We live in a time of significant global risk. Some research has focused on understanding systemic sources of this risk, while other research has focused on possible worst-case outcomes. In this article, we bring together these two areas of research and provide a simple conceptual framework that shows how emergent features of the global system contribute to the risk of global catastrophe.

Humanity faces a complex and dangerous global risk landscape, and many different terms and concepts have been used to make sense of it. One broad strand of research characterises how risk emerges within the complex global system, using concepts like systemic risk, Anthropocene risk, synchronous failure, negative social tipping points, and polycrisis. Another focuses on possible worst-case outcomes, using concepts like global catastrophic risk (GCR), existential risk, and extinction risk. Despite their clear relevance to each other, connections between these two strands remain limited. Here, we provide a simple conceptual framework that synthesises these research strands and shows how emergent properties of the global system contribute to the risk of global catastrophic outcomes. In particular, we show that much of GCR stems from the interaction of hazards and vulnerabilities that arise endogenously within the global system, and how ‘systems thinking’ and complex adaptive systems theory can help illuminate this. We also highlight some unique challenges that systemic sources of GCR pose for risk assessment and mitigation, discuss insights for policy, and outline potential paths forward.

The global system is generating global catastrophic risk.

Extreme heat waves are a growing global health concern, with their frequency and intensity escalating due to climate change. Understanding past trends in heat wave impacts is crucial for informing effective mitigation and adaptation strategies.

This study aims to analyze the historical impact of extreme heat waves on global mortality and morbidity, identifying geographical and temporal trends to inform public health interventions.

We conducted a retrospective analysis using data from the Emergency Events Database. This comprehensive database provided records of heat wave events and associated mortality and morbidity data spanning recent decades. Statistical analysis was performed to identify trends and patterns in heat wave occurrences and their health impacts.

Our analysis reveals a concerning increase in both the frequency and severity of extreme heat waves globally. This trend corresponds with a significant rise in heat-related mortality and morbidity, particularly in regions with limited adaptive capacity and among vulnerable populations such as the elderly and those with pre-existing health conditions.

The findings underscore the urgent need for proactive measures to mitigate the health risks posed by extreme heat. These include strengthening healthcare infrastructure to manage heat-related illnesses, developing effective early warning systems, and implementing community-based interventions to reduce heat exposure. This research provides a critical historical perspective on the growing threat of extreme heat, emphasizing the importance of global cooperation and immediate action to protect populations from this escalating public health challenge.

This study investigates the public health implications of terrorist attacks on telecommunications infrastructure globally, assessing the direct and indirect impacts on emergency response and medical services.

Utilizing retrospective analysis, this research delves into incidents recorded in the Global Terrorism Database (GTD) from 1970 to 2020. The study employs descriptive statistical methods to identify patterns and examine the regional distribution and frequency of these attacks, alongside the types of weaponry used and the direct casualties involved.

The analysis underscores a significant focus on telecommunications by terrorist groups, revealing a frequent use of high-impact weapons like explosives and incendiary devices aimed at maximizing disruption. The study highlights considerable regional variations in the frequency and nature of attacks, emphasizing the strategic importance of these infrastructures to public safety and health systems.

The findings demonstrate the critical need for robust security enhancements tailored to regional threats and the integration of advanced technologies in public safety strategies. The research advocates for enhanced international cooperation and policymaking to mitigate the impacts of these attacks, ensuring telecommunications resilience in the face of global terrorism.

Terrorist attacks on the aviation sector represent a significant security challenge due to the high-profile status of airports and aircraft. These attacks not only jeopardize global security but also have severe public health repercussions, leading to widespread casualties and psychological distress.

This study conducted a comprehensive retrospective analysis using data from the Global Terrorism Database to explore the patterns, frequencies, and impacts of terrorist attacks on the aviation sector worldwide. The analysis spanned incidents from 1970 to 2020, focusing on attack types, affected regions, and the direct and indirect health consequences arising from these incidents.

