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Assessing the effect of climate extremes on maternal and infant health is hindered by gaps in exposure data, vulnerability assessments and integration of sociobehavioural dimensions.

A significant increase in number of publications and number of citations is evident in the last decade which is accessible through online databases such as Google Scholar, Web of Science, Scopus, etc. The large data set of scientific literature and respective authors in these platforms can be utilized to get a broad overview of academic discourse which falls under the field of Scientomtrics. This article aims to investigate the state of academia in the field of Natural Hazards and Climate Extremes (NHCE) using Google Scholar data which hasn't been done before. We find that, among 2614 researchers identified, 77.2 % are male, 22.6 % are female, and 0.2 % could not be categorized. Male researchers, on average, received a larger median number of citations compared to women. Notably, regression analysis showed that there is a limited difference in number of citations per publication between the two genders. The data also shows that 78.5 % of citations are attributed to researchers in high-income countries, 14.4 % for those in middle-income countries, and 7.1 % for those in low-income countries. Researchers from high-income countries get a larger number of citations per author, on average, even when controlling for number of publications. However, the citation gap between genders and across income levels has narrowed considerably in recent years. In conclusion, even though disasters affect poor countries and women disproportionately, the fact that the field of NHCE is largely high-income country and male-dominated raises fundamental questions on the ontology and epistemology of the scientific knowledge that has been generated.

Humans face various hazards, making it challenging to apply a precautionary approach to all of them. Instead, individuals prioritize risk reduction based on perceived threats and lived experiences, often considering multiple hazards simultaneously. This study explores how public perceptions of multiple hazards are interconnected and change over time in Italy and Sweden, using data from three representative surveys (n = 12,476) conducted in August 2020, November 2020, and August 2021. We assess risk perception across three dimensions (likelihood, impact, and authority knowledge) for nine hazards, including epidemics, climate change, and natural disasters. Findings reveal that recently encountered hazards, such as COVID-19, become more closely connected to other hazards. At the same time, connections among hazards such as wildfires, droughts, and floods remain stable over time. These results indicate a dual component of public risk perception of multiple hazards, offering valuable insights for shaping public health policies and climate adaptation strategies.

Background

Even though HIV-TB co-infection is an emerging public health issue among migrants in European countries, the number of related articles has shown a decreasing trend.

Methods

To better estimate the extent of this problem, we analyzed 34 articles reporting both prevalence and odds ratio for HIV-TB co-infection in migrants in European countries. Heterogeneity analysis was conducted to assess potential bias, and a random-effects model was used to calculate the effect size.

Results

The overall prevalence of HIV-TB co-infection was 9% (95%CI: 7% − 11%) in foreign-born individuals, with higher rates observed in specific subgroups: 14% (95%CI: 5% − 33%) in those from Sub-Saharan Africa, which is higher than the overall average, and 4% (95%CI: 2% − 7%) in those from Latin America, which is lower than the overall average. Compared to the native-born European population, foreign-born individuals had a twofold increased risk of HIV-TB co-infection, with a threefold increased risk for those from Sub-Saharan Africa.

Conclusions

Our meta-analysis results highlight the disproportionate burden of HIV-TB co-infection among foreign-born people in Europe, particularly those from Sub-Saharan Africa.

Climate change increasingly impacts health and livelihoods, with extreme climate events causing significant economic losses and health risks. Understanding how socio-economic drivers and political orientation influence public risk perception is key for effective climate policies. This study aims to show how gender, age, income, political orientation, education, and place of residence shape perceptions of climate change as compared to other global crises (epidemics and economic crises), using Italy and Sweden as case studies (N = 12,476 individuals representative of the general population in both countries). Our findings indicate that women, low-income, and left-leaning respondents report higher risk perceptions across all hazards compared to men, higher-income, and right-leaning individuals. Younger individuals perceive higher risks for climate change and economic crisis but lower for epidemics compared to older individuals. These findings illustrate the importance of tailored communication strategies to address diverse perceptions and enhance public support for climate policies. By contextualizing climate change risk perceptions with other global crises, this study does not only provide crucial insights for advancing our understanding of risk perception dynamics in the context of global challenges but can also inform policymakers in designing interventions that consider socio-economic disparities and ideological influences.

