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In the last decade, many malaria-endemic countries, like Zambia, have achieved significant reductions in malaria incidence among children <5 years old but face ongoing challenges in achieving similar progress against malaria in older age groups. In parts of Zambia, changing climatic and environmental factors are among those suspectedly behind high malaria incidence. Changes and variations in these factors potentially interfere with intervention program effectiveness and alter the distribution and incidence patterns of malaria differentially between young children and the rest of the population. We used parametric and non-parametric statistics to model the effects of climatic and socio-demographic variables on age-specific malaria incidence vis-à-vis control interventions. Linear regressions, mixed models, and Mann-Kendall tests were implemented to explore trends, changes in trends, and regress malaria incidence against environmental and intervention variables. Our study shows that while climate parameters affect the whole population, their impacts are felt most by people aged ≥5 years. Climate variables influenced malaria substantially more than mosquito nets and indoor residual spraying interventions. We establish that climate parameters negatively impact malaria control efforts by exacerbating the transmission conditions via more conducive temperature and rainfall environments, which are augmented by cultural and socioeconomic exposure mechanisms. We argue that an intensified communications and education intervention strategy for behavioural change specifically targeted at ≥5 aged population where incidence rates are increasing, is urgently required and call for further malaria stratification among the ≥5 age groups in the routine collection, analysis and reporting of malaria mortality and incidence data.

Digitalization and artificial intelligence increasingly affect the world of work. Rising risk of massive job losses have sparked technological fears. Limited income and productivity gains concentrated among a few tech companies are fueling inequalities. In addition, the increasing ecological footprint of digital technologies has become the focus of much discussion. This creates a trilemma of rising inequality, low productivity growth and high ecological costs brought by technological progress. How can this trilemma be resolved? Which digital applications should be promoted specifically? And what should policymakers do to address this trilemma? This contribution shows that policymakers should create suitable conditions to fully exploit the potential in the area of network applications (transport, information exchange, supply, provisioning) in order to reap maximum societal benefits that can be widely shared. This requires shifting incentives away from current uses toward those that can, at least partially, address the trilemma. The contribution analyses the scope and limits of current policy instruments in this regard and discusses alternative approaches that are more aligned with the properties of the emerging technological paradigm underlying the digital economy. In particular, it discusses the possibility of institutional innovations required to address the socio-economic challenges resulting from the technological innovations brought about by artificial intelligence.

The complex interaction between social, economic, and environmental processes coupled with transformations of the landscape primarily driven by urbanization have impacts on the access, availability, and distribution, of food. This has resulted in a global micronutrient deficiency and hunger. Given rapid urbanization and population growth, a more sustainable food system is necessary to feed more urban populations and provide adequate nutrition, especially in developing countries. Existing frameworks for modelling urban-environment interactions contain components related to food security, however, lack the specificity needed to evaluate the effects of land use decisions and agricultural production strategies on the health of local populations measured through metrics such as nutritional output. The research presented here proposes an urban nutrition (UN) extension to the previously published urban ecological economic system by developing a focused component that simulates scenarios of different degrees of urbanization and agricultural production techniques to improve the nutritional output of agricultural land, while considering the conservation of soil. This simulation approach was subsequently applied to the Toluca Metropolitan Zone, Mexico. Results showed that nutritional output would greatly increase when adding a variety of crops, even in scenarios where agricultural land is limited. The proposed extension can be used by decision makers worldwide to evaluate how landscape configurations and agricultural production systems affect the nutritional needs of the local population while fostering sustainable practices.

AbstractThe role of climate change on global malaria is often highlighted in World Health Organisation reports. We modelled a Zambian socio-environmental dataset from 2000 to 2016, against malaria trends and investigated the relationship of near-term environmental change with malaria incidence using Bayesian spatio-temporal, and negative binomial mixed regression models. We introduced the diurnal temperature range (DTR) as an alternative environmental measure to the widely used mean temperature. We found substantial sub-national near-term variations and significant associations with malaria incidence-trends. Significant spatio-temporal shifts in DTR/environmental predictors influenced malaria incidence-rates, even in areas with declining trends. We highlight the impact of seasonally sensitive DTR, especially in the first two quarters of the year and demonstrate how substantial investment in intervention programmes is negatively impacted by near-term climate change, most notably since 2010. We argue for targeted seasonally-sensitive malaria chemoprevention programmes.

