Urban climate policy and action through a health lens-an untapped opportunity

Motivated by a growing recognition of the climate emergency, reflected in the 26th Conference of the Parties (COP26), we outline untapped opportunities to improve health through ambitious climate actions in cities. Health is a primary reason for climate action yet is rarely integrated in urban climate plans as a policy goal. This is a missed opportunity to create sustainable alliances across sectors and groups, to engage a broad set of stakeholders, and to develop structural health promotion. In this statement, we first briefly review the literature on health co-benefits of urban climate change strategies and make the case for health-promoting climate action; we then describe barriers to integrating health in climate action. We found that the evidence-base is often insufficiently policy-relevant to be impactful. Research rarely integrates the complexity of real-world systems, including multiple and dynamic impacts of strategies, and consideration of how decision-making processes contend with competing interests and short-term electoral cycles. Due to siloed-thinking and restrictive funding opportunities, research often falls short of the type of evidence that would be most useful for decision-making, and research outputs can be cryptic to decision makers. As a way forward, we urge researchers and stakeholders to engage in co-production and systems thinking approaches. Partnering across sectors and disciplines is urgently needed so pathways to climate change mitigation and adaptation fully embrace their health-promoting potential and engage society towards the huge transformations needed. This commentary is endorsed by the International Society for Environmental Epidemiology (ISEE) and the International Society for Urban Health (ISUH) and accompanies a sister statement oriented towards stakeholders (published on the societies’ websites)

Voice Therapy For Transgender People

Transrodne osobe su osobe koje osjećaju nesklad između roda s kojim se poistovjećuju i spola u kojem su se rodili. Transrodnost je širok pojam i obuhvaća čitav spektar rodno nenormativnih identiteta. Dva glavna obrasca tranzicije prema drugom spolu, odnosno rodu su: Male-to-Female (MtF) i Female-to-Male (FtM). Transrodne osobe navode da ih njihov glas često “izdaje”, odnosno otkriva njihov biološki rod te predstavlja posljednju prepreku u potpuno uživljavanje u novu rodnu ulogu. Bez obzira na to, često nisu svjesni da se zbog glasa mogu obratiti logopedu. Cilj ovog preglednog rada je dati uvid u poremećaje glasa kod transrodnih osoba, odnosno opisati logopedsku procjenu te terapijske postupke, a sve u svrhu boljeg razumijevanja potreba ovih osoba.Transgender individuals are people who feel an incongruity between their self-identified gender and their birth gender. Transgenderism is a broad term and includes a spectrum of gender-nonconforming identities. The two main patterns of gender transition are Male-to-Female (MtF) and Female-to-Male (FtM).Transgender people often think their voice “betrays” them, i.e. it reveals their biological gender and represents the last obstacle to the individual’s full enjoyment of his/her new gender role. Regardless of this, many transgender individuals are not aware of the fact that they can go to speech and language pathologists (SLP) for therapy. The aim of this review article is to provide insight into the voice disorders of transgender people, i.e. to describe the assessment process and therapy protocols in hope of gaining a better understanding of the needs of this population

State-of-the-art methods for exposure-health studies: Results from the exposome data challenge event

The exposome recognizes that individuals are exposed simultaneously to a multitude of different environmental factors and takes a holistic approach to the discovery of etiological factors for disease. However, challenges arise when trying to quantify the health effects of complex exposure mixtures. Analytical challenges include dealing with high dimensionality, studying the combined effects of these exposures and their interactions, integrating causal pathways, and integrating high-throughput omics layers. To tackle these challenges, the Barcelona Institute for Global Health (ISGlobal) held a data challenge event open to researchers from all over the world and from all expertises. Analysts had a chance to compete and apply state-of-the-art methods on a common partially simulated exposome dataset (based on real case data from the HELIX project) with multiple correlated exposure variables (P > 100 exposure variables) arising from general and personal environments at different time points, biological molecular data (multi-omics: DNA methylation, gene expression, proteins, metabolomics) and multiple clinical phenotypes in 1301 mother–child pairs. Most of the methods presented included feature selection or feature reduction to deal with the high dimensionality of the exposome dataset. Several approaches explicitly searched for combined effects of exposures and/or their interactions using linear index models or response surface methods, including Bayesian methods. Other methods dealt with the multi-omics dataset in mediation analyses using multiple-step approaches. Here we discuss features of the statistical models used and provide the data and codes used, so that analysts have examples of implementation and can learn how to use these methods. Overall, the exposome data challenge presented a unique opportunity for researchers from different disciplines to create and share state-of-the-art analytical methods, setting a new standard for open science in the exposome and environmental health field

