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From Invisibility to Inclusion: Evidence, Lived Experience, and Policy Directions for Multiple Chemical Sensitivity Report from the Resilience 2025 International Conference

Int. J. Environ. Res. Public Health 2026, 23(3), 280; https://doi.org/10.3390/ijerph23030280

Organized by the Environmental Health Association of Canada (EHAC-ASEC) and the Environmental Health Association of Quebec (ASEQ-EHAQ), Resilience: An International Conference on Multiple Chemical Sensitivity, a groundbreaking event, was held online over two days, on 1 and 2 May 2025, and brought together experts and stakeholders from multiple sectors to address a condition that has received limited attention in health, policy and research contexts. The conference convened leading international researchers, legal experts, medical professionals, policymakers, and advocates to examine one of the most pressing but under-represented public health and human rights challenges of our time. Multiple Chemical Sensitivity (MCS) is a disabling condition affecting a growing number of individuals globally. Despite its prevalence, MCS remains marginalized and under-recognized in healthcare systems, policy frameworks, and scientific discourse. The conference spanned 2 days, drew nearly 900 participants, and featured engaging presentations and discussions that integrated scientific evidence, lived experience, and cross-sector perspectives. A central theme emerged: recognition of MCS extends beyond medical considerations, encompassing accessibility, gender equity, environmental justice and human rights.
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Rehabilitation Engineering Research Center on Mobile Rehabilitation: State of the Science Conference Report—Future Directions for mRehab for People with Disabilities

Int. J. Environ. Res. Public Health 2025, 22(4), 532; https://doi.org/10.3390/ijerph22040532

This article summarizes proceedings of the State of the Science (SOS) Conference on Information and Communication Technology (ICT) Access for Mobile Rehabilitation, convened by the Rehabilitation Engineering Research Center on Mobile Rehabilitation (mRehab RERC), which is funded by the U.S. National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). The conference sought to assess the current state of the field and identify future research and development priorities for the field of mobile rehabilitation. The conference comprised four sessions addressing the following broad areas: (1) adherence to and effectiveness of home therapeutic exercise programs (HEPs); (2) technology for remote monitoring to support rehabilitation in the home and community (mRehab); (3) analytic techniques for using “big data” generated by remote monitoring to customize home exercise; and (4) barriers and facilitators to adoption of mRehab technology. Priorities for further research and development were identified using a three-stage process of gathering and refining expert opinions informed by the Delphi method for identifying future states in specific fields of inquiry. Results: Eight research and six technology development priorities were identified in the third and last stage of refinement of the initial set of priorities identified during the SOS Conference.
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AI in Biomedicine—A Forward-Looking Perspective on Health Equity

Int. J. Environ. Res. Public Health 2024, 21(12), 1642; https://doi.org/10.3390/ijerph21121642

As new artificial intelligence (AI) tools are being developed and as AI continues to revolutionize healthcare, its potential to advance health equity is increasingly recognized. The 2024 Research Centers in Minority Institutions (RCMI) Consortium National Conference session titled “Artificial Intelligence: Safely, Ethically, and Responsibly” brought together experts from diverse institutions to explore AI’s role and challenges in advancing health equity. This report summarizes presentations and discussions from the conference focused on AI’s potential and its challenges, particularly algorithmic bias, transparency, and the under-representation of minority groups in AI datasets. Key topics included AI’s predictive and generative capabilities in healthcare, ethical governance, and key national initiatives, like AIM-AHEAD. The session highlighted the critical role of RCMI institutions in fostering diverse AI/machine learning research and in developing culturally competent AI tools. Other discussions included AI’s capacity to improve patient outcomes, especially for underserved communities, and underscored the necessity for robust ethical standards, a diverse AI and scientific workforce, transparency, and inclusive data practices. The engagement of RCMI institutions is critical to ensure practices in AI development and deployment which prioritize health equity, thus paving the way for a more inclusive AI-driven healthcare system.
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Structural Racism and Obesity-Related Cancer Inequities in the United States: Challenges and Research Priorities