China, with its growing population and economic development, faces increasing risks to health from climate change, but also opportunities to address these risks and protect health for generations to come. Without a timely and adequate response, climate change will impact lives and livelihoods at an accelerated rate. In 2020, the Lancet Countdown Regional Centre in Asia, led by Tsinghua University, built on the work of the global Lancet Countdown and began its assessment of the health profile of climate change in China with the aim of triggering rapid and health-responsive actions. This 2021 report is the first annual update, presenting 25 indicators within five domains: climate change impacts, exposures, and vulnerability; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. The report represents the contributions of 88 experts from 25 leading institutions in, and outside of, China. From 2020 to 2021, five new indicators have been added and methods have been improved for many indicators. Where possible, the indicator results are presented at national and provincial levels to facilitate local understanding and policy making. In a year marked by COVID-19, this report also endeavours to reflect on China's pathway for a green recovery, ensuring it aligns with the carbon neutrality goal, for the health of the current and future generations.

Almost 46% of the world's population resides in a rural landscape. Smart villages, alongside smart cities, are in need of time for future economic growth, improved agriculture, better health, and education. The smart village is a concept that improves the traditional rural aspects with the help of digital transformation. The smart village is built up using heterogeneous digital technologies pillared around the Internet-of-Thing (IoT). There exist many opportunities in research to design a low-cost, secure, and efficient technical ecosystem. This article identifies the key application areas, where the IoT can be applied in the smart village. The article also presents a comparative study of communication technology options. 5 Pages, Conference: IEEE 7th World Forum on Internet of Things (WF-IoT), New Orleans, June 2021

BackgroundStudies of alcohol use presume valid assessment measures. To evaluate this presumption, we examined the concordance of alcohol use as measured by ecological momentary assessment (EMA) self‐reports, transdermal alcohol concentration readings via the Secure Continuous Remote Alcohol Monitor (SCRAM), and retrospective self‐reports via the Timeline Follow‐Back (TLFB) among adults experiencing homelessness.MethodsForty‐nine adults who reported alcohol misuse (mean age = 47, SD = 9; 57% Black; 82% men) were recruited from a homeless shelter. For 4 weeks, alcohol use was assessed: (i) 5 times or more per day by EMA, (ii) every 30 minutes by a SCRAM device worn on the ankle, and (iii) by TLFB for the past month at the end of the study period. There were 1,389 days of observations of alcohol use and alcohol use intensity for 49 participants.ResultsEMA and SCRAM alcohol use data agreed on 73% of days, with an interrater agreement Kappa = 0.46. A multilevel analysis of concordance of 3 measures for alcohol use yielded statistically significant correlations of 0.40 (day level) and 0.63 (person level) between EMA and SCRAM. Alcohol use was detected on 49, 38, and 33% of days by EMA, SCRAM, and TLFB, respectively. For alcohol use intensity, EMA and SCRAM resulted in statistically significant correlations of 0.46 (day level) and 0.78 (person level). The concordance of TLFB with either EMA or SCRAM was weak, especially at the day level.ConclusionsThis is the first study to examine concordance of alcohol use estimates using EMA, SCRAM, and TLFB methods in adults experiencing homelessness. EMA is a valid approach to quantifying alcohol use, especially given its relatively low cost, low participant burden, and ease of use. Furthermore, any stigma associated with wearing the SCRAM or reporting alcohol use in person may be attenuated by using EMA, which may be appealing for use in studies of stigmatized and underserved populations.

