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Authors: Cameron Smith, Emily M. H. Woerner, Alan Leslie, Benjamin Beale, Kelly Nichols, Shannon Dill, Sarah Hirsh, Jeff Semler, Andrew Kness, Jack Keane, Marina Costa, Julie Yang, Raul Cruz-Cano, Andrew Lazur, Rachel Rosenberg Goldstein

Over 43 million individuals in the United States use private wells for drinking water, but these wells are not regulated by the Safe Drinking Water Act. Unmaintained private wells on farms could become contaminated from pathogens from various potential sources including on-farm animal waste. Microbial contaminants in private wells could increase infectious disease risks among well users, therefore it is important to conduct well water testing and keep a well maintained system. We distributed surveys and collected water samples from private wells that supply drinking water on farms from all seven regions of Maryland. Our objective was to evaluate the presence of total coliforms and E. coli in private wells and the impact of well, geographic, and precipitation factors on the bacterial contamination risk. Eighty-four water samples were collected from 79 private wells on farms across Maryland. Samples were analyzed for total coliforms and E. coli with U.S. EPA Method 1604. Data were analyzed using Fisher’s Exact test and logistic regression. Forty-three percent (34/79) of the sampled wells were positive for total coliforms and 10% (8/79) were positive for E. coli. Total coliform presence was significantly associated with county (p = 0.02), region (p < 0.01), and well condition description (p = 0.02). E. coli presence was significantly associated with region (p < 0.01), geological province type (p < 0.01), county (p = 0.04), and wellhead cover type (p = 0.03). Based on the multivariable logistic regression, wells that were described as being in okay or fair condition had significantly lower odds of total coliforms compared to wells described as being in good or excellent condition (p = 0.03), suggesting a lack of understanding about actual well conditions. There was a significant decrease in the odds of E. coli presence as precipitation levels 14 days prior to sampling increased (p = 0.02). These results emphasize the importance of private well water testing, particularly for farmers.

Source: PLOS Water. DOI: 10.1371/journal.pwat.0000636. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Emmanuel Oloche Otukpa, Abdhalah K. Ziraba, Luchuo Engelbert Bain

Co-creation is widely advocated in global health research and inconsistently practiced. This paper offers a reflective, practice-based synthesis of two decades of co-created research, policy engagement and advocacy at the African Population and Health Research Center (APHRC).We define co-creation through four dimensions; shared agenda setting, joint knowledge production, power sharing, and community leadership and ownership. We distinguish it from consultation, stakeholder engagement and partnership, and assess each dimension on a graded scale. To this we add a second axis: the reach of co-creation across the research-to-policy-to-advocacy interface, and the condition of the transitions between its segments. Six cases spanning evidence generation, policy processes, capacity strengthening and rights-based advocacy are assessed against both axes. Three findings emerge. Co-creation in this institution’s practice is substantive where knowledge is produced and weak where authority is held. Agendas were substantively shared in four of six cases and financial resources in none. It fails at the transitions between research, policy engagement and advocacy rather than within them, at moments that were neither designed nor evaluated nor recorded. And the domains of co-creation differ systematically in the dimensions they can realize, with community leadership substantive only in rights-based advocacy. We draw practice guidance on governance, funding, community roles, transitions and assessment, and state what a single-institution insider synthesis cannot establish.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0007405. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Webster Mavhu, Jermaine M. Dambi, Victoria Simms, Faith Martin, Joni Lariat, Rufaro Mbundure, Leviticus Makoni, Laura Kafata, Carol Wogrin, Vivian Chitiyo, Abigail Mutsinze, Frances M. Cowan, Nicola Willis, Sarah Bernays

Adolescents living with HIV (ALHIV) in Eastern and Southern Africa experience challenges around medication adherence, mental health and wellbeing. Although interventions such as Zvandiri aim to strengthen mental health and wellbeing to impact HIV treatment outcomes, available measures often focus on negative outcomes or rely on positive psychology instruments developed in high-income settings. These tools may not adequately capture culturally embedded and relational dimensions of wellbeing. We describe the development of the Zvandiri Character Strength (ZCS) scale and draw methodological lessons for culturally grounded wellbeing measurement. The multi-stage scale-development process (2022–2025) comprised a scoping and systematic review, qualitative discussions, expert panel input, construct and item prioritisation, cognitive interviews, iterative item reduction, and exploratory factor and Rasch analyses. We reduced an initial item bank to a 53-item candidate scale, then to the ZCS 38 (38 items) and finally, the ZCS 25 (25 items), based on quantitative analyses and participant feedback. We subsequently assessed the ZCS 25 using retrospective pretest, post-test and follow-up administration. The review identified conceptually overlapping positive psychological constructs, many of which are measured using instruments developed in high-income settings and not adequately validated for ALHIV in Africa. Qualitative work highlighted connectedness, hope, self-acceptance, self-efficacy, purpose, and flourishing as key. Discussions also highlighted that wellbeing was relational, contextually situated, and often co-occurring with distress. Quantitative testing showed highly positive responses, disordered thresholds, ceiling effects, weak internal structure, and fluctuating retrospective ratings. Participant feedback suggested that positive responses likely reflected affirmations, and were partly linked to social desirability. In conclusion, the ZCS scale did not support a single interpretable total score, but its development offers important methodological lessons. Future measurement should begin with clearer construct definition, response-process validation, domain-level testing and explicit decisions about whether the measure aims to capture lived wellbeing, domain-specific positive outcomes or intervention-relevant change.