Over the 50-year period, the study identified 1183 terrorist attacks targeting the aviation sector. Bombings and explosions emerged as the most common and deadliest forms of attack, responsible for the majority of fatalities and injuries. The data also highlighted significant regional disparities, with certain areas experiencing higher frequencies of attacks and more severe outcomes. Notably, North America bore a disproportionately high number of fatalities, primarily due to the events of September 11, 2001.

The findings emphasize the ongoing and evolving threat of terrorism in the aviation industry, underscoring the critical need for a proactive and comprehensive approach to security and public health preparedness. Future strategies should prioritize the integration of advanced technological solutions, enhanced international cooperation, and thorough public health planning to mitigate the impact of terrorist attacks on aviation effectively.

Hemorrhage control, triage efficiency, and triage accuracy are essential skills for optimal outcomes in mass casualty incidents. This study evaluated user application of skills through a Virtual Reality (VR) simulation of a subway bombing.

EMS clinicians and healthcare professionals engaged in a VR simulation of a bomb/blast scenario utilizing VRFirstResponder, a high-fidelity, fully immersive, automated, customizable, and programmable VR simulation platform. Metrics including time to control life-threatening hemorrhage and triage efficacy were analyzed using median and interquartile ranges (IQR).

389 EMS responders engaged in this high-fidelity VR simulation encountering 11 virtual patients with varying injury severity. The median time to triage the scene was 7:38 minutes (SD = 2:27, IQR = 6:13, 8:59). A robust 93% of participants successfully implemented all required hemorrhage control, with a median time of 3:51 minutes for life-threatening hemorrhage control (SD = 1:44, IQR = 2:41, 4:52). Hemorrhage control per patient took a median of 11 seconds (SD = 0:47, IQR = 0:06, 0:20). Participants accurately tagged 73% of patients and 17% effectively utilized the SALT sort commands for optimal patient evaluation.

The VRFirstResponder simulation, currently under validation, aims to enhance realism by incorporating distractors and refining assessment tools.

Following the declaration of the pandemic, students’ education has to be done at a distance due to the COVID-19 pandemic. This study evaluated the association of university students’ COVID-19 phobia, pain severity, sleep quality, physical activity, fatigue levels, and quality of life on students’ achievement.

This cross-sectional survey was conducted by including 353 students from the university faculty of health sciences. The Pain Quality Assessment Scale was used to assess pain, the Fatigue Severity Scale to evaluate fatigue, the COVID-19 Phobia Scale to assess fear of disease, the International Physical Activity Questionnaire Short Form to evaluate physical activity level, and the Jenkins Sleep Scale to assess sleep quality, The Short Form-36 to determine the quality of life, and Online Learning Systems Acceptance Scale to evaluate satisfaction with distance education. Multiple linear regression and path analysis were conducted to identify factors associated with academic achievement.

It was found that age (B = 0.045; P = 0.040), BMI (B = −0.200; P = 0.004), and physical (B = 0.128; P = 0.008), psychological (B = 0.057; P = 0.012) and social (B = 0.189; P = 0.018) domains of quality of life were associated with the level of achievement.

Precautions must be taken to improve students’ academic achievement and quality of life in preparing for the future against infectious and epidemic diseases.

Wildfires have escalated into a global threat with profound impacts on health, society, and the environment. The increasing frequency and intensity of these disasters, influenced by climate change and urban expansion, necessitate a comprehensive understanding of their direct health consequences.

This study conducted a retrospective analysis of global wildfire disasters from January 2000 to December 2023, utilizing data from the Emergency Events Database (EM-DAT). The analysis focused on the direct health outcomes—mortalities and injuries—excluding indirect effects such as smoke inhalation. Data were meticulously cleaned, categorized, and analyzed using quantitative methods, with statistical tests employed to validate the findings.