Understanding how individuals perceive risks of natural and health hazards can improve risk communication. This study aimed to investigate perceptions of natural and biological hazards among smokers and nonsmokers, using smoking as a proxy for risk-taking propensity. A cross-sectional survey was conducted in Italy and Sweden in August 2021 with representative samples (n = 4,131). Risk perception across seven hazards was measured using Likert scales. Ordinal logistic regression was used to assess associations between smoking and risk perception, stratified by country and adjusted for sociodemographic confounders. Smoking prevalence was higher in Italy (32.7%) than Sweden (8.8%). In Italy, smokers, particularly moderate-heavy smokers, perceived higher hazard risks than non-smokers. No such pattern was found in Sweden. Contrary to the initial hypothesis, smoking was associated with heightened risk perception in Italy. This study challenges traditional categorizations of risk-seeking versus risk-averse individuals, emphasizing the complex interplay of individual behaviors, perceptions, and societal norms.

Background

Heart failure is common, complex, and often associated with coexisting chronic medical conditions and a high mortality. We aimed to assess the epidemiology of people admitted to hospital with heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), including the period covering the COVID-19 pandemic, which was previously not well characterised.

Methods

In this retrospective, cohort study, we used whole-population electronic health records with 57 million individuals in England to identify patients hospitalised with heart failure as the primary diagnosis in any consultant episode of an in-patient admission to a National Health Service (NHS) hospital. We excluded individuals with less than 1 year of medical history records in primary or secondary care; admissions to NHS hospitals for which less than 10% of heart failure cases were linkable to the National Heart Failure Audit (NHFA); individuals younger than 18 years at the time of the heart failure hospitalisation; and patients who died in hospital during the index heart failure admission. For patients with new onset heart failure, we assessed incidence rates of 30-day and 1-year all-cause and cause-specific (cardiovascular, non-cardiovascular, and heart failure-related) emergency rehospitalisation and mortality after discharge, and dispensed guideline-recommended medical therapy (GRMT). Follow-up occurred from the index admission to the earliest occurrence of the event of interest, death, or end of data coverage. We estimated adjusted hazard ratios (HRs) to compare HFrEF with HFpEF. We computed population-attributable fractions to quantify the percentage of outcomes attributable to coexisting chronic medical conditions.

Findings

Among 233 320 patients identified who survived the index heart failure admission across 335 NHS hospitals between Jan 1, 2019, and Dec 31, 2022, 101 320 (43·4%) had HFrEF, 71 910 (30·8%) had HFpEF, and 60 090 (25·8%) had an unknown classification. In patients with new onset heart failure, there were reductions in all-cause 30-day (–5·2% [95% CI –7·7 to –2·6] in 2019–22) and 1-year rehospitalisation rates (–3·9% [–6·6 to –1·2]). Declining 30-day rehospitalisation rates affected patients with HFpEF (–4·8% [–9·2 to –0·2]) and HFrEF (–6·2% [–10·5 to –1·6]), although 1-year rates were not statistically significant for patients with HFpEF (–2·2% [–6·6 to 2·3] vs –5·7% [–10·6 to –0·5] for HFrEF). There were no temporal trends in incidence rates of 30-day or 1-year mortality after discharge. The rates of all-cause (HR 1·20 [1·18–1·22]) and cause-specific rehospitalisation were uniformly higher in those with HFpEF than those with HFrEF. Patients with HFpEF also had higher rates of 1-year all-cause mortality after discharge (HR 1·07 [1·05–1·09]), driven by excess risk of non-cardiovascular death (HR 1·25 [1·21–1·29]). Rates of rehospitalisation and mortality were highest in patients with coexisting chronic kidney disease, chronic obstructive pulmonary disease, dementia, and liver disease. Chronic kidney disease contributed to 6·5% (5·6–7·4) of rehospitalisations within 1 year for HFrEF and 5·0% (4·1–5·9) of rehospitalisations for HFpEF, double that of any other coexisting condition. There was swift implementation of newer GRMT, but markedly lower dispensing of these medications in patients with coexisting chronic kidney disease.