WHO Air Quality Guidelines 2021-aiming for healthier air for all: a joint statement by medical, public health, scientific societies and patient representative organisations

[Extract] After years of intensive research and deliberations with experts across the globe, the World Health Organization (WHO) updated its 2005 Global Air Quality Guidelines (AQG) in September 2021 [1, 2]. The new air quality guidelines (WHO AQG) are ambitious and reflect the large impact that air pollution has on global health. They recommend aiming for annual mean concentrations of PM2.5 not exceeding 5 µg/m3 and NO2 not exceeding 10 µg/m3, and the peak season mean 8-hr ozone concentration not exceeding 60 µg/m3 [1]. For reference, the corresponding 2005 WHO guideline values for PM2.5 and NO2 were, respectively, 10 µg/m3 and 40 µg/m3 with no recommendation issued for long-term ozone concentrations [3]. While the guidelines are not legally binding, we hope they will influence air quality policy across the globe for many years to come

Inequalities in Exposure to Nitrogen Dioxide in Parks and Playgrounds in Greater London.

Elevated levels of nitrogen dioxide (NO2) have been associated with adverse health outcomes in children, including reduced lung function and increased rates of asthma. Many parts of London continue to exceed the annual average NO2 concentration of 40 µg/m3 set by the EU directive. Using high-resolution maps of annual average NO2 for 2016 from the London Atmospheric Emissions Inventory and detailed maps of open spaces from Britain's national mapping agency, Ordnance Survey, we estimated average NO2 concentrations for every open space in Greater London and analysed geospatial patterns comparing Inner verses Outer London and the 32 London Boroughs. Across Greater London, 24% of play spaces, 67% of private parks and 27% of public parks had average levels of NO2 that exceeded the EU limit for NO2. Rates of exceedance were higher in Inner London; open spaces in the City of London had the highest average NO2 values among all the London Boroughs. The closest play space for more than 250,000 children (14% of children) under 16 years old in Greater London had NO2 concentrations above the recommended levels. Of these children, 66% (~165,000 children) lived in the most deprived areas of London, as measured by the Index of Multiple Deprivations, where average NO2 concentrations in play spaces were on average 6 µg/m3 higher than for play spaces in the least deprived quintile. More action is needed to reduce NO2 in open spaces to safe levels through pollution reduction and mitigation efforts, as currently, open spaces in Greater London, including play spaces, parks and gardens, still have dangerously high levels of NO2, according to the most recent NO2 map

Fluorine in pheromones:synthesis of fluorinated 12-dodecanolides as emerald ash borer pheromone mimetics

A series of five 12-dodecanolides have been synthesised containing CF2 groups at C5, C6, C7, C8 and in one case a double substitution at C5 & C8, as a strategy to bias the conformational space accessed by these macrocycles, and to assess if the analogues may act as mimetics for 12-decenolide pheromones associated with the Emerald Ash Borer. Accordingly individual syntheses of 5,5-difluoro- 5, 6,6-difluoro- 6, 7,7-difluoro- 7, 8,8-difluoro- 8 and 5,5,8,8-tetrafluoro- 9, 12-decanolides is outlined and X-ray structural data was obtained for three (5, 8 and 9) of these compounds. The structures show clearly that the CF2 groups occupy ‘corner’ locations in the macrocycle consistent with their ability to bias accessible conformations. The fluorine containing 12-dodecanolides all generated an electro-antennogram response in female beetles