La dengue est liée au changement climatique dans les pays tropicaux et subtropicaux, notamment en République démocratique populaire lao (Laos) et en Thaïlande. La connaissance de ces problèmes et les mesures préventives peuvent affecter l'incidence et le risque d'épidémie de dengue. Par conséquent, la présente étude a été menée pour déterminer les connaissances, les attitudes et les pratiques (cap) parmi les communautés urbaines et rurales et les responsables gouvernementaux sur le changement climatique et la dengue au Laos et en Thaïlande. Une enquête transversale sur le changement climatique et la dengue a été menée auprès de 360 ménages au Laos (180 urbains et 180 ruraux), 359 ménages en Thaïlande (179 urbains et 180 ruraux) et 20 représentants du gouvernement (10 dans chaque pays) à l'aide de questionnaires structurés. L'analyse des données a été entreprise en utilisant des méthodes descriptives, l'analyse en composantes principales (ACP), le test du Chi carré ou le test exact de Fisher (le cas échéant) et la régression logistique. Des différences significatives entre les communautés sélectionnées dans les deux pays ont été trouvées en termes d'âge, de niveau d'éducation, de statut socio-économique, de niveau d'attitude face au changement climatique et de niveau de cap de la dengue (P < 0,05 ; IC à 95 %). Dans l'ensemble, le cap des participants sur le changement climatique et la dengue était faible, à l'exception du niveau d'attitude pour la dengue dans les deux pays. Le niveau de sensibilisation des responsables gouvernementaux à la relation climatique avec la dengue était également faible. Dans les ménages laotiens, les connaissances des participants sur le changement climatique et la dengue étaient significativement associées au niveau d'éducation et au statut socio-économique (SSE) (P < 0,01). Leurs attitudes à l'égard du changement climatique et de la dengue étaient associées au niveau d'éducation et à l'utilisation d'Internet (P < 0,05). Les pratiques liées au changement climatique des ménages étaient associées au SSE (P < 0,01) et les pratiques liées à la dengue étaient associées au niveau d'éducation, au SSE, à l'expérience antérieure de la dengue et à l'utilisation d'Internet (P < 0,01). En Thaïlande, les connaissances des participants sur le changement climatique étaient associées au niveau d'éducation et au SSE (P < 0,01). Leurs attitudes à l'égard du changement climatique étaient associées au statut de résidence (urbain/rural) et à l'utilisation d'Internet (P < 0,05) ; les pratiques liées au changement climatique étaient associées au niveau d'éducation et au SSE (P < 0,05). Les connaissances liées à la dengue des participants étaient associées au SSE et à l'expérience antérieure de la dengue (P < 0,05) ; les attitudes et les pratiques liées à la dengue des participants étaient associées au niveau d'éducation (P < 0,01). Les résultats appellent à des programmes de sensibilisation intégrés et urgents pour augmenter les niveaux de cap concernant l'adaptation au changement climatique, l'atténuation et la prévention de la dengue afin d'améliorer la santé et le bien-être des populations de ces deux pays et des pays similaires où la dengue est endémique. El dengue está relacionado con el cambio climático en países tropicales y subtropicales como la República Democrática Popular Lao (Laos) y Tailandia. El conocimiento sobre estos problemas y las medidas preventivas pueden afectar la incidencia y el riesgo de brote de dengue. Por lo tanto, el presente estudio se realizó para determinar el conocimiento, las actitudes y las prácticas (CAP) entre las comunidades urbanas y rurales y los funcionarios gubernamentales sobre el cambio climático y el dengue en Laos y Tailandia. Se realizó una encuesta Cap transversal sobre el cambio climático y el dengue en 