Description: Objectives We aimed to prospectively study the association between normalised difference vegetation index (NDVI) as a measure of greenness around homes and occupational stress. Setting A population-based cohort in Munich and Dresden cities was followed from age 16–18 years to age 20–23 years (n=1632). Participants At baseline, all participants attended high-school while at follow-up some had started working and others studying at university. At baseline and in each follow-up, we assigned NDVI based on participants’ residential geocoded addresses and categorised it by quartiles. Outcome measures School-related, university-related or job-related self-reported chronic stress was assessed at the two follow-ups by the Trier Scale for Assessment of Chronic Stress using work discontent and work overload as outcomes. We modelled the association employing ordinal generalised estimating equations model accounting for changes in sociodemographics, non-job-related stress, job history and environmental covariates. Stratified analysis by each city was performed. Results NVDI at baseline was higher for participants from Dresden (median=0.36; IQR 0.31–0.41) than Munich (0.31; 0.26–0.34). At follow-up, it decreased only for participants in Dresden (0.34; 0.30–0.40). Higher greenness (quartile 4 vs quartile 1) was associated with less work discontent (OR 0.89; 95% CI 0.80 to 0.99) and less work overload (OR 0.87; 95% CI 0.78 to 0.96). In stratified analyses, results were more consistent for Munich than for Dresden. Conclusions Our results suggest that residential green spaces, using the vegetation index as a proxy for exposure, are inversely associated with two types of job-related chronic stress in German young adults transitioning from school to university or working life.

Description: Objectives Dealing with multiple workflow interruptions is a major challenge in emergency department (ED) work. This study aimed to establish a taxonomy of workflow interruptions that takes into account the content and purpose of interruptive communication. It further aimed to identify associations of workflow interruptions with ED professionals’ work stress. Design Combined data from expert observation sessions and concomitant self-evaluations of ED providers. Setting ED of an academic community hospital in Germany. Participants Multidisciplinary sample of ED physicians and nurses. 77 matched observation sessions of interruptions and self-evaluations of work stress were obtained on 20 randomly selected days. Outcome measures ED professionals’ stress evaluations were based on standardised measures. ED workload data on patient load, patient acuity and staffing were included as control variables in regression analyses. Results Overall mean rate was 7.51 interruptions/hour. Interruptions were most frequently caused by ED colleagues of