Nurses and Climate Change: A Narrative Review of Nursing Associations' Recommendations for Integrating Climate Change Mitigation Strategies.

BACKGROUND: According to the World Health Organization, climate change is the greatest challenge of the twenty-first century. It is already affecting the health of many Canadians through extreme heat, wildfires and the expansion of zoonotic diseases. As trusted professionals, nurses are in favourable position to take action on climate change. PURPOSE: To document the recommendations issued by Quebec, Canadian, American and international nursing associations regarding nursing practices that address climate change or environmental issues. METHODS: This narrative review was conducted by establishing a list of environmental and general nursing associations in the geographical areas of interest through Google searches as well as by retrieving documents about climate change or environmental issues published by these organizations on their websites. Data related to the documents' characteristics and recommended nursing roles were then extracted. RESULTS: The review identified 13 nurses' organizations and 20 documents describing 37 recommendations for nurses in seven socioecological areas: individual, patient-focused, workplace, nursing associations, public health organizations, political and education. CONCLUSIONS: There is a gap between the breadth of roles that nurses may be called upon to play in addressing climate change and the degree to which relevant organizations are prepared to create the required conditions for them to do so. Several lessons emerged, including that the urgency of the climate crisis requires clear guidelines on how nurses can integrate climate change and its resultant health concerns into practice through nurses' associations, education and bottom-up nursing innovations. Funding is required for such initiatives, which must also prioritize health inequalities.

Overall and central obesity and prostate cancer risk in African men.

PURPOSE: African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men. METHODS: Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case-control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively. RESULTS: Among controls 16.4% were obese (BMI ≥ 30 kg/m2), 26% and 90% had WC > 97 cm and WHR > 0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99-1.93), and central obesity (WC > 97 cm: OR = 1.60, 95% CI 1.10-2.33; and WHtR > 0.59: OR = 1.68, 95% CI 1.24-2.29) were positively associated with D'Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these differences were not statistically significant. DISCUSSION: The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations.

Tools and Methods to Include Health in Climate Change Adaptation and Mitigation Strategies and Policies: A Scoping Review.

Climate change represents a serious threat to the health and well-being of populations. Today, many countries, regions, and cities around the world are implementing policies and strategies to adapt to climate change and mitigate its effects. A scoping review was performed to identify tools and methods that help integrate health into climate change adaptation and mitigation policies and strategies. The literature search includes scientific and grey literature. The scientific literature was conducted using PubMed, Elsevier Embase, and Web of Science databases. A grey literature web search was performed to complement the results. A total of 35 studies (28 from the scientific literature and 7 from the grey literature) were finally included. A large majority of research articles (24/28) and almost all reports (6/7) from the grey literature were published after 2010. Results show that the tools that were found most frequently are the nested models (12/35), health impact assessment (6/35), vulnerability and adaptation assessment (3/35), conceptual frameworks (3/35), and mixed methods (3/35). This review shows an increasing interest in the topic of developing tools to better manage health issues in adaptation and mitigation strategies, with a recent increase in the number of publications. Additional analyses of tools' effectiveness should be conducted in further studies.

The Elaboration of an Intersectoral Partnership to Perform Health Impact Assessment in Urban Planning: The Experience of Quebec City (Canada).

Health impact assessments (HIA) allow evaluation of urban interventions' potential effects on health and facilitate decision-making in the urban planning process. However, few municipalities have implemented this method in Canada. This paper presents the approach developed with partners, the process, and the outcomes of HIA implementation after seven years of interinstitutional collaborations in Quebec City (ten HIA). Using direct observation and meeting minutes, information includes: perceived role of each institution taking part in HIA beforehand, how the HIA process was implemented, if it was appreciated, and which outcomes were observed. The intersectoral interactions contributed to the development of a common language, which sped up the HIA process over time and fostered positive collaborations in unrelated projects. It was an effective tool to share concerns and responsibilities among independent institutions. This experience resulted in the creation of an informal group of stakeholders from four different institutions that perform HIA to this day in collaboration with researchers.

A Comparative Analysis of Health Impact Assessment Implementation Models in the Regions of Montérégie (Québec, Canada) and Nouvelle-Aquitaine (France).

Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level.

Effective Project Management of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate (MADCaP).