Source: PLOS Global Public Health. DOI: 10.1371/journal.pgph.0006845. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Pono Pono, Alan M. Jones

Climate change and air pollution affect every major organ system, altering both the disease burden and patient responses to pharmaceutical treatments. However, current knowledge on how health systems, patients, healthcare professionals, and governments should prepare for these challenges remains fragmented. This review synthesises evidence on the potential impact of climate change on human health and pharmaceuticals, with the aim of identifying the diseases, populations, and medications most vulnerable, and assessing potential implications for pharmacotherapy. Emerging evidence shows that climate-related stressors, particularly extreme heat, contribute to increased morbidity and mortality and exacerbation of diseases affecting cardiovascular, cerebrovascular, gastrointestinal, renal, and respiratory systems. Furthermore, the review found that high temperature and humidity can affect drug stability, bioavailability, and pharmacokinetics by degrading active pharmaceutical ingredients and altering pharmaceutical formulations, potentially reducing efficacy and increasing the risk of adverse drug events. Older adults, patients with chronic diseases, and those taking medications that impair the thermoregulatory system are particularly at higher risk. In addition, extreme weather events may also disrupt pharmaceutical supply chains, further threatening access to essential medicines. This review finds that climate change has implications for healthcare through increasing disease burden and affecting the effectiveness and safety of medicines. Therefore, there is an urgent need for integrated research to explore the interplay between climate change, therapeutic response, and drug safety to support resilient, climate‑ready healthcare systems.

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001068. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Shonali Pachauri, Elina Brutschin, Mathew J. Gidden, Tomoko Hasegawa, Mohamad Hejazi, Kejun Jiang, Jarmo S. Kikstra, Volker Krey, William F. Lamb, Kian Mintz-Woo, Alexander Nauels, Setu Pelz, Joeri Rogelj, Joyashree Roy, Roberto Schaeffer, Karl Scheifinger, Youba Sokona, Massimo Tavoni, Bas van Ruijven, Adriano Vinca, Saritha Sudharmma Vishwanathan, Caroline Zimm, Keywan Riahi

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001079. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Fred Tusabe, Sarah Lebu, Musa Manga

Climate change is intensifying rainfall extremes and urban flooding, amplifying public health risks in settings with fragile sanitation and drainage systems. In dense urban informal settlements, floods can overwhelm onsite sanitation and fecal sludge management systems, causing pit inundation, latrine overflow or collapse, and contamination of household environments and water sources. These conditions increase fecal exposure and can amplify cholera risk, particularly where water supply is intermittent and households depend on unsafe sources. Using Lusaka, Zambia as an illustrative case, this essay illustrates flood-driven sanitation failure modes and the feedback loops that can sustain exposure and delay recovery. Lessons from prolonged cholera epidemics in fragile water and sanitation settings underscore that emergency response tools can suppress transmission, but long-term durability depends on sustained investment in safe water and sanitation services and reliable surveillance. Building on recent calls for climate-resilient sanitation, this essay frames sanitation functionality during floods as a core component of epidemic preparedness in LMIC cities, with priorities including flood-resilient containment and fecal sludge services, management of shared sanitation facilities (clear responsibility, cleaning and maintenance systems), routine maintenance and supply-chain reliability, community-engaged early warning and response, and monitoring systems that link service and environmental indicators to health outcomes.

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001082. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Jason P. Evans, Marcus Thatcher, Daniel Argüeso, Alejandro Di Luca, Ralph Trancoso, Julia Andrys, Sarah Chapman, Giovanni Di Virgilio, Andrew Dowdy, Lluís Fita, Peter B. Gibson, Michael Grose, Emma Howard, Fei Ji, Jatin Kala, Jack Katzfey, Leena Khadke, Omer Mughal, Benjamin Ng, Neelesh Rampal, Christian Stassen, Stephen J. Stuart, Chun Hsu Su, Jozef Syktus, Son C. H. Truong, Harvey Ye

