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Driven by the existential threats of climate change to planetary health, the United Nations Framework Convention on Climate Change (UNFCCC) established a mandate for National Adaptation Plans (NAPs) to facilitate adaptation planning in low- and middle-income countries. However, the extent to which NAPs consider health risks, particularly those affecting maternal and child health in the adaptation planning process, remains unexplored. Employing the READ approach for document analysis, this study assesses the thoroughness with which these risks were considered during the development and implementation of NAPs in selected Asia-Pacific countries: Cambodia, Nepal, Sri Lanka, and Timor-Leste. The findings reveal health is consistently identified as a high-priority sector vulnerable to climate change. Cambodia, Nepal, and Timor-Leste prioritized maternal and child health issues. Consequently, these countries have outlined a broader gender-based approach in their NAP development and implementation processes, addressing some of the maternal and child health threats posed by climate change. The findings underscore the need for enhanced efforts to prioritize reducing maternal and child health risks associated with climate change through effective interventions in national adaptation planning. This need could be met through evidence generation based on the maternal and child health impacts of climate change in under-represented countries. Additionally, the future development and updating of NAPs should involve a more comprehensive and diverse representation of women from various cultural and geographic backgrounds to prioritize the protection of maternal and child health in the climate change policy discourse.

Purpose To perform a comprehensive evaluation of eight adaptive radiation therapy strategies in the treatment of prostate cancer patients who underwent hypofractionated volumetric modulated arc therapy (VMAT) treatment. Material and methods The retrospective study included 20 prostate cancer patients treated with 40 Gy total dose over five fractions (8 Gy/fraction) using VMAT. Daily cone beam computed tomography images were acquired before the delivery of every fraction and then, with the application of deformable image registration used for the estimation of daily dose, contouring and plan re‐optimization. Dosimetric benefits of the various ART strategies were quantified by the comparison of dose and dose‐volume metrics derived from treatment planning objectives for original treatment plan and adapted plans with the consideration of target volumes (PTV and CTV) as well as critical structures (bladder, rectum, left, and right femoral heads). Results Percentage difference (ΔD) between planning objectives and delivered dose in the D99% > 4000cGy (CTV) metric was −3.9% for the non‐ART plan and 2.1% to 4.1% for ART plans. For D99% > 3800cGy and Dmax < 4280cGy (PTV), ΔD was −11.2% and −6.5% for the non‐ART plan as well as −3.9% to −1.6% and −0.2% to 1.8% for ART plans, respectively. For D15% < 3200 cGy and D20% < 2800 cGy (bladder), ΔD was −62.4% and −68.8% for the non‐ART plan as well as −60.0% to −57.4% and −67.0% to −64.0% for ART plans. For D15% < 3200 cGy and D20% < 2800 cGy (rectum), ΔD was −11.4% and −8.15% for non‐ART plan as well as −14.9% to −9.0% and −11.8% to −5.1% for ART plans. Conclusions Daily on‐line adaptation approaches were the most advantageous, although strategies adapting every other fraction were also impactful while reducing relative workload as well. Offline treatment adaptations were shown to be less beneficial due to increased dose delivered to bladder and rectum compared toother ART strategies.

Progressing climate change significantly affects the quality of life in cities. The related changes in the rainfall structure lead to an increased frequency of extreme hydrological phenomena such as droughts and floods. The increasing intensity of rainfall is a particular threat to urbanised areas, where due to the high degree of area sealing, an increase in runoff volumes and peak flow rate is observed. Storm water drainage systems are often not adapted to accommodate increased rainwater flows, which leads to the so-called urban floods. On the other hand, prolonged periods without precipitation may, in turn, lead to periodic water shortages. Cities must implement a climate change adaptation strategy. One of the solutions for rational rainwater management is the implementation of Blue-Green Infrastructure. These facilities are a modern solution supporting the sewage networks operation, water retention, and improving the quality of life in cities. The article presents the literature review on the current state of knowledge about Blue-Green Infrastructure and the implementation stage of these solutions in the world. Solutions that are newly introduced, not necessarily newly invented, in many places around the world are described. The literature review was limited to the period 2018–2023 to indicate the most modern and up-to-date strategies.HighlightsNot all Blue-Green Infrastructure solutions will work in all climatic conditions.A broad description of existing BGI solutions in individual countries is lacking.There is still a lack of BGI solutions implementation in areas most vulnerable to water stress.BGI implementation studies are carried out mainly in countries with high GDP.Africa is neglected in the literature related to Blue-Green Infrastructure.

AbstractCities can be severely affected by climate change. Hence, many of them have started to develop climate adaptation strategies or implement measures to help prepare for the challenges it will present. This study aims to provide an overview of climate adaptation in 104 German cities. While existing studies on adaptation tracking rely heavily on self-reported data or the mere existence of adaptation plans, we applied the broader concept of adaptation readiness, considering five factors and a total of twelve different indicators, when making our assessments. We clustered the cities depending on the contribution of these factors to the overall adaptation readiness index and grouped them according to their total score and cluster affiliations. This resulted in us identifying four groups of cities. First, a pioneering group comprises twelve (mainly big) cities with more than 500,000 inhabitants, which showed high scores for all five factors of adaptation readiness. Second, a set of 36 active cities, which follow different strategies on how to deal with climate adaptation. Third, a group of 28 cities showed considerably less activity toward climate adaptation, while a fourth set of 28 mostly small cities (with between 50,000 and 99,999 inhabitants) scored the lowest. We consider this final group to be pursuing a ‘wait-and-see’ approach. Since the city size correlates with the adaptation readiness index, we recommend policymakers introduce funding schemes that focus on supporting small cities, to help them prepare for the impact of a changing climate.

