In the Mediterranean Basin, recent accelerated changes in the environment (climate, land use, pollution, biodiversity loss) have caused loss of life and damages to infrastructure and ecosystems. The future presents unprecedented risks for human well-being, socioeconomic development, ecosystems and biodiversity. Policies for sustainable development need to aim for the mitigation of these risks but lack adequate information about the rates of environmental change and the combined risk they present to human society. For five interconnected impact domains (water, ecosystems, food, health and security), trends and scenarios point to significant risks during coming decades. More observations and better impact models exist for the Northern Mediterranean shores than for the South. This important bias is exacerbated by the large difference in financial resources available for adaptation and the development of resilience between north and south. A dedicated effort to synthesize existing scientific knowledge from all relevant disciplines is now underway to provide better understanding of the risks posed. In the Mediterranean Basin, human society and the natural environment have co-evolved over several millennia with significant climatic variations, laying the ground for diverse and culturally rich communities. The region lies in a transition zone between mid-latitude and subtropical circulation regimes. It is characterized by a complex morphology of mountain chains and strong land-sea contrasts, dense and growing human population and various environmental pressures. Observed rates of climate change in the Mediterranean Basin exceed global trends for most variables. Annual mean temperatures are now 1.4 °C above late nineteenth century levels (Figure 1), notably during the summer months. Heat waves occur more frequently, and the frequency and intensity of droughts have increased since 1950. 1,2,3 For each of the most recent decades, the surface of the Mediterranean Sea has warmed by around 0.4 °C. 4 During the period 1945-2000, sea-level has risen at a rate of 0.7±0.2 mm yr-1 , 5 accelerating to 1.1 mm yr-1 for the period 1970-2006. 6 During the last two decades, sea-level has been estimated to rise by about 3 cm decade-1 , 7 in part due to

Abiotic and biotic conditions are both important determinants of West Nile Fever (WNF) epidemiology. Ambient temperature plays an important role in the growth rates of vector populations, the interval between blood meals, viral replication rates and transmission of West Nile Virus (WNV). The contribution of precipitation is more complex and less well understood. In this paper we discuss impacts of climatic parameters (temperature, relative humidity, precipitation) and other environmental drivers (such as bird migration, land use) on WNV transmission in Europe. WNV recently became established in southeastern Europe, with a large outbreak in the summer of 2010 and recurrent outbreaks in 2011 and 2012. Abundant competent mosquito vectors, bridge vectors, infected (viremic) migrating and local (amplifying) birds are all important characteristics of WNV transmission. In addition, certain key climatic factors, such as increased ambient temperatures, and by extension climate change, may also favor WNF transmission, and they should be taken into account when evaluating the risk of disease spread in the coming years. Monitoring epidemic precursors of WNF, such as significant temperature deviations in high risk areas, could be used to trigger vector control programs and public education campaigns.

This article focuses on tourists' perception of health risk among tourists who intend to travel to developing countries. It examines the relative importance tourists assign to this risk. It unveils the factors that shape health risk perceptions and explores the relative role of each factor in shaping tourists' perception. With a sample of 232 and a self-administered questionnaire, the study interviewed visitors at a travelers medical clinic before their trip. Using ordered logistic regression, the results show that health risk perception ranks relatively high against other types of risk perception. The study unveiled the relative contribution of the various determinants to the overall travelers' perception of health risk. Furthermore, three groups of perception-type hierarchy were discovered, representing levels of importance and tourists' potential behavioral control: first, difficult-to-control environmental components; second, partially behaviorally controllable by the tourist; third, fully behaviorally controlled types of health risks perceptions.

The Middle East and southwest Asia are a region that is water stressed, societally vulnerable, and prone to severe droughts. Large-scale climate variability, particularly La Niña, appears to play an important role in regionwide droughts, including the two most severe of the last 50 years—1999–2001 and 2007/08—with implications for drought forecasting. Important dynamical factors include orography, thermodynamic influence on vertical motion, storm-track changes, and moisture transport. Vegetation in the region is strongly impacted by drought and may provide an important feedback mechanism. In future projections, drying of the eastern Mediterranean region is a robust feature, as are temperature increases throughout the region, which will affect evaporation and the timing and intensity of snowmelt. Vegetation feedbacks may become more important in a warming climate. There are a wide range of outstanding issues for understanding, monitoring, and predicting drought in the region, including dynamics of the regional storm track, the relative importance of the range of dynamical mechanisms related to drought, the regional coherence of drought, the relationship between synoptic-scale mechanisms and drought, the predictability of vegetation and crop yields, the stability of remote influences, data uncertainty, and the role of temperature. Development of a regional framework for cooperative work and dissemination of information and existing forecasts would speed understanding and make better use of available information.

BackgroundIn the summer of 2010, Europe experienced outbreaks of West Nile Fever (WNF) in humans, which was preceded by hot spells. The objective of this study was to identify potential drivers of these outbreaks, such as spring and summer temperatures, relative humidity (RH), and precipitation.MethodsPearson and lag correlations, binary and multinomial logistic regressions were used to assess the relationship between the climatic parameters and these outbreaks.ResultsFor human morbidity, significant (<0.05) positive correlations were observed between a number of WNF cases and temperature, with a geographic latitude gradient: northern (“colder”) countries displayed strong correlations with a lag of up to four weeks, in contrast to southern (“warmer”) countries, where the response was immediate. The correlations with RH were weaker, while the association with precipitation was not consistent. Horse morbidity started three weeks later than in humans where integrated surveillance was conducted, and no significant associations with temperature or RH were found for lags of 0 to 4 weeks.ConclusionsSignificant temperature deviations during summer months might be considered environmental precursors of WNF outbreaks in humans, particularly at more northern latitudes. These insights can guide vector abatement strategies by health practitioners in areas at risk for persistent transmission cycles.