An urgent need for COP27: confronting converging crises.

The last 12 months have provided further evidence of the potential for cascading ecological and socio-political crises that were warned of 12 months ago. Then a consensus statement from the Regional Action on Climate Change Symposium warned: "the Earth's climatic, ecological, and human systems are converging towards a crisis that threatens to engulf global civilization within the lifetimes of children now living." Since then, the consequences of a broad set of extreme climate events (notably droughts, floods, and fires) have been compounded by interaction with impacts from multiple pandemics (including COVID-19 and cholera) and the Russia-Ukraine war. As a result, new connections are becoming visible between climate change and human health, large vulnerable populations are experiencing food crises, climate refugees are on the move, and the risks of water, food, and climate disruption have been visibly converging and compounding. Many vulnerable populations now face serious challenges to adapt. In light of these trends, this year, RACC identifies a range of measures to be taken at global and regional levels to bolster the resilience of these populations in the face of such emerging crises. In particular, at all scales, there is a need for globally available local data, reliable analytic techniques, community capacity to plan adaptation strategies, and the resources (scientific, technical, cultural, and economic) to implement them. To date, the rate of growth of the support for climate change resilience lags behind the rapid growth of cascading and converging risks. As an urgent message to COP27, it is proposed that the time is now right to devote much greater emphasis, global funding, and support to the increasing adaptation needs of vulnerable populations.

Disaster resilience and population ageing: the 1995 Kobe and 2004 Chuetsu earthquakes in Japan.

This paper provides a framework for evaluating the effects of population ageing on disaster resilience. In so doing, it focuses on the 1995 Kobe and 2004 Chuetsu earthquakes, two major disasters that affected Japan before the 2011 Great East Japan earthquake. It analyses regional population recovery on the basis of pre-disaster and post-recovery demographic characteristics using defined transition patterns of population ageing. The evaluation framework demonstrates that various recovery measures make different contributions to disaster resilience for each transition pattern of population ageing. With reference to regional population ageing, the framework allows for a prediction of disaster resilience, facilitating place vulnerability assessments and potentially informing policy-making strategies for Japan and other countries with ageing populations.

Psychological stress contributed to the development of low-grade fever in a patient with chronic fatigue syndrome: a case report.

BACKGROUND: Low-grade fever is a common symptom in patients with chronic fatigue syndrome (CFS), but the mechanisms responsible for its development are poorly understood. We submit this case report that suggests that psychological stress contributes to low-grade fever in CFS. CASE PRESENTATION: A 26-year-old female nurse with CFS was admitted to our hospital. She had been recording her axillary temperature regularly and found that it was especially high when she felt stress at work. To assess how psychological stress affects temperature and to investigate the possible mechanisms for this hyperthermia, we conducted a 60-minute stress interview and observed the changes in the following parameters: axillary temperature, fingertip temperature, systolic blood pressure, diastolic blood pressure, heart rate, plasma catecholamine levels, and serum levels of interleukin (IL)-1ß and IL-6 (pyretic cytokines), tumor necrosis factor-α and IL-10 (antipyretic cytokines). The stress interview consisted of recalling and talking about stressful events. Her axillary temperature at baseline was 37.2°C, increasing to 38.2°C by the end of the interview. In contrast, her fingertip temperature decreased during the interview. Her heart rate, systolic and diastolic blood pressures, and plasma levels of noradrenaline and adrenaline increased during the interview; there were no significant changes in either pyretic or antipyretic cytokines during or after the interview. CONCLUSIONS: A stress interview induced a 1.0°C increase in axillary temperature in a CFS patient. Negative emotion-associated sympathetic activation, rather than pyretic cytokine production, contributed to the increase in temperature induced by the stress interview. This suggests that psychological stress may contribute to the development or the exacerbation of low-grade fever in some CFS patients.

Edrophonium provocative testing for the evaluation of upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia.

The aim of this study was to examine if edrophonium provocative testing is useful for evaluating upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia (NUD). A questionnaire rating dyspeptic symptoms was done for 58 patients with NUD. The patients were then given an intravenous infusion of saline followed by 5 mg of edrophonium. Baseline esophageal manometry was also done. Patients whose usual symptoms were reproduced (48.3%) had significantly higher symptom scores (13.0 [8.5, 17.0] vs. 8.5 [6.0, 11.0]; P = 0.015) and a significantly higher number of symptoms (4.0 [2.5, 6.0] vs. 3.0 [1.0, 4.0]; P = 0.010) than patients whose usual symptoms were not reproduced. The presence of an esophageal motility disorder was not significantly different between the two groups. These findings suggest upper gastrointestinal hypersensitivity in the patients whose symptoms were reproduced. Edrophonium provocative testing might be useful for evaluating upper gastrointestinal hypersensitivity in patients with NUD.

Comparison of the esophageal manometric characteristics of idiopathic and reflux-associated esophageal spasm: evaluation by 24-hour ambulatory esophageal motility and pH monitoring.

Diffuse esophageal spasm (DES) is a typical esophageal dysfunction, but its cause is unknown. DES has been classified into reflux-associated esophageal spasm (RDES), caused by acid exposure, and idiopathic esophageal spasm (IDES), of unknown causes. The differences in esophageal motility pattern between the RDES and IDES are clues to elucidating the pathogenesis of DES. Although 24-hr ambulatory esophageal motility and pH monitoring is considered a feasible method for evaluating gastroesophageal reflux and esophageal function, most researchers previously defined the RDES as DES accompanied by esophagitis and heartburn using standard manometry over a short time frame. To clarify the pathogenesis of RDES, we did this research using 24-hr ambulatory esophageal motility and pH monitoring. The investigation included 25 normal controls and 116 patients with upper digestive symptoms. Among the 116 patients, 45 had DES (11 RDES, 30 IDES, and DES-GERD coexistence). Patients with RDES showed a significantly higher frequency of simultaneous contractions than did patients with IDES. Heartburn has been said to be peculiar to RDES, but also occurred in 12.5% of IDES. No significant differences in the mean pH of the esophagus during acid reflux were found between the RDES and IDES patients. Based on the results, we have proposed a refined definition of RDES.

Development of pictogram system for natural disaster reduction through Internet

The purpose of this study is to develop a pictogram system for natural disaster reduction. Long lasting and tangible achievement of IDNDR is needed which may be used in all over the world for many coming generations. As Neurath said "World divide, pictures unite", pictograms could be a powerful communication tool as well as an educational tool to improve global disaster awareness. In this project, we formed a multi-disciplinary team to compile "A database of pictograms for natural disaster reduction", which we intend to release our copyrights to be used widely and freely as an achievement of IDNDR through internet. We developed the lexicon and grammar of the pictograms for natural disaster reduction. Over 700 pictograms in use were collected for evaluation, and new designs were also added to complete the list of concepts related to natural hazards and their disaster management. Home page will be introduce for worldwide participation in this project.(AU)

How lifeline service restoration affects emergency management issues

The relationship between lifeline service restoration and societal reactions after the Hanshin-Awaji earthquake disaster of January 17, 1995 is reviewed in terms of the emergency management point of view. We will discuss how formal organizational responses were enacted, issues concerning emergency responses, relief activities, and restoration activities. We introduce a decision making model for disaster management.(AU)