Int. J. Environ. Res. Public Health 2024, 21(8), 1085; https://doi.org/10.3390/ijerph21081085

Structural racism has been identified as a fundamental cause of health disparities. For example, racial, ethnic, and economic neighborhood segregation; concentrated poverty; community disinvestment; and sociocultural context influence obesity and cancer disparities. Effects of structural racism are also evident through neighborhood obesogenic conditions such as limited access to affordable and healthy foods and physical activity opportunities within segregated communities that contribute to obesity and obesity-related cancer disparities. This article describes and expands on cross-cutting themes raised during a webinar held by the National Cancer Institute (NCI): (1) how structural factors, including neighborhood segregation and obesogenic conditions within racial and ethnic disadvantaged communities, influence disparities in the United States; (2) current research challenges and best ways to address them; and (3) selected priorities of the NCI aimed at addressing multilevel and intersecting factors that influence obesity-related cancer disparities. Further research is needed to understand how residential segregation and neighborhood obesogenic conditions influence cancer prevention and control across the continuum. Identifying the best approaches to address obesity and cancer disparities using social determinants of health framework and community-engaged approaches guided by a structural racism lens will allow researchers to move beyond individual-level approaches.
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Identifying Future Study Designs for Mental Health and Social Wellbeing Associated with Diets of a Cohort Living in Eco-Regions: Findings from the INSUM Expert Workshop

Int. J. Environ. Res. Public Health 2023, 20(1), 669; https://doi.org/10.3390/ijerph20010669

Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project “Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions” (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions.
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Stress across the Lifespan: From Risk to Management—Conference Report on the Inaugural Canadian Stress Research Summit

Int. J. Environ. Res. Public Health 2022, 19(17), 11015; https://doi.org/10.3390/ijerph191711015

In 2021, the Toronto Metropolitan University Institute for Stress and Wellbeing Research welcomed over 200 conference delegates across Canada to the inaugural Canadian Stress Research Summit (CSRS) to share ideas and foster collaboration among Canadian scholars. This conference was unique from existing international stress-related conferences as it bridged science and community. The objective of this conference report is to provide an overview of the 3-day virtual inaugural stress conference, offering a summary of the keynote addresses, themed symposia, spotlight presentations, graphical designs of selected presentations, and conference feedback. Overall, the CSRS highlighted important methodological considerations in understanding the relationship between stress exposure and various outcomes of interest that pertain to the mental health and wellbeing of Canadians. Furthermore, there is a need for continued work to understand stress across the lifespan from an inclusive and diverse Canadian lens.
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Partnership for International Development: Finland-Nigeria Conference on Climate, Food, Health and Entrepreneurship

Int. J. Environ. Res. Public Health 2022, 19(6), 3375; https://doi.org/10.3390/ijerph19063375

A joint collaboration between the Arctic Centre of the University of Lapland, Finland and the Federal Institute of Industrial Research, Oshodi, Lagos, Nigeria was organised as a hybrid conference on several topics that are related to climate, food, health and entrepreneurship. The utilisation of natural resources in both regions is an important theme in meeting the sustainable development goals agenda. The topics discussed were multidisciplinary, they include Nigerian indigenous foods, bioeconomy, circular economy, nutrition, health, innovation and entrepreneurship under four themes (Climate, Food, Health and Entrepreneurship). There were dignitaries from Finland and Nigeria. The presenters are researchers from Nigerian universities (University of Ibadan, University of Abuja and Eko university, Lagos), Nigerian Federal Institute of Industrial research centre and from the Finnish side we have the university of Lapland, Rovaniemi, University of Oulu, Oulu and the Centria University of Applied Sciences, Kokkola. The topics discussed will serve as training materials for students and learners, the discussion focussed on research opportunities for institutions in both countries. The experts from both countries will continue to dialogue on the possibility of promoting common topics as research agenda in these important areas with the possibilities of creating more jobs.
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Project Earthrise: Proceedings of the Ninth Annual Conference of inVIVO Planetary Health