Interpretation

Rates of rehospitalisation in patients with heart failure in England have decreased during 2019–22. Further population health improvements could be reached through enhanced implementation of GRMT, particularly in patients with coexisting chronic kidney disease, who, despite being at high risk, remain undertreated.

Background: The extent to which COVID-19 diagnosis and vaccination during pregnancy are associated with risks of common and rare adverse pregnancy outcomes remains uncertain. We compared the incidence of adverse pregnancy outcomes in women with and without COVID-19 diagnosis and vaccination during pregnancy.

Methods: We studied population-scale linked electronic health records for women with singleton pregnancies in England and Wales from 1 August 2019 to 31 December 2021. This time period was divided at 8th December 2020 into pre-vaccination and vaccination roll-out eras. We calculated adjusted hazard ratios (HRs) for common and rare pregnancy outcomes according to the time since COVID-19 diagnosis and vaccination and by pregnancy trimester and COVID-19 variant.

Findings: Amongst 865,654 pregnant women, we recorded 60,134 (7%) COVID-19 diagnoses and 182,120 (21%) adverse pregnancy outcomes. COVID-19 diagnosis was associated with a higher risk of gestational diabetes (adjusted HR 1.22, 95% CI 1.18-1.26), - 1.26), gestational hypertension (1.16, 1.10-1.22), - 1.22), pre-eclampsia (1.20, 1.12-1.28), - 1.28), preterm birth (1.63, 1.57-1.69, - 1.69, and 1.68, 1.61-1.75 - 1.75 for spontaneous preterm), very preterm birth (2.04, 1.86-2.23), - 2.23), small for gestational age (1.12, 1.07-1.18), - 1.18), thrombotic venous events (1.85, 1.56-2.20) - 2.20) and stillbirth (only within 14-days since COVID-19 diagnosis, 3.39, 2.23-5.15). - 5.15). HRs were more pronounced in the pre-vaccination era, within 14-days since COVID-19 diagnosis, when COVID-19 diagnosis occurred in the 3rd trimester, and in the original variant era. There was no evidence to suggest COVID-19 vaccination during pregnancy was associated with a higher risk of adverse pregnancy outcomes. Instead, dose 1 of COVID-19 vaccine was associated with lower risks of preterm birth (0.90, 0.86-0.95), - 0.95), very preterm birth (0.84, 0.76-0.94), - 0.94), small for gestational age (0.93, 0.88-0.99), - 0.99), and stillbirth (0.67, 0.49-0.92). - 0.92).

Interpretation: Pregnant women with a COVID-19 diagnosis have higher risks of adverse pregnancy outcomes. These fi ndings support recommendations towards high-priority vaccination against COVID-19 in pregnant women.

Funding: BHF, ESRC, Forte, HDR-UK, MRC, NIHR and VR. Copyright (c) 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Managing climate change-related risks requires robust and actionable insights into future climates. Here we develop the plural climate storylines framework to complement existing physical climate storylines, which have strengthened the usability of climate projections yet struggled to generate action for just climate futures. By taking urban adaptation as a case in point, we illustrate the plural climate storylines framework through four complementary methodological schools that bring together multiple knowledges on complex social and climatic processes: power-sensitive storylines, decolonizing storylines, co-producing storylines and aspirational storylines. Our framework generates storylines with the potential to advance transformative policies and new pathways towards climate-just futures.

Climate extremes are unprecedented straining healthcare systems and intensifying pre-existing issues. This commentary addresses lack of (1) knowledge on unintended health consequences of adaptation actions, (2) interdisciplinary research frameworks, and (3) forward-looking, context-based scenarios. Collaboration across natural, medical, and social sciences can facilitate shifts toward more sustainable and equitable healthcare.