This article critically examines UNEP's Adaptation Gap Report 2023 (AGR2023) as a foundational source in the narrative that insufficient adaptation finance is the primary barrier to climate change adaptation and, based on this analysis, offers suggestions for future Conference of the Parties (COP) discussions on the adaptation framework. This article identifies key methodological challenges in AGR2023’s estimation of the adaptation finance gap. These issues are traced back to deeper systemic issues within the UNFCCC adaptation framework, including the misalignment of national adaptation plans (NAPs) with the UNFCCC mandate and the lack of clear boundaries for adaptation activities. The article calls for more informed and evidence-based COP discussions, which should lead to a fundamental rethinking of the adaptation framework.

National adaptation plans (NAPs) are intended to provide an evidence-based, coordinated, and systematic approach to climate preparedness initiatives. In order to identify how NAPs could be improved, this paper analyzes 38 national adaptation plans using plan quality evaluation methods and explores national characteristics that are associated with high-quality plans. We find that NAPs typically include multiple data sources, explore current impacts and future vulnerabilities, establish goals, and identify potential adaptation strategies. Plans are weaker in the articulation of implementation and monitoring measures, raising concerns about whether plans will translate into action and how success will be measured. In addition, plans generally do not include a broad range of stakeholders in the planning process. The institutional authorship is a strong predictor of plan quality. Plans written by multi-agency committees are significantly higher quality than those written by single agencies, especially on engagement of stakeholders. Based on these results, we recommend that countries form multi-agency teams to lead the adaptation planning process and intentionally address components that are commonly overlooked including implementation guidance and evaluation metrics.

Aim Many conservation efforts now focus on mitigating biodiversity loss due to climate change. While a focus on impacts from mean, long‐term changes in climate is warranted, the vast majority of conservation plans largely ignore another key factor of climate change—changes in the frequency and intensity of extreme weather and climate events. A typology of the full range and severity of ecological responses to extreme events would help underpin tracking of their impacts. Location Global. Methods Here, we review 519 observational studies of ecological responses to extreme events between 1941 and 2015. We include responses from amphibians, birds, fish, invertebrates, mammals, plants and reptiles to cyclones, drought, flood, cold waves and heat waves. Results Negative ecological responses were the most commonly reported, accounting for 57% of all documented responses. There were over 100 cases of a >25% population decline and 31 cases of local extirpation. Sixty per cent of the studies in our review observed ecological responses for more than 1 year, and of the studies that monitored species or ecosystem recovery following exposure to an extreme event, 38% showed species or ecosystems did not recover to pre‐disturbance levels. Main conclusions Extreme weather and climate events have profound implications for species and ecosystem management. We discuss current conceptual challenges associated with incorporating extreme events into conservation planning efforts, which include how to quantify species sensitivity and adaptive capacity to extreme events, how to account for interactions between extreme events and other stressors, and how to maximize adaptive capacity to more frequent and intense extreme events.

Abstract National Climate Change Risk Assessments (CCRAs) have a key role in informing priorities for adaptation policy but face significant challenges due to multiple facets of risk and adaptation. Issues are especially pronounced for meeting goals of environmental sustainability due to the complex dynamics of socio-ecological systems. In practice, a CCRA can therefore differ from its original conceptual blueprint. These challenges are explored from a knowledge systems perspective, focusing on the role of stakeholders/policymakers, risk descriptors, methods, evidence sources, and scientists. A UK case study evaluates recent developments (CCRA3) including identification of policy urgency through adaptation shortfalls and its application to the natural environment. Important science-policy issues are also highlighted regarding inclusion of opportunities, systemic risks, residual risks, and risk tolerance. A general conclusion is that CCRAs inevitably leave open questions which lead back to their evolving role in the science-policy interface. A knowledge systems perspective identifies CCRAs as open, adaptive, reflexive processes that help redefine interpretations of risk and adaptation, rather than just providing a specific policy-relevant product. This perspective identifies scope for progressive refinement of CCRAs to enhance collective science-policy adaptive capacity whilst also engaging wider society. For environmental sustainability, this open process can be used to iteratively redefine robust future pathways and system reference conditions that also better reflect evolving societal perceptions and tolerance on sustainability risk in the face of climate change.

Climate change threatens archaeological sites and cultural landscapes globally. While to date, awareness and action around cultural heritage and climate change adaptation planning has focused on Europe and North America, in this article, the authors address adaptation policy and measures for heritage sites in low- and middle-income countries. Using a review of national adaptation plans, expert survey and five case studies, results show the varied climate change adaptation responses across four continents, their strengths and weaknesses, and the barriers to be addressed to ensure better integration of cultural heritage in climate change adaptation planning.

While European regions face a range of different climate hazards, little is known about how these differences affect local climate adaptation planning. We present an analytical framework for evaluating local climate adaptation plans (LCAPs) and apply it to 327 cities in 28 countries across different European regions. To do this, we use statistical methods to identify regional clusters based on overall plan quality, impacts, vulnerable population groups, and sectors addressed by LCAPs. By comparing both geographic and statistical clusters, we found (1) significant spatial heterogeneity across European cities but (2) higher average plan quality scores and more consistent strategies across cities in Central and Eastern Europe. Notably, we found no regional differences regarding (a) the climate impacts and vulnerable communities identified in plans: (b) the most commonly addressed impacts, which were urban temperature and changing precipitation patterns; and (c) the residents that cities identified as most vulnerable, namely older people, women, infants, and the sick. Our study provides a spatial analysis of European LCAPs to uncover regional policy perspectives on local climate adaptation issues. Such approaches can effectively inform broader EU, national and regional strategies that aim to support local adaptation planning in a context of multi-level governance.