Int. J. Environ. Res. Public Health 2021, 18(20), 10654; https://doi.org/10.3390/ijerph182010654

The “Earthrise” photograph, taken on the 1968 Apollo 8 mission, became one of the most significant images of the 20th Century. It triggered a profound shift in environmental awareness and the potential for human unity—inspiring the first Earth Day in 1970. Taking inspiration from these events 50 years later, we initiated Project Earthrise at our 2020 annual conference of inVIVO Planetary Health. This builds on the emergent concept of planetary health, which provides a shared narrative to integrate rich and diverse approaches from all aspects of society towards shared solutions to global challenges. The acute catastrophe of the COVID-19 pandemic has drawn greater attention to many other interconnected global health, environmental, social, spiritual, and economic problems that have been underappreciated or neglected for decades. This is accelerating opportunities for greater collaborative action, as many groups now focus on the necessity of a “Great Transition”. While ambitious integrative efforts have never been more important, it is imperative to apply these with mutualistic value systems as a compass, as we seek to make wiser choices. Project Earthrise is our contribution to this important process. This underscores the imperative for creative ecological solutions to challenges in all systems, on all scales with advancing global urbanization in the digital age—for personal, environmental, economic and societal health alike. At the same time, our agenda seeks to equally consider our social and spiritual ecology as it does natural ecology. Revisiting the inspiration of “Earthrise”, we welcome diverse perspectives from across all dimensions of the arts and the sciences, to explore novel solutions and new normative values. Building on academic rigor, we seek to place greater value on imagination, kindness and mutualism as we address our greatest challenges, for the health of people, places and planet.
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Policy Implications for Protecting Health from the Hazards of Fire Smoke. A Panel Discussion Report from the Workshop Landscape Fire Smoke: Protecting Health in an Era of Escalating Fire Risk

Int. J. Environ. Res. Public Health 2021, 18(11), 5702; https://doi.org/10.3390/ijerph18115702

Globally, and nationally in Australia, bushfires are expected to increase in frequency and intensity due to climate change. To date, protection of human health from fire smoke has largely relied on individual-level actions. Recent bushfires experienced during the Australian summer of 2019–2020 occurred over a prolonged period and encompassed far larger geographical areas than previously experienced, resulting in extreme levels of smoke for extended periods of time. This particular bushfire season resulted in highly challenging conditions, where many people were unable to protect themselves from smoke exposures. The Centre for Air pollution, energy and health Research (CAR), an Australian research centre, hosted a two-day symposium, Landscape Fire Smoke: Protecting health in an era of escalating fire risk, on 8 and 9 October 2020. One component of the symposium was a dedicated panel discussion where invited experts were asked to examine alternative policy settings for protecting health from fire smoke hazards with specific reference to interventions to minimise exposure, protection of outdoor workers, and current systems for communicating health risk. This paper documents the proceedings of the expert panel and participant discussion held during the workshop.
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Progress towards the Development of Research Agenda and the Launch of Knowledge Hub: The WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN)

Int. J. Environ. Res. Public Health 2021, 18(9), 4959; https://doi.org/10.3390/ijerph18094959

