Making the climate crisis personal through a focus on human health

Cleavage of cell junction proteins as a host invasion strategy in leptospirosis

Infection and invasion are the prerequisites for developing the disease symptoms in a host. While the probable mechanism of host invasion and pathogenesis is known in many pathogens, very little information is available on Leptospira invasion/pathogenesis. For causing systemic infection Leptospira must transmigrate across epithelial barriers, which is the most critical and challenging step. Extracellular and membrane-bound proteases play a crucial role in the invasion process. An extensive search for the proteins experimentally proven to be involved in the invasion process through cell junction cleavage in other pathogens has resulted in identifying 26 proteins. The similarity searches on the Leptospira genome for counterparts of these 26 pathogenesis-related proteins identified at least 12 probable coding sequences. The proteins were either extracellular or membrane-bound with a proteolytic domain to cleave the cell junction proteins. This review will emphasize our current understanding of the pathogenic aspects of host cell junction-pathogenic protein interactions involved in the invasion process. Further, potential candidate proteins with cell junction cleavage properties that may be exploited in the diagnostic/therapeutic aspects of leptospirosis will also be discussed. KEY POINTS: • The review focussed on the cell junction cleavage proteins in bacterial pathogenesis • Cell junction disruptors from Leptospira genome are identified using bioinformatics • The review provides insights into the therapeutic/diagnostic interventions possible.

The Double Burden: Climate Change Challenges for Health Systems

Climate change presents significant challenges to human health and health systems, and there is a critical need for health systems to adapt and become more resilient in order to effectively mediate the impacts of climate change on population health. This paper analyzes existing academic literature to identify key themes, trends, and research gaps at the intersection of climate change and health systems. Utilizing a scoping review of 179 studies, we explore how health systems can enhance their resilience through effective governance, sustainable financing, resource generation, and adaptive service delivery. Our findings emphasize the importance of integrating climate considerations into health system governance, mobilizing innovative financial resources, and adapting infrastructure and workforce capacities to address climate-related health challenges. The study highlights the need for continued interdisciplinary research and targeted interventions to ensure health systems are equipped to promote equity and protect vulnerable populations in the face of climate change. These insights contribute to the development of climate-resilient health systems and identify crucial areas for future research.

Climate-specific health literacy in health professionals: an exploratory study

Background

Health professionals such as physicians and nurses may play an important role in the transformation process towards a healthy, sustainable and climate-sensitive society. However, little is known about their climate-specific health literacy. This study aimed to assess knowledge regarding climate change and its impacts on health and climate-specific health literacy in health professionals.

Methods

In July/August 2022, a cross-sectional, questionnaire-based study was carried out at the University Hospital Regensburg, Germany, to assess climate-specific health literacy in nurses and physicians from various clinical specialties. Descriptive and exploratory statistical analyses were performed.

Results

The study population consisted of 142 participants (57.7% women; response rate: 24,7%). Most participants (93%) considered climate change to be highly relevant. However, only 12% of respondents stated to be very well informed regarding the general consequences of climate change. Although 57% of all participants had never mentioned climate change in relation to health to their patients, participants with higher levels of knowledge regarding the effects of climate change were more likely to mention it compared to those with lower levels of knowledge. The most frequently stated obstacle to integrate the topic of climate change in clinical work was lack of time during work (79%), not enough information (42%) and lacking materials (39%). Differences between health professions were apparent.

Conclusion

The results of our survey suggest that the current state of climate-specific health literacy differs between different groups of health professionals. There is a need to improve health professionals' levels of climate-specific health literacy and to increase the potential in interprofessional cooperation regarding planetary health.

'I don't really associate climate change with actual people's health': a qualitative study in England of perceptions of climate change and its impacts on health

OBJECTIVES

The health impacts of climate change are increasing, but qualitative evidence on people's perceptions is limited. This qualitative study investigated people's perceptions of climate change and its impacts on health.

STUDY DESIGN

This was an online study using semistructured interviews.

METHODS

A total of 41 semistructured interviews were conducted in 2021 with members of the public aged ≥15 years living in England, recruited via community-based groups. Data were analysed using reflexive thematic analysis.

RESULTS

Participants were concerned about climate change, which was often perceived as extreme weather events happening elsewhere. Changes in the UK's seasons and weather patterns were noted, but participants were uncertain whether these changes resulted from climate change. Participants often struggled to identify health impacts of climate change; where health impacts were described, they tended to be linked to extreme weather events outside the United Kingdom and their associated threats to life. The mental health impacts of such events were also noted.

CONCLUSIONS

The study found that most participants did not perceive climate change to be affecting people's health in England. This raises questions about whether framing climate change as a health issue, an approach advocated for countries less exposed to the direct effects of climate change, will increase its salience for the British public.

A blueprint for strengthening climate and health literacy through professional adaptability

Responding effectively to intensifying climate change hazards to protect human health in personal and professional settings is an urgent and pressing challenge. This will require collaboration and subject matter expertise of people across the life course and occupations. In this perspective piece, we build on a previously published compilation of climate and health literacy elements to explore tangible opportunities to strengthen climate and health understanding among individuals spanning educational levels, professional settings, and societal needs. Educational materials addressing climate change and health linkages have historically focused on K-12, college, post-graduate education, and continuing medical education, with less attention devoted to reaching students in trade schools and other professional settings. Here, we outline a flexible blueprint for strengthening climate and health literacy among all people by targeting education in a way that is relevant for each age group or profession. In particular, we discuss the idea of professional adaptability as a way to design practical climate and health training for people currently in the workforce.

Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy

Climate change poses numerous near and long-term challenges for our society, and the human health consequences are increasingly recognized as unprecedented. Responding to these health hazards requires a healthcare workforce composed of climate-informed clinicians. As trusted messengers, physicians play a vital role in informing and preparing the public for health impacts of climate change. We describe an evolving graduate medical education fellowship for physicians from all specialties capable of training leaders in this field. Our program pairs fellows with federal and non-governmental partners to provide expertise in climate policy and empower them to be change agents. The accelerating response to climate change from the federal government coupled with an increased recognition of the impacts of climate hazards on health demands a climate-informed clinical workforce. The expansion of this fellowship to accommodate trainees from multiple specialties and its innovative structure leveraging local and national partnerships sets a standard for how similar programs can be developed in addressing the greatest public health threat and opportunity of the century.