13 bibliographic databases, Google scholar as a web-based search engine, and 21 organisational sites. Articles were screened by title, abstract, and full text based on defined eligibility criteria. Checks were performed for consistency amongst reviewers. Forms of effectiveness were coded on the basis of the included studies in the systematic map. The quantity and characteristics of the available evidence are summarised with the frequencies of effectiveness forms for each NFM measure are presented in heat maps. Review findings A total of 216 articles reported eligible studies that were coded as part of the systematic map. Overall, the systematic map shows that the majority of studies considered at least one approach to effectiveness; however, very few studies considered multiple forms of effectiveness. The systematic map also demonstrates that climate change is considered systematically by around one-quarter of studies although many studies make claims about NFM’s effectiveness in the face of future climatic change. Conclusions NFM can be effective in several different ways owing to their multiple benefits; however, there are evidence gaps around understanding these different forms of effectiveness. This is particularly marked for studies considering transactive and normative effectiveness. Interdisciplinary studies are more likely to consider multiple forms of effectiveness. This systematic map also found that whilst 75% of studies mention future climate change in their studies, only 24.1% contain a systematic consideration of the issue through, for example, using climate change projections. NFM is also at risk of climate change (e.g. through drought) and therefore it is imperative that study designs seek to incorporate consideration of effectiveness under future climate change. Policymakers should be made aware of the lack of understanding of how NFM measures perform under future climate change. Keywords Flooding, Flood risk management, Environmental Impact Assessment, Climate change adaptation, River catchments, Nature-based solutions, Natural Flood Management Background Natural flood management (NFM) measures seek to protect, enhance, emulate, or restore the natural function of rivers as part of approaches to flood risk management (FRM). While there is agreement in both academic and practice/policy literature that NFM, in a general sense, should be part of a holistic FRM strategy to address current and future flood risk, the specifics of how to consistently implement NFM successfully in practice are less well known. This is particularly acute for practitioners in the UK given the nature of the UK’s biophysical and socio-political context. There is a recognition that existing reviews of NFM effectiveness in the UK tend to focus on the natural science basis and it is unclear how studies account for climate change. Further, reviews tend to focus only on UK studies. This systematic map aims to highlight the way in which existing NFM studies, from different disciplinary backgrounds and across Europe, evaluate effectiveness, and the extent to which they account for climate change. This knowledge can help to make recommendations for future areas of research where the multiple issues around understanding effectiveness can be synthesised, and where climate change is systematically taken into account. Methods This systematic map protocol addresses the following question: what approaches exist to evaluate the effectiveness of UK-relevant natural flood management measures? The protocol details the methodology that will be used to conduct a systematic map of the range of peer-reviewed journal papers, policy documents, guidance, and other forms of grey literature which currently exist on NFM to give an overview on the way in which the effectiveness of NFM is conceived. The methods detail the search strategy employed for gathering items across the peer-reviewed academic literature and grey literature. Additionally, the methods outline how the reviewers will approach article screening, and the eligibility criteria to include/exclude articles. The methods also details the steps taken to ensure consistency across all reviewers, the data coding strategy, and methods for presenting the final systematic map. Together, the methods employed will help to identify current knowledge gaps, and will enable recommendations to be made for future research.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Adaptation, Vulnerability and Ecosystems (AVE) project, Costa Rica and Panama. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Mountain EbA Project, Peru. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Extant literature illustrates a substantive impact on human health because of climate change. Despite this, discussions of the ethical and policymaking role of US health care's response to this problem are underdeveloped within peer-reviewed literature indexed in core medical databases. We conducted a systematic literature review in August 2017 at Vanderbilt University Medical Center of the following medical, business and policy databases to examine the state of inquiry on this topic: PubMed, CINAHL, PsychINFO, JAMA Network, Health Affairs, Business Source Complete, Greylit.org, LexisNexis Academic, Proquest Dissertations and Theses Global. An initial sample of n = 4434 rendered n = 75 articles precisely addressing this question following a two-tiered systematic examination of content. US medical professionals were most concerned by the health impacts of air pollution and respiratory complications, extreme weather events, and rising infectious/vector-borne diseases. They were least concerned by rising rates of migration and stresses to sanitation systems. Medical professionals took a broadly proactive stance to the issue, highlighting the need to implement education and advocacy strategies. Politics was the least pertinent motivation for climate change-related recommendations. Furthermore, partnerships between health care and public agencies were identified as holding the greatest potential for meaningful change. Mitigation approaches were slightly more common than adaptation approaches. We conclude that, while the enthusiasm of the medical community is commendable, efforts to address climate change in US health care are overly fractured, and lack the necessary expertise for efficaciousness.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Ecosystems Protecting Infrastructure and Communities project, Burkina Faso. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Ecosystems Protecting Infrastructure and Communities project, Senegal. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Mountain EbA Project, Nepal. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Governance for Ecosystem-based Adaptation: Transforming Evidence into Change project, El Salvador. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.

Ecosystem-based adaptation (EbA) is the use of biodiversity and ecosystem services as part of an overall strategy to help people to adapt to the adverse effects of climate change and promote sustainable development. This report presents the results of using our Framework for Assessing EbA Effectiveness at the Incentive-based Hilsa Conservation Programme, Bangladesh. The findings will be combined with those from 12 other sites in 11 other countries to help show climate change policymakers when and why EbA is effective.