In response to the increasing burden of recent health emergencies and disasters, the World Health Organization (WHO) and its partners established the WHO thematic platform for health emergency and disaster risk management research network (health EDRM RN) in 2016, with the purposes of promoting global research collaboration among various stakeholders and enhancing research activities that generate evidence to manage health risks associated with all types of emergencies and disasters. With the strong support and involvement of all WHO regional offices, the health EDRM RN now works with more than 200 global experts and partners to implement its purposes. The 1st and 2nd Core Group Meetings of the health EDRM RN were held on 17–18 October 2019 and 27 November 2020, respectively, to discuss the development of a global research agenda that the health EDRM RN will focus on facilitating, promoting, synthesizing and implementing, taking into account the emergence of the coronavirus disease 2019 (COVID-19) (health EDRM RN research agenda). A focus of the meetings was the establishment of an online platform to share information and knowledge, including the databases that the health EDRM RN accumulates (WHO health EDRM knowledge hub). This paper presents a summary of the discussion results of the meetings.
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Expected Scopes of Health Emergency and Disaster Risk Management (Health EDRM): Report on the Expert Workshop at the Annual Conference for the Japanese Association for Disaster Medicine 2020

Int. J. Environ. Res. Public Health 2021, 18(9), 4447; https://doi.org/10.3390/ijerph18094447

The World Health Organization (WHO) and its partners established the WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (HEALTH EDRM RN) in 2016 to respond to the increasing burden of recent health emergencies and disasters. The mission of the HEALTH EDRM RN, whose secretariat is located at the WHO Kobe Centre (WKC), is to promote global research collaboration and strengthen research activities to inform policies and programs by generating new evidence to manage health risks associated with all types of emergencies and disasters. With the strong support and involvement of all WHO regional offices, the HEALTH EDRM RN now works with more than 200 global experts and partners to pursue its mission. The first Core Group Meetings of the HEALTH EDRM RN were held on 17–18 October 2019, and concluded with the HEALTH EDRM RN-activity priorities to (1) promote operational research to better meet the needs of emergency- and disaster-exposed individuals and communities and efforts to translate science to policies and programs and (2) strengthen the research capacity of the Health EDRM community. In collaboration with the Japanese Association for Disaster Medicine, the WKC held a workshop on 21 February 2020, in which 20 Japanese experts from different research fields participated to further discuss these two points. This paper summarizes the discussion at the workshop.
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Report of Alliance of International Science Organizations on Disaster Risk Reduction (ANSO-DRR) Conference 2020

Int. J. Environ. Res. Public Health 2020, 17(23), 8772; https://doi.org/10.3390/ijerph17238772

This article summarizes the proceedings of the four-session meeting (webinar) conducted by the Alliance of International Science Organizations on Disaster Risk Reduction (ANSO-DRR) on 18 May 2020. ANSO-DRR is an international, nonprofit and nongovernmental scientific alliance bringing together academies of science, research organizations and universities which share a strong interest in disaster risk reduction in the regions along the land-based and maritime routes of the Belt and Road Initiative. ANSO-DRR convenes an annual meeting to review its work progress and discuss its scientific programs. The first session was the opening statements and was followed by the introduction and updates on ANSO-DRR in the second session. The third session was the depiction of the big picture of ANSO, the umbrella organization of ANSO-DRR, led by the Assistant Executive Director of ANSO, while the fourth session was a presentation of perspectives on the strategic development of ANSO-DRR. One of ANSO-DRR’s key strategies is to enhance disaster mitigation and response through multidisciplinary cooperation among disaster and healthcare sciences (i.e., health emergency and disaster risk management (Health-EDRM)). It aims to enhance DRR efforts by performing as an instrument in connecting people along the Belt and Road regions, focusing on DRR resource and database development, involving higher education institutions in DRR efforts and increasing disaster resilience in built infrastructures.
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Recent Advances in Health Impact Assessment and Health in All Policies Implementation: Lessons from an International Convening in Barcelona

Int. J. Environ. Res. Public Health 2020, 17(21), 7714; https://doi.org/10.3390/ijerph17217714

