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With increasing incidence of harmful algal blooms (HABs) and their associated illnesses such as ciguatera poisoning (CP), there is need for educating current and future clinicians. This study sought to assess medical and physician assistant (PA) students' knowledge, attitudes, and beliefs toward HABs and their related illnesses. A survey of medical students and PA students at the University of South Alabama (USA) was conducted using an online questionnaire on climate change, HABs/associated illnesses, and CP. Response rate was calculated using fully executed questionnaires. Frequency data was utilized for demographics and knowledge-based questions; stratified analysis was used for associations. Three hundred three medical students received the questionnaire; 27% (n= 81) completed it. One hundred seventy-one PA students received the questionnaire; 19% (n= 33) completed the survey. These students were demographically representative of their student bodies. Out of 10 questions regarding knowledge of HABs, the percent correct was 30.7% for medical students and 20.3% for PA students. 34.6% of medical students and 47.1% of PA students had never heard of HABs. 90.1% of medical students and 84.8% of PA students believed climate change will impact human health in the future and more knowledge is needed about the relationship between health and climate change. Seventy six percentage of medical students and 51.6% of PA students expressed that HAB education should be part of health professional school curriculum. Future clinicians have little knowledge of HABs and their associated illnesses despite recognizing that climate change is a vital health issue. Medical and health professional schools should consider adding HAB education for future clinicians. 

This Review synthesizes progress and outlines a new framework for understanding how land surface hazards interact and propagate as sediment cascades across Earth’s surface, influenced by interactions among the atmosphere, biosphere, hydrosphere, and solid Earth. Recent research highlights a gap in understanding these interactions on human timescales, given rapid climatic change and urban expansion into hazard-prone zones. We review how surface processes such as coseismic landslides and post-fire debris flows form a complex sequence of events that exacerbate hazard susceptibility. Moreover, innovations in modeling, remote sensing, and critical zone science can offer new opportunities for quantifying cascading hazards. Looking forward, societal resilience can increase by transforming our understanding of cascading hazards through advances in integrating data into comprehensive models that link across Earth systems. 

Cities have a critical role to play in meeting global-scale biodiversity targets. Urban socio-ecological systems connect human and ecological well-being. The outsized impact of cities reaches well-beyond their geographic borders through cultural, ecological, and economic interactions. Although cities account for just 2% of the earth's surface, they host over half of the human population and are responsible for 75% of consumption. The Parties to the Convention on Biological Diversity (CBD) and others have acknowledged the important role cities can play in achieving global targets. In response, at least 110 cities have produced plans focused on biodiversity, but we do not know the extent to which these city plans align with global targets or what role they play in achieving these targets. Here, we explore the relationship between global biodiversity conservation targets and local biodiversity plans to identify how elements at the two scales align or diverge. We compared the CBD Strategic Plan 2011–2020 (Aichi Targets) with 44 local biodiversity plans (often called LBSAPs) from cities around the world. We analyzed more than 2,800 actions from the local plans to measure the relationship with these global targets. Our results show how local approaches to biodiversity conservation can inform post-2020 global frameworks to improve coordination between global and local scale processes. We identify actions particular to the local scale that are critical to conserve global biodiversity and suggest a framework for improved coordination between actors at different scales that address their respective roles and spheres of influence.