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Over 200 health journals call on the United Nations, politi- cal leaders, and health professionals to recognize that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. Read more in the PDF.

Background: When exposed to events that transgress one's moral beliefs, a plethora of negative consequences may follow, which are captured by the concept of moral injury (MI). Despite its relevance to experiences of healthcare workers during a global health emergency, there is lack of validated MI instruments adapted to the healthcare setting. Objective: The present study aims to provide a validation of the Italian version of the Moral Injury Events Scale (MIES) adjusted to the healthcare setting by assessing its factor structure, internal consistency and construct validity. Methods: A sample of 794 healthcare workers (46% nurses, 51% female) engaged in hospital facilities during the COVID-19 pandemic in Italy completed measures of MI, PTSD, anxiety, depression, burnout, meaning in life and positive affect. Results: Using an exploratory structural equation modelling (ESEM) we assessed the scale factor structure for the entire sample and separately for nurse professional and female healthcare worker groups. Findings support a three-factor solution: Factor 1 'perceived transgressions by others'; Factor 2 'perceived transgressions by self'; and Factor 3 'perceived betrayals by others'. Findings also indicate some level of convergence with measures of PTSD, anxiety, depression and burnout. Conclusion: Results suggest that the MIES may be useful in capturing unique experiences of moral injury amongst healthcare workers engaged in a global health emergency. The low range correlations with measures of psychological distress might potentially indicate that MI, which captures cognitive value judgements rather than manifest symptomatology, may uniquely explain a certain amount of variance. Implications for the development of new empirically derived and theoretical guided tools are discussed, highlighting the need for future research to examine the role of individualising and social binding moral principles in gaining a more nuanced understanding of moral injury experiences amongst healthcare professionals across different socio-cultural settings. The Italian validation of the MIES adapted to the healthcare setting yielded a three-factor structure: (a) 'perceived transgressions by self'; (b) 'perceived transgressions by others'; (c) 'perceived betrayals by others'. Findings suggest that the MIES may be useful in capturing unique experiences of moral injury amongst healthcare workers engaged in a global health emergency. Future research should consider the role of individualising and social binding moral principles in shaping moral injury experiences among healthcare professionals across different socio-cultural settings. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has declared human monkeypox as a global health emergency on 23 July 2022. This indicates that the outbreak poses a serious risk to global health and requires a united worldwide response to stop the virus from spreading and possibly turning into a pandemic. Vaccines can play a vital role in this context, contributing to pre- and post-exposure prophylaxis. Methods: The aim of our rapid review was to go through the background of the vaccine approach for human monkeypox over the years and to find out what current guidelines are highlighting relating to it. A rapid review with a systematic search and manual searching have been performed here. Results: 22 relevant published articles from MEDLINE bibliographic database and 8 vaccine recommendations from manual searching have been deliberated here. Conclusion: The significant synopsis of this review is that the smallpox vaccine is the only immunization option for monkeypox so far, and it is up to 85% effective to prevent the infection. Third-generation smallpox vaccines are advised over first and second generations due to their minimal side effects. Healthcare providers and lab professionals at risk are on the priority list to get vaccinated, as well as pregnant women or lactating mothers, and immunocompromised or chronically ill patients can get vaccinated if they are surely exposed to the monkeypox infection. Lastly, JYNNEOS/IMVAMUNE is the current most preferable smallpox vaccine that is highly advised for the latest outbreak of human monkeypox but more clinical trials on humans should be conducted to evaluate its safety, efficacy, and adverse events.

The ongoing multi-country human monkeypox (HMPX) outbreak was declared as a public health emergency of international concern. Considering the key role of healthcare workers (HCWs) in mitigating the HMPX outbreak, we aimed to assess their level of knowledge and their confidence in diagnosis and management of the disease, besides the assessment of their attitude towards emerging virus infections from a conspiracy point of view. An online survey was distributed among HCWs in Jordan, a Middle Eastern country, during May–July 2022 using a questionnaire published in a previous study among university students in health schools in Jordan. The study sample comprised 606 HCWs, with about two-thirds being either physicians (n = 204, 33.7%) or nurses (n = 190, 31.4%). Four out of the 11 HMPX knowledge items had <50% correct responses with only 33.3% of the study respondents having previous knowledge that vaccination is available to prevent HMPX. A majority of study respondents (n = 356, 58.7%) strongly agreed, agreed or somewhat agreed that the spread of HMPX is related to a role of male homosexuals. Confidence in the ability of diagnosis based on the available monkeypox virus diagnostic tests was reported by 50.2% of the respondents, while the confidence levels were lower for the ability to manage (38.9%) and to diagnose (38.0%) HMPX cases based on their current level of knowledge and skills. Higher confidence levels for HMPX diagnosis and management were found among physicians compared to nurses. The endorsement of conspiracy beliefs about virus emergence was associated with lower HMPX knowledge, the belief in the role of male homosexuals in HMPX spread, and with lower diagnosis and management confidence levels. The current study highlighted the gaps in knowledge regarding HMPX among HCWs in Jordan as well as the lack of confidence to diagnose and manage cases among physicians and nurses. Raising the awareness about the disease is needed urgently considering the rapid escalation in the number of cases worldwide with reported cases in the Middle East. The attitude towards male homosexuals' role in HMPX spread necessitates proper intervention measures to prevent stigma and discrimination among this risk group. The adoption of conspiratorial beliefs regarding virus emergence was widely prevalent and this issue needs to be addressed with proper and accurate knowledge considering its potential harmful impact. [ABSTRACT FROM AUTHOR]

• A climate and nature crisis have been postulated to threat global health. • It is indicated that the present-day climate change does not represent a crisis. • The nature crisis is not a consequence of climate change but of overpopulation. • Measures to counteract climate change and biodiversity decline are not effective. • Counteracting overpopulation should, instead, have the highest medical priority. [ABSTRACT FROM AUTHOR]

Background : Public Health Emergencies (PHE) demand expeditious research responses to evaluate new or repurposed therapies and prevention strategies. Alternative Design Trials (ADTs) and Adaptive Platform Trials (APTs) have enabled efficient large-scale testing of biomedical interventions during recent PHEs. Design features of these trials may have implications for engagement and/or informed consent processes. We aimed to rapidly review evidence on engagement and informed consent for ADTs and APTs during PHE to consider what (if any) recommendations can inform practice. Method : In 2022, we searched 8 prominent databases for relevant peer reviewed publications and guidelines for ADTs/APTs in PHE contexts. Articles were selected based on pre-identified inclusion and exclusion criteria. We reviewed protocols and informed consent documents for a sample of large platform trials and consulted with key informants from ADTs/APT trial teams. Data were extracted and summarised using narrative synthesis. Results : Of the 49 articles included, 10 were guidance documents, 14 discussed engagement, 10 discussed informed consent, and 15 discussed both. Included articles addressed ADTs delivered during the West African Ebola epidemic and APTs delivered during COVID-19. PHE clinical research guidance documents highlight the value of ADTs/APTs and the importance of community engagement, but do not provide practice-specific guidance for engagement or informed consent. Engagement and consent practice for ADTs conducted during the West African Ebola epidemic have been well-documented. For COVID-19, engagement and consent practice was described for APTs primarily delivered in high income countries with well-developed health service structures. A key consideration is strong communication of the complexity of trial design in clear, accessible ways. Conclusion : We highlight key considerations for best practice in community engagement and informed consent relevant to ADTs and APTs for PHEs which may helpfully be included in future guidance. Protocol : The review protocol is published online at Prospero on 15/06/2022: registration number CRD42022334170., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Davies A et al.)