Health Impact Assessment (HIA) and Health in All Policies (HiAP) are policy tools used to include health considerations in decision-making processes across sectors such as transportation, education, and criminal justice that can play a role in improving health and equity. This article summarizes proceedings from an international convening of HIA and HiAP experts held in July 2019 in Barcelona, Spain. The presentations and panel discussions included different models, best practices, and lessons learned, including from government, international banks, think tanks, and academia. Participants discussed ideas from around the world for cross-sector collaboration to advance health. The convening covered the following topics: community engagement, building greater understanding of and support for HiAP, and exploring how mandates for HIA and HiAP approaches may advance health and equity.
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A Review of Maternal Nutrition during Pregnancy and Impact on the Offspring through Development: Evidence from Animal Models of Over- and Undernutrition

Int. J. Environ. Res. Public Health 2020, 17(18), 6926; https://doi.org/10.3390/ijerph17186926

Similarities in offspring phenotype due to maternal under- or over-nutrition during gestation have been observed in studies conducted at University of Wyoming. In these studies, ewes were either nutrient-restricted (NR) from early to mid-gestation, or fed an obesogenic diet (MO) from preconception through term. Offspring necropsies occurred at mid-gestation, late-gestation, and after parturition. At mid gestation, body weights of NR fetuses were ~30% lighter than controls, whereas MO fetuses were ~30% heavier than those of controls. At birth, lambs born to NR, MO, and control ewes exhibited similar weights. This was a consequence of accelerated fetal growth rates in NR ewes, and reduced fetal growth rates in MO ewes in late gestation, when compared to their respective controls. These fetal growth patterns resulted in remarkably similar effects of increased susceptibility to obesity, cardiovascular disease, and glucose intolerance in offspring programmed mostly during fetal stages of development. These data provide evidence that maternal under- and over-nutrition similarly induce the development of the same cadre of physical and metabolic problems in postnatal life.
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Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

Int. J. Environ. Res. Public Health 2020, 17(16), 5998; https://doi.org/10.3390/ijerph17165998

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended.
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Peri-implant Soft Tissue Management: Cairo Opinion Consensus Conference

Int. J. Environ. Res. Public Health 2020, 17(7), 2281; https://doi.org/10.3390/ijerph17072281

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4–6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.
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Improving Education and Training to Reduce the Burden of Occupational Cancer. The Riga-European Association of Schools of Occupational Medicine (EASOM) Statement on Work-Related Cancer

Int. J. Environ. Res. Public Health 2020, 17(7), 2279; https://doi.org/10.3390/ijerph17072279

Reducing the burden of occupational cancers (OCs) is currently one of the most challenging Occupational Health (OH) issues. The European Union (EU) has made efforts to improve the existing legal framework and developed specific legislation aimed at reducing the burden of OC. However, available data suggest that OC are underreported. In August 2019, the European Association of Schools of Occupational Medicine (EASOM) adopted a statement that highlighted the importance of improving the education and training of Medical Doctors (MDs) to facilitate improvements in recognizing and reporting OC. To achieve this, EASOM proposes to promote OH education and training of MDs at undergraduate and postgraduate levels, foster harmonization of OH education and teaching standards and programs across EU countries, and enhance cooperation between universities and international scientific associations. Finally, we suggest that occupational data should be recorded in cancer and medical registers. By engaging MDs more fully in the debate about OCs, they will become more aware of the Occupational Physician’s role in reducing the burden of OCs and, furthermore, embed consideration of occupation as a potential cause of cancer into their own practice. These interventions will help promote the implementation of policies and interventions aimed to reduce OC in the workplace.
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Geneva Health Forum: The Forum of Innovative Practices in Global Health

Int. J. Environ. Res. Public Health 2020, 17(5), 1517; https://doi.org/10.3390/ijerph17051517

In the past years, Global Health has interfaced with important challenges related to several dynamic changes. Technological progress, the digital revolution and the emergence of new actors in the field of health, increase the possibility of finding solutions to these unprecedented challenges. Starting from these assumptions, the idea of providing an adequate platform for good management of the health system has flowed into the creation of a meeting place that would allow a wide exchange of information, ideas sharing and proposals for new collaborations: the Geneva Health Forum (GHF). The GHF is a global health conference that aims to promote critical reflections and constructive debates on contemporary global health issues, thus influencing and informing policy formulation with experience from the field. The profile and impact of the Geneva Health Forum has grown year on year, establishing itself as a unique forum, ranging from more traditional sessions to innovative events.
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LiveWell RERC State of the Science Conference Report on ICT Access to Support Community Living, Health and Function for People with Disabilities