Regional climate modelling plays a central role in understanding and projecting climate change across Australasia, a region characterised by complex topography, diverse climate regimes, and high exposure to climate extremes. Over the past fifteen years, CORDEX-Australasia has coordinated regional climate downscaling under an international framework while operating alongside complementary national and state-based initiatives. Here we synthesise the evolution, achievements, scientific advances, applications, and future priorities of regional climate modelling in the region. Successive CORDEX-CMIP5 and CORDEX-CMIP6 ensembles have produced the largest coordinated high-resolution projection datasets for Australasia. Regional climate models demonstrate clear added value over their driving global climate models, particularly in representing temperature extremes, heavy precipitation, coastal processes, and complex terrain. CMIP6-based projections show robust agreement on substantial 21st-century warming, with uncertainty dominated by emissions scenarios, while precipitation responses remain more regionally heterogeneous. Advances in convection-permitting modelling, benchmarking frameworks, and bias-correction methods have further improved process representation and evaluation. Regional projections now underpin applications in water resources, agriculture, disaster risk reduction, energy, health, and national climate services. Progress has been supported by shared infrastructure through the National Computational Infrastructure and strengthened coordination via the National Partnership for Climate Projections, highlighting strong synergies between State and Federal programs contributing to CORDEX. Key challenges remain including computational demands, persistent model biases, precipitation uncertainty, ensemble design, and translating complex multi-model information into decision-ready guidance. Strategic priorities include kilometre-scale (convection-permitting) modelling, enhanced Earth system coupling, coordinated super-ensembles, responsible integration of artificial intelligence approaches, strengthened observational constraints, and expanded support for vulnerable remote Australian islands and Pacific Island nations. Sustained investment, collaboration, and innovation will be essential to deliver robust, high-resolution climate information for adaptation and resilience across Australasia.

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001066. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: John Chung-En Liu, Genet Yan Hang Yu

Gender scholarship has shown that climate governance is deeply shaped by social inequalities in voice, authority, and participation. Building on this insight, we examine sustainability conferences as key arenas where climate expertise is publicly staged and legitimised. We treat speaker composition at sustainability forums as a diagnostic indicator of how climate governance allocates visibility and authority. Using an original dataset of 976 speaker appearances across 61 conferences held in Taiwan between July and December 2024, we examine gender representation by speaking role, organiser type, and thematic focus. Women accounted for only 25.9% of speakers overall, with particularly low representation in climate and energy transition sessions (15.9%). Female visibility was higher in government-organised events and equity-focused sessions but remained limited across all categories. These findings reveal a persistent gendered division of expertise within Taiwan’s climate governance landscape. We argue that speaker composition offers a useful diagnostic indicator of how visibility and public recognition are distributed in sustainability governance arenas. The analysis illustrates how gender-composition mapping can be used to assess inclusivity in hybrid governance arenas beyond formal institutions.

Source: PLOS Sustainability and Transformation. DOI: 10.1371/journal.pstr.0000293. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.

Authors: Kobe Vandelanotte, Bram Du Moulin, Siebe Puynen, Thomas Vergauwen, Sara Top, Steven Caluwaerts

Heat stress is an increasing concern as climate change drives more frequent and intense extreme heat episodes. In particular, participants in outdoor endurance events face a high risk of heat stress related health issues due to prolonged exposure to heat and physical exertion. The Wet Bulb Globe Temperature (WBGT) is a widely used ISO-standard heat stress index that integrates air temperature, humidity, wind speed, and radiation (both shortwave and longwave) to assess heat stress. Meteorological heat stress metrics such as WBGT can be used to activate heat management plans and to guide or evaluate heat mitigation strategies. To this end, we present a modelling system that combines a numerical weather prediction (NWP) model with a micro-scale radiation model to simulate meter-scale heat stress. We conducted a mobile measurement campaign to collect spatio-temporal WBGT data along the 2024 Dodentocht, a 100-km ultra-endurance hiking event in Belgium. These observations were used to evaluate the modelling system, which demonstrated a reasonable approximation of the observed WBGT along the route and was able to capture some local shade-induced cooling effects. Finally, we used the modelling system as an adaptation tool to simulate various event-management scenarios, including alternative start times, routes, and walking speeds. For the 2024 Dodentocht, starting 3 hours earlier, at 18:00 local time (UTC + 2), would have reduced the cumulative heat-stress exposure, measured as degree hours above 20∘C WBGT, by 35%. The 2023 route exhibited 16.5% more cumulative degree hours above 20∘C WBGT than the 2024 route for the official 21:00 start time under identical meteorological conditions. Our findings demonstrate the potential of high-resolution heat stress modelling systems as reliable and actionable tools to support the development and implementation of effective heat management strategies for outdoor endurance events.

Source: PLOS Climate. DOI: 10.1371/journal.pclm.0001058. Abstract from the publisher’s feed; HTML formatting and repeated author line removed.