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AirRater is a free environmental health smartphone app developed and available in Australia that collects individual health data and disseminates environmental hazard information to populations. Following previous evaluations with app users, the aim of this study was to better understand how clinicians, government agency and non-government advocacy group representatives perceive an app designed to reduce the impacts of environmental hazards on individual and public health. Nine government agency and non-government advocacy group representatives, along with 11 clinicians based in Australia participated in a semi-structured interview or focus group to explore perspectives on AirRater. Interview and focus group data were transcribed and analysed using the qualitative data analysis software NVivo. Results indicate that for clinicians, apps like AirRater can add value as an educational, patient self-management and diagnostic tool. For government and peak bodies, apps can add value by addressing environmental health literacy and monitoring and forecasting gaps, as well as supporting advocacy efforts and public health surveillance. We conclude that environmental health smartphone apps can support a range of stakeholders to achieve shared goals and priorities related to individual and public health outcomes. Further research is needed to better understand how apps could be embedded into clinical practice and policy settings.

A rapid phase-out of unabated coal use is essential to limit global warming to below 2 °C. This review presents a comprehensive assessment of coal transitions in mitigation scenarios consistent with the Paris Agreement, using data from more than 1500 publicly available scenarios generated by more than 30 integrated assessment models. Our ensemble analysis uses clustering techniques to categorize coal transition pathways in models and bridges evidence on technological learning and innovation with historical data of energy systems. Six key findings emerge: First, we identify three archetypal coal transitions within Paris-consistent mitigation pathways. About 38% of scenarios are ‘coal phase out’ trajectories and rapidly reduce coal consumption to near zero. ‘Coal persistence’ pathways (42%) reduce coal consumption much more gradually and incompletely. The remaining 20% follow ‘coal resurgence’ pathways, characterized by increased coal consumption in the second half of the century. Second, coal persistence and resurgence archetypes rely on the widespread availability and rapid scale-up of carbon capture and storage technology (CCS). Third, coal-transition archetypes spread across all levels of climate policy ambition and scenario cycles, reflecting their dependence on model structures and assumptions. Fourth, most baseline scenarios—including the shared socio-economic pathways (SSPs)—show much higher coal dependency compared to historical observations over the last 60 years. Fifth, coal-transition scenarios consistently incorporate very optimistic assumptions about the cost and scalability of CCS technologies, while being pessimistic about the cost and scalability of renewable energy technologies. Sixth, evaluation against coal-dependent baseline scenarios suggests that many mitigation scenarios overestimate the technical difficulty and costs of coal phase-outs. To improve future research, we recommend using up-to-date cost data and evidence about innovation and diffusion dynamics of different groups of zero or low-carbon technologies. Revised SSP quantifications need to incorporate projected technology learning and consistent cost structures, while reflecting recent trends in coal consumption.

BackgroundClimate change is projected to increase environmental health hazard risks through fire-related air pollution and increased airborne pollen levels. To protect vulnerable populations, it is imperative that evidence-based and accessible interventions are available. The environmental health app, AirRater, was developed in 2015 in Australia to provide information on multiple atmospheric health hazards in near real time. The app allows users to view local environmental conditions, and input and track their personal symptoms to enable behaviors that protect health in response to environmental hazards. ObjectiveThis study aimed to develop insights into users’ perceptions of engagement, comprehension, and trust in AirRater to inform the future development of environmental health apps. Specifically, this study explored which AirRater features users engaged with, what additional features or functionality needs users felt they required, users’ self-perception of understanding app information, and their level of trust in the information provided. MethodsA total of 42 adult AirRater users were recruited from 3 locations in Australia to participate in semistructured interviews to capture location- or context-specific experiences. Participants were notified of the recruitment opportunity through multiple avenues including newsletter articles and social media. Informed consent was obtained before participation, and the participants were remunerated for their time and perspectives. A preinterview questionnaire collected data including age range, any preexisting conditions, and location (postcode). All participant data were deidentified. Interviews were recorded, transcribed, and analyzed using thematic analysis in NVivo 12 (QSR International). ResultsParticipants discussed app features and functionality, as well as their understanding of, and trust in, the information provided by the app. Most (26/42, 62%) participants used and valued visual environmental hazard features, especially maps, location settings, and hazard alerts. Most (33/42, 78%) found information in the app easy to understand and support their needs, irrespective of their self-reported literacy levels. Many (21/42, 50%) users reported that they did not question the accuracy of the data presented in the app. Suggested enhancements include the provision of meteorological information (eg, wind speed or direction, air pressure, UV rating, and humidity), functionality enhancements (eg, forecasting, additional alerts, and the inclusion of health advice), and clarification of existing information (eg, symptom triggers), including the capacity to download personal summary data for a specified period. ConclusionsParticipants’ perspectives can inform the future development of environmental health apps. Specifically, participants’ insights support the identification of key elements for the optimal development of environmental health app design, including streamlining, capacity for users to customize, use of real time data, visual cues, credibility, and accuracy of data. The results also suggest that, in the future, iterative collaboration between developers, environmental agencies, and users will likely promote better functional design, user trust in the data, and ultimately better population health outcomes.