Int. J. Environ. Res. Public Health 2020, 17(1), 274; https://doi.org/10.3390/ijerph17010274

This article summarizes the proceedings of the three session State of the Science (SOS) Conference that was conducted by the Rehabilitation Engineering Research Center for Community Living, Health and Function (LiveWell RERC) in June 2019 in Toronto, Canada. RERCs customarily convene an SOS conference toward the end of their five-year funding cycle in order to assess the current state and identify potential future research, development, and knowledge translation efforts needed to advance their field. The first two sessions focused on the current and future state of information and communication technology (ICT) for mobile health (mHealth) and mobile rehabilitation (mRehab). The third session was a wide-ranging discussion of pressing needs for future research and development in the field. Several “big ideas” resulted from the discussion among participants in the SOS Conference that should inform the structure and operation of future efforts, including: (1) identifying active ingredients of interventions, (2) incorporating effective behavior-change techniques into all interventions, (3) including measures of social determinants of health in evaluation studies, (4) incorporating user-customizable features into technology solutions, and (5) ensuring “discoverability” of research and development outputs by stakeholders via structured and continuous outreach, education and training. Substantive areas of work include gaming and esports, the gamification of interventions for health and fitness, the cultivation of community supports, and continuous outreach and education wherever a person with a disability may live.
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Understanding Discomfort in Order to Appropriately Treat Fever

Int. J. Environ. Res. Public Health 2019, 16(22), 4487; https://doi.org/10.3390/ijerph16224487

Although national and international guidelines on the management of childhood and adolescent fever are available, some inadequate practices persist, both from parents and healthcare professionals. The main goal of bringing children’s temperature back to normal can lead to the choice of inappropriate drugs or non-necessary combination/alternation of antipyretic treatments. This behavior has been described in the last 35 years with the concept of fever-phobia, caused also by the dissemination of unscientific information and social media. It is therefore increasingly important that pediatricians continue to provide adequate information to parents in order to assess the onset of signs of a possible condition of the child’s discomfort rather than focusing only on temperature. In fact, there is no clear and unambiguous definition of discomfort in literature. Clarifying the extent of the feverish child’s discomfort and the tools that could be used to evaluate it would therefore help recommend that antipyretic treatment is appropriate only if fever is associated with discomfort.
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Eighth Annual Conference of inVIVO Planetary Health: From Challenges to Opportunities

Int. J. Environ. Res. Public Health 2019, 16(21), 4302; https://doi.org/10.3390/ijerph16214302

inVIVO Planetary Health (inVIVO) is a progressive scientific movement providing evidence, advocacy, and inspiration to align the interests and vitality of people, place, and planet. Our goal is to transform personal and planetary health through awareness, attitudes, and actions, and a deeper understanding of how all systems are interconnected and interdependent. Here, we present the abstracts and proceedings of our 8th annual conference, held in Detroit, Michigan in May 2019, themed “From Challenges, to Opportunities”. Our far-ranging discussions addressed the complex interdependent ecological challenges of advancing global urbanization, including the biopsychosocial interactions in our living environment on physical, mental, and spiritual wellbeing, together with the wider community and societal factors that govern these. We had a strong solutions focus, with diverse strategies spanning from urban-greening and renewal, nature-relatedness, nutritional ecology, planetary diets, and microbiome rewilding, through to initiatives for promoting resilience, positive emotional assets, traditional cultural narratives, creativity, art projects for personal and community health, and exploring ways of positively shifting mindsets and value systems. Our cross-sectoral agenda underscored the importance and global impact of local initiatives everywhere by contributing to new normative values as part of a global interconnected grass-roots movement for planetary health.
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Academic Response to Storm-Related Natural Disasters—Lessons Learned