360 hogares en Laos (180 urbanos y 180 rurales), 359 hogares en Tailandia (179 urbanos y 180 rurales) y 20 funcionarios gubernamentales (10 en cada país) utilizando cuestionarios estructurados. El análisis de datos se realizó utilizando métodos descriptivos, análisis de componentes principales (PCA), prueba de Chi-cuadrado o prueba exacta de Fisher (según corresponda) y regresión logística. Se encontraron diferencias significativas entre las comunidades seleccionadas en ambos países en términos de edad de los participantes del hogar, nivel de educación, nivel socioeconómico, nivel de actitud ante el cambio climático y nivel Cap de dengue (P < 0,05; IC del 95%). En general, la Cap de los participantes sobre el cambio climático y el dengue fue baja, excepto el nivel de actitud para el dengue en ambos países. El nivel de conciencia entre los funcionarios gubernamentales con respecto a la relación climática con el dengue también fue bajo. En los hogares de Laos, el conocimiento de los participantes sobre el cambio climático y el dengue se asoció significativamente con el nivel de educación y el nivel socioeconómico (ses) (P < 0,01). Sus actitudes hacia el cambio climático y el dengue se asociaron con el nivel educativo y el uso de internet (P < 0.05). Las prácticas relacionadas con el cambio climático de los hogares se asociaron con el ses (P < 0,01) y las prácticas relacionadas con el dengue se asociaron con el nivel educativo, el ses, la experiencia previa con el dengue y el uso de Internet (P < 0,01). En Tailandia, el conocimiento de los participantes sobre el cambio climático se asoció con el nivel de educación y el ses (P < 0,01). Sus actitudes hacia el cambio climático se asociaron con el estado de residencia (urbano/rural) y el uso de Internet (P < 0.05); las prácticas relacionadas con el cambio climático se asociaron con el nivel educativo y el ses (P < 0.05). El conocimiento relacionado con el dengue de los participantes se asoció con el ses y la experiencia previa del dengue (P < 0,05); las actitudes y prácticas relacionadas con el dengue de los participantes se asociaron con el nivel educativo (P < 0,01). Los hallazgos exigen programas de concientización integrados que se necesitan con urgencia para aumentar los niveles de Cap con respecto a la adaptación al cambio climático, la mitigación y la prevención del dengue para mejorar la salud y el bienestar de las personas en estos dos países y en países similares donde el dengue es endémico. Dengue is linked with climate change in tropical and sub-tropical countries including the Lao People's Democratic Republic (Laos) and Thailand. Knowledge about these issues and preventive measures can affect the incidence and outbreak risk of dengue. Therefore, the present study was conducted to determine the knowledge, attitudes, and practices (KAP) among urban and rural communities and government officials about climate change and dengue in Laos and Thailand. A cross-sectional KAP survey about climate change and dengue were conducted in 360 households in Laos (180 urban and 180 rural), 359 households in Thailand (179 urban and 180 rural), and 20 government officials (10 in each country) using structured questionnaires. Data analysis was undertaken using descriptive methods, principal component analysis (PCA), Chi-square test or Fisher's exact test (as appropriate), and logistic regression. Significant differences among the selected communities in both countries were found in terms of household participant's age, level of education, socioeconomic status, attitude level of climate change and KAP level of dengue (P < 0.05; 95% CI). Overall, participants' KAP about climate change and dengue were low except the attitude level for dengue in both countries. The level of awareness among government officials regarding the