The study identified 309 significant wildfire disasters, with forest fires accounting for 80% of these events. These incidents resulted in 1890 fatalities and 14 360 injuries, with the highest tolls observed in Southern Europe, Northern America, and the Australia-New Zealand region. A notable rise in wildfire incidents was observed over the study period, underscoring the critical intersections between climate change, urban expansion, and wildfire risks. The analysis highlighted significant geographical and temporal patterns, emphasizing the regions and factors contributing to heightened wildfire vulnerability.

The findings underscore the urgent need for robust disaster preparedness and effective mitigation strategies. Integrating advanced early warning systems and Traditional Ecological Knowledge into wildfire management practices is essential. The study calls for proactive public health measures and interdisciplinary approaches to address the multifaceted challenges posed by wildfires. Continuous research and policy formulation are crucial to protect vulnerable communities and mitigate the increasing threat of wildfires globally.

The mortality and morbidity due to road traffic crashes (RTCs) are increasing drastically world-wide. Poor prehospital care management contributes to dismal patient outcomes, especially in low- and middle-income countries (LMICs). This study aimed to assess the knowledge, attitude, and self-reported practice (KAP) of providing first aid for RTC victims by commercial motorcyclists. In addition, it determined the relationship between sociodemographic characteristics and the level of KAP, then the predicting factors of outcome variables.

A cross-sectional study of 200 randomly selected commercial motorcyclists was conducted in May 2021. A chi-square test and multivariate analysis were used to analyze data.

The findings showed that most participants had a poor knowledge level (87.5 %), positive attitudes (74.5%), and poor self-reported practice (51.5%). Previous first-aid training and knowing an emergency call number for the police were predictors of good knowledge (AOR = 3.7064; 95% CI, 1.379-9.956 and AOR = 6.132; 95% CI,1.735-21.669, respectively). Previous first-aid training was also a predictor of positive attitudes (AOR = 3.087; 95% CI, 1.033-9.225). Moreover, the likelihood of having an excellent self-reported practice was less among participants under 40 years of age (AOR = 0.404; 95% CI, 0.182-0.897) and those who cared for up to five victims (AOR = 0.523; 95% CI, 0.282-0.969). Contrary, previous first-aid training (AOR = 2.410; 95% CI, 1.056-5.499) and educational level from high school and above increased the odds of having good self-reported practice (AOR = 2.533; 95% CI, 1.260-5.092).

Considering the study findings, training should be provided to improve the knowledge and skills of commercial motorcyclists since they are among the primary road users in Rwanda and involved in RTCs.

This clinical audit aimed to assess if the recording of patients seen for their diagnostic appointments in memory clinic measures up to the minimum standards required in the delivery of dementia services. This standard mandated primarily that a minimum body of key information must be promptly recorded by clinicians, in patient electronic records within 24 hours, as stipulated by Trust and NICE guidelines.

The first cycle was conducted from 16 October 2022 to 10 February 2023. In this cycle random sampling was used to select 25 patients on the caseloads of the mental health services for older people. Before the start of the second phase all diagnosing clinicians within the team were informed about the project and the expected improvements against which compliance would be audited. The second phase was conducted between 10 February 2023 to 31 March 2023 and another 25 patients on the caseloads were obtained via random sampling for the second cycle. Inclusion criteria for both phases were patients who had received a diagnostic assessment in these periods.

In the first set of records, the minimum body of information was recorded in 90–100% of cases according to the team's recommended standards namely diagnostic information, prognostic information, treatment plans, post-diagnostic contact plans and documentations being made within 24hrs of consultation. In the Set 2 the minimum body of information was recorded in 95–100% records studied. That is, diagnosis, treatment, medication treatment plans (prescription plans), and post-diagnostic contact plans were covered in the diagnostic sessions. In particular, case note documentations were made within 24 hours in all but one of the records applicable.

Given that a diagnosis of dementia can be life-changing, not discussing prognostic information would not prepare patients and carers adequately with information on how to live well with dementia following their diagnosis. This could potentially lead to poor adjustment to the condition and anxiety for some. At a trust-wide level, this means there is still room for improvement for the trust as regards dementia care ideals recommended by NICE.