PURPOSE: Health research in low- and middle-income countries can generate novel scientific knowledge and improve clinical care, fostering population health improvements to prevent premature death. Project management is a critical part of the success of this research, applying knowledge, skills, tools, and techniques to accomplish required goals. Here, we describe the development and implementation of tools to support a multifaceted study of prostate cancer in Africa, focusing on building strategic and operational capacity. METHODS: Applying a learning organizational framework, we developed and implemented a project management toolkit (PMT) that includes a management process flowchart, a cyclical center-specific schedule of activities, periodic reporting and communication, and center-specific monitoring and evaluation metrics. RESULTS: The PMT was successfully deployed during year one of the project with effective component implementation occurring through periodic cycles of dissemination and feedback to local center project managers. A specific evaluation was conducted 1 year after study initiation to obtain enrollment data, evaluate individual quality control management plans, and undertake risk log assessments and follow-up. Pilot data obtained identified areas in which centers required mentoring, strengthening, and capacity development. Strategies were implemented to improve project goals and operational capacity through local problem solving, conducting quality control checks and following compliancy with study aims. Moving forward, centers will perform quarterly evaluations and initiate strengthening measures as required. CONCLUSION: The PMT has fostered the development of both strategic and operational capacity across project centers. Investment in project management resources is essential to ensuring high-quality, impactful health research in low- and middle-income countries.

Development, Evaluation, and Implementation of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate.

PURPOSE: Cancer of the prostate (CaP) is the leading cancer among men in sub-Saharan Africa (SSA). A substantial proportion of these men with CaP are diagnosed at late (usually incurable) stages, yet little is known about the etiology of CaP in SSA. METHODS: We established the Men of African Descent and Carcinoma of the Prostate Network, which includes seven SSA centers partnering with five US centers to study the genetics and epidemiology of CaP in SSA. We developed common data elements and instruments, regulatory infrastructure, and biosample collection, processing, and shipping protocols. We tested this infrastructure by collecting epidemiologic, medical record, and genomic data from a total of 311 patients with CaP and 218 matched controls recruited at the seven SSA centers. We extracted genomic DNA from whole blood, buffy coat, or buccal swabs from 265 participants and shipped it to the Center for Inherited Disease Research (Baltimore, MD) and the Centre for Proteomics and Genomics Research (Cape Town, South Africa), where genotypes were generated using the UK Biobank Axiom Array. RESULTS: We used common instruments for data collection and entered data into the shared database. Double-entered data from pilot participants showed a 95% to 98% concordance rate, suggesting that data can be collected, entered, and stored with a high degree of accuracy. Genotypes were obtained from 95% of tested DNA samples (100% from blood-derived DNA samples) with high concordance across laboratories. CONCLUSION: We provide approaches that can produce high-quality epidemiologic and genomic data in multicenter studies of cancer in SSA.

Correction to: The GREENH-City interventional research protocol on health in all policies.

After publication of the article [1], it has been brought to our attention that in the original publication the third author's name was spelt incorrectly. The correct spelling is "Emmanuelle Faure". This was previously spelt as "Emmannuelle Faure". The original article has been revised to reflect this.

The GREENH-City interventional research protocol on health in all policies.

BACKGROUND: This paper presents the research protocol of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project funded by the National Institute for Cancer (Subvention N°2017-003-INCA). In France, health inequities have tended to increase since the late 1980s. Numerous studies show the influence of social, economic, geographic and political determinants on health inequities across the life course. Exposure to environmental factors is uneven across the population and may impact on health and health inequities. In cities, green spaces contribute to creating healthy settings which may help tackle health inequities. Health in All Policies (HiAP) represents one of the key strategies for addressing social and environmental determinants of health inequities. The objective of this research is to identify the most promising interventions to operationalize the HiAP approaches at the city level to tackle health inequities through urban green spaces. It is a participatory interventional research to analyze public policy in real life setting (WHO Healthy Cities). METHOD/DESIGN: It is a mixed method systemic study with a quantitative approach for the 80 cities and a comparative qualitative multiple case-studies of 6 cities. The research combines 3 different lens: 1/a political analysis of how municipalities apply HiAP to reduce social inequities of health through green space policies and interventions 2/a geographical and topological characterization of green spaces and 3/ on-site observations of the use of green spaces by the inhabitants. RESULTS: City profiles will be identified regarding their HiAP approaches and the extent to which these cities address social inequities in health as part of their green space policy action. The analysis of the transferability of the results will inform policy recommendations in the rest of the Health City Network and widely for the French municipalities. DISCUSSION/CONCLUSION: The study will help identify factors enabling the implementation of the HiAP approach at a municipal level, promoting the development of green spaces policies in urban areas in order to tackle the social inequities in health.