Int. J. Environ. Res. Public Health 2018, 15(8), 1768; https://doi.org/10.3390/ijerph15081768

On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in Puerto Rico, Florida, and Texas. The presenters reviewed emergency response measures taken by their institutions to maintain community health care access and delivery, the storm-related impact on clinical and research infrastructure, and strategies to retain locally grown clinical expertise and translational science research talent in the aftermath of natural disasters. A longer-term perspective was provided through a comparative review of lessons learned by one New Orleans-based institution (now more than a decade post-storm) in the aftermath of Hurricane Katrina. Caring for the internal and external communities associated with each institution and addressing the health disparities exacerbated by storm-related events is one key strategy that will pay long-term dividends in the survival of the academic institutions and the communities they serve.
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Dental Providers’ Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology

Int. J. Environ. Res. Public Health 2017, 14(7), 767; https://doi.org/10.3390/ijerph14070767

The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the ‘Toward a Diagnosis-Driven Profession’ National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care.
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Ultrafine Particle Metrics and Research Considerations: Review of the 2015 UFP Workshop

Int. J. Environ. Res. Public Health 2016, 13(11), 1054; https://doi.org/10.3390/ijerph13111054

In February 2015, the United States Environmental Protection Agency (EPA) sponsored a workshop in Research Triangle Park, NC, USA to review the current state of the science one missions, air quality impacts, and health effects associated with exposures to ultraﬁne particles[1].[...]
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Fatigue Risk Management: A Maritime Framework

Int. J. Environ. Res. Public Health 2016, 13(2), 175; https://doi.org/10.3390/ijerph13020175

It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer’s role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this “poor compliance” trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue.
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SalHUD—A Graphical Interface to Public Health Data in Puerto Rico

Int. J. Environ. Res. Public Health 2016, 13(1), 18; https://doi.org/10.3390/ijerph13010018

Purpose: This paper describes SalHUD, a prototype web-based application for visualizing health data from Puerto Rico. Our initial focus was to provide interactive maps displaying years of potential life lost (YPLL). Methods: The public-use mortality file for year 2008 was downloaded from the Puerto Rico Institute of Statistics website. Data was processed with R, Python and EpiInfo to calculate years of potential life lost for the leading causes of death on each of the 78 municipalities in the island. Death records were classified according to ICD-10 codes. YPLL for each municipality was integrated into AtlasPR, a D3 Javascript map library. Additional Javascript, HTML and CSS programing was required to display maps as a web-based interface. Results: YPLL for all municipalities are displayed on a map of Puerto Rico for each of the ten leading causes of death and for all causes combined, so users may dynamically explore the impact of premature mortality. Discussion: This work is the first step in providing the general public in Puerto Rico with user-friendly, interactive, visual access to public health data that is usually published in numerical, text-based media.
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The Oglala Sioux Tribe CHOICES Program: Modifying an Existing Alcohol-Exposed Pregnancy Intervention for Use in an American Indian Community

Int. J. Environ. Res. Public Health 2016, 13(1), 1; https://doi.org/10.3390/ijerph13010001

Alcohol-exposed pregnancies are a health issue for many American Indian communities. The goal of this manuscript is to outline how an existing alcohol-exposed pregnancy prevention program with non-pregnant women (Project CHOICES) was modified to fit the needs and norms of an American Indian community. The Oglala Sioux Tribe CHOICES Program was developed and implemented using community feedback through initial meetings, reviewing materials, gathering input into recruitment and intervention logistics, and conducting interviews to evaluate the program. The intervention was implemented and has been enrolling non-pregnant American Indian women for the past several years. While data collection is ongoing, it has shown preliminary success in changing behaviors and in impacting how the community views the prevention of alcohol-exposed pregnancies. Overall, this study highlights the potential to expand this prevention program to other sites and with other populations, such as adolescents. By the end of this article, readers will comprehend the steps necessary to replicate such a program at other tribal and rural sites.
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U.S. Recreational Water Quality Criteria: A Vision for the Future