Background: The long-term health effects of bushfires include the potential to trigger new and exacerbate existing mental health problems. Objective: This review aimed to determine the prevalence of long-term mental health issues in Australian populations exposed to bushfires. Method: A systematic search was conducted in five databases (Embase, Medline, PsycINFO, Scopus, and Web of Science) to identify studies focusing on Australian populations impacted by bushfires with the prevalence of mental health issues reported at 2+ years after bushfire. The Joanna Briggs Institute prevalence critical appraisal tool was utilised. We conducted meta-analyses to determine the prevalence of general psychological distress in the general population, and a narrative synthesis. Results: We included 21 articles based on 5 studies and conducted on 3 bushfire events. Meta-analyses showed a pooled prevalence of 14% (95% CI 12%-16%) for psychological distress in the general population at 2–4 years post bushfire. The overall prevalence of long-term psychological problems in firefighters at 2–7 years ranged from 28% to 47.6%. The prevalence of some psychological issues decreased with time and was directly proportional to the level of bushfire impact. Conclusions: As the magnitude of long-term bushfire-related mental health impacts in Australia is severe, it is important to monitor psychological problems and assist communities in future. Future research needs include: (a) more studies on the full range of long-term psychological impacts of bushfires, and (b) consensus on instruments and diagnostic criteria to define mental health issues. HIGHLIGHTS First systematic review of long-term bushfire mental health issues in Australia. Indicating substantial mental health problems among affected populations. Long-term issues were linked to bushfire impact and elevated among firefighters. Highlighting need for further rigorous research on long-term disaster sequalae.

A rapid coal phase-out is needed to meet the goals of the Paris Agreement, but is hindered by serious challenges ranging from vested interests to the risks of social disruption. To understand how to organize a global coal phase-out, it is crucial to go beyond cost-effective climate mitigation scenarios and learn from the experience of previous coal transitions. Despite the relevance of the topic, evidence remains fragmented throughout different research fields, and not easily accessible. To address this gap, this paper provides a systematic map and comprehensive review of the literature on historical coal transitions. We use computer-assisted systematic mapping and review methods to chart and evaluate the available evidence on historical declines in coal production and consumption. We extracted a dataset of 278 case studies from 194 publications, covering coal transitions in 44 countries and ranging from the end of the 19th century until 2021. We find a relatively recent and rapidly expanding body of literature reflecting the growing importance of an early coal phase-out in scientific and political debates. Previous evidence has primarily focused on the United Kingdom, the United States, and Germany, while other countries that experienced large coal declines, like those in Eastern Europe, are strongly underrepresented. An increasing number of studies, mostly published in the last 5 years, has been focusing on China. Most of the countries successfully reducing coal dependency have undergone both demand-side and supply-side transitions. This supports the use of policy approaches targeting both demand and supply to achieve a complete coal phase-out. From a political economy perspective, our dataset highlights that most transitions are driven by rising production costs for coal, falling prices for alternative energies, or local environmental concerns, especially regarding air pollution. The main challenges for coal-dependent regions are structural change transformations, in particular for industry and labor. Rising unemployment is the most largely documented outcome in the sample. Policymakers at multiple levels are instrumental in facilitating coal transitions. They rely mainly on regulatory instruments to foster the transitions and compensation schemes or investment plans to deal with their transformative processes. Even though many models suggest that coal phase-outs are among the low-hanging fruits on the way to climate neutrality and meeting the international climate goals, our case studies analysis highlights the intricate political economy at work that needs to be addressed through well-designed and just policies.

Urgent and ambitious climate action is required to avoid catastrophic climate change and consequent health impacts. Political will is a critical component of the ambitious climate action equation. The current level of political will observed for many national governments is considered inadequate, with numerous political leaders yet to commit to climate action commensurate with the projected risks and responsibilities for their respective jurisdictions. Under the leadership of the Obama administration, however, the United States of America arguably provided an example to the contrary. Strategically utilising an available legislative lever, the Obama administration pursued comparatively ambitious climate change mitigation policies, with health as a core motivation. Analysis of Obama-led climate policies and policy-making strategies provides valuable insight into the utility of health as a motivator for climate action. It also reaffirms that strong political leadership constitutes an essential element in the pursuit of increasingly ambitious climate change policies, particularly in the face of strong opposition.