climatic relationship with dengue was also low. In Lao households, participants' knowledge about climate change and dengue was significantly associated with the level of education and socioeconomic status (SES) (P < 0.01). Their attitudes towards climate change and dengue were associated with educational level and internet use (P < 0.05). Householders' climate change related practices were associated with SES (P < 0.01) and dengue related practices were associated with educational level, SES, previous dengue experience and internet use (P < 0.01). In Thailand, participants' knowledge about climate change was associated with the level of education and SES (P < 0.01). Their attitudes towards climate change were associated with residence status (urban/rural) and internet use (P < 0.05); climate change related practices were associated with educational level and SES (P < 0.05). Dengue related knowledge of participants was associated with SES and previous dengue experience (P < 0.05); participants' dengue related attitudes and practices were associated with educational level (P < 0.01). The findings call for urgently needed integrated awareness programs to increase KAP levels regarding climate change adaptation, mitigation and dengue prevention to improve the health and welfare of people in these two countries, and similar dengue-endemic countries. ترتبط حمى الضنك بتغير المناخ في البلدان الاستوائية وشبه الاستوائية بما في ذلك جمهورية لاو الديمقراطية الشعبية (لاوس) وتايلاند. يمكن أن تؤثر المعرفة بهذه القضايا والتدابير الوقائية على حدوث وخطر تفشي حمى الضنك. لذلك، أجريت هذه الدراسة لتحديد المعرفة والمواقف والممارسات (KAP) بين المجتمعات الحضرية والريفية والمسؤولين الحكوميين حول تغير المناخ وحمى الضنك في لاوس وتايلاند. وأجريت دراسة استقصائية مستعرضة للمعارف والمواقف والممارسات بشأن تغير المناخ وحمى الضنك في 360 أسرة معيشية في لاوس (180 في المناطق الحضرية و 180 في المناطق الريفية)، و 359 أسرة معيشية في تايلند (179 في المناطق الحضرية و 180 في المناطق الريفية)، و 20 مسؤولا حكوميا (10 في كل بلد) باستخدام استبيانات منظمة. تم إجراء تحليل البيانات باستخدام الأساليب الوصفية، وتحليل المكونات الرئيسية (PCA)، واختبار مربع كاي أو اختبار فيشر الدقيق (حسب الاقتضاء)، والانحدار اللوجستي. تم العثور على اختلافات كبيرة بين المجتمعات المختارة في كلا البلدين من حيث عمر المشارك في الأسرة، ومستوى التعليم، والوضع الاجتماعي والاقتصادي، ومستوى الموقف من تغير المناخ ومستوى المعرفة والتعلم والتعلم والتعلم من حمى الضنك (P < 0.05 ؛ 95 ٪ CI). بشكل عام، كانت المعارف والمواقف والممارسات للمشاركين حول تغير المناخ وحمى الضنك منخفضة باستثناء مستوى الموقف تجاه حمى الضنك في كلا البلدين. كما كان مستوى الوعي بين المسؤولين الحكوميين فيما يتعلق بالعلاقة المناخية مع حمى الضنك منخفضًا. في أسر لاو، كانت معرفة المشاركين حول تغير المناخ وحمى الضنك مرتبطة بشكل كبير بمستوى التعليم والوضع الاجتماعي والاقتصادي (P < 0.01). ارتبطت مواقفهم تجاه تغير المناخ وحمى الضنك بالمستوى التعليمي واستخدام الإنترنت (P < 0.05). ارتبطت الممارسات المتعلقة بتغير المناخ لدى الأسر بالخدمات الاجتماعية والاقتصادية (P < 0.01) وارتبطت الممارسات المتعلقة بحمى الضنك بالمستوى التعليمي، والخدمات الاجتماعية والاقتصادية، وتجربة حمى الضنك السابقة واستخدام الإنترنت (P < 0.01). في تايلاند، ارتبطت معرفة المشاركين بتغير المناخ بمستوى التعليم و SES (P < 0.01). ارتبطت مواقفهم تجاه تغير المناخ بوضع الإقامة (حضري/ريفي) واستخدام الإنترنت (P < 0.05 )؛ ارتبطت الممارسات المتعلقة بتغير المناخ بالمستوى التعليمي و SES (P < 0.05). ارتبطت معرفة المشاركين المتعلقة بحمى الضنك بالخدمات البيئية والاجتماعية وتجربة حمى الضنك السابقة (P < 0.05 )؛ وارتبطت مواقف المشاركين وممارساتهم المتعلقة بحمى الضنك بالمستوى التعليمي (P < 0.01). تدعو النتائج إلى برامج توعية متكاملة مطلوبة بشكل عاجل لزيادة مستويات المعارف والمواقف والممارسات فيما يتعلق بالتكيف مع تغير المناخ والتخفيف من آثاره والوقاية من حمى الضنك لتحسين صحة ورفاهية الناس في هذين البلدين، والبلدان الموبوءة بحمى الضنك المماثلة.