Int. J. Environ. Res. Public Health 2015, 12(7), 7752-7776; https://doi.org/10.3390/ijerph120707752

This manuscript evaluates the U.S. Recreational Water Quality Criteria (RWQC) of 2012, based upon discussions during a conference held 11–13 March 2013, in Honolulu, Hawaii. The RWQC of 2012 did not meet expectations among the research community because key recommended studies were not completed, new data to assess risks to bathers exposed to non-point sources of fecal indicator bacteria (FIB) were not developed, and the 2012 RWQC did not show marked improvements in strategies for assessing health risks for bathers using all types of recreational waters. The development of the 2012 RWQC was limited in scope because the epidemiologic studies at beach sites were restricted to beaches with point sources of pollution and water samples were monitored for only enterococci. The vision for the future is development of effective RWQC guidelines based on epidemiologic and quantitative microbial risk assessment (QMRA) studies for sewage specific markers, as well as human enteric pathogens so that health risks for bathers at all recreational waters can be determined. The 2012 RWQC introduced a program for states and tribes to develop site-specific water quality criteria, and in theory this approach can be used to address the limitations associated with the measurements of the traditional FIB.
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Detection of Pathogenic Escherichia coli in Samples Collected at an Abattoir in Zaria, Nigeria and at Different Points in the Surrounding Environment

Int. J. Environ. Res. Public Health 2015, 12(1), 679-691; https://doi.org/10.3390/ijerph120100679

Pathogenic Escherichia coli can be released with the wastes coming from slaughterhouses into the environment, where they can persist. We investigated the presence of diarrheagenic E. coli in specimens taken at an abattoir located in the Zaria region, Nigeria, in samples of water from the river Koreye, where the effluent from the abattoir spills in, and vegetable specimens taken at a nearby farm. All the isolated E. coli were assayed for the production of Shiga toxins (Stx) by using the Ridascreen verotoxin Immunoassay and by PCR amplification of genes associated with the diarrheagenic E. coli. Three strains from the rectal content of two slaughtered animals and a cabbage were positive for the presence of the Stx-coding genes. Additionally we have isolated one Enteroaggregative E. coli (EAggEC) from the abattoir effluent and two Subtilase-producing E. coli from the slaughterhouse’s effluent and a sample of carrots. Our results provide evidence that pathogenic E. coli can contaminate the environment as a result of the discharge into the environment of untreated abattoir effluent, representing a reservoir for STEC and other diarrheagenic E. coli favouring their spread to crops.
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Early Origins of Child Obesity: Bridging Disciplines and Phases of Development - September 30–October 1, 2010

Int. J. Environ. Res. Public Health 2012, 9(4), 1227-1262; https://doi.org/10.3390/ijerph9041227

This report summarizes a conference: “Early Origins of Child Obesity: Bridging Disciplines and Phases of Development”, held in Chicago on September 30–October 1, 2010. The conference was funded in part by the National Institutes of Health and the Williams Heart Foundation, to achieve the conference objective: forging a next-step research agenda related to the early origins of childhood obesity. This research agenda was to include working with an array of factors (from genetic determinants to societal ones) along a continuum from prenatal life to age 7, with an emphasis on how the developing child deals with the challenges presented by his/her environment (prenatal, parental, nutritional, etc.). The conference offered a unique opportunity to facilitate communication and planning of future work among a variety of researchers whose work separately addresses different periods in early life. Over the span of two days, speakers addressed existing, critical research topics within each of the most-studied age ranges. On the final day, workshops fostered the discussion needed to identify the highest priority research topics related to linking varied early factor domains. These are presented for use in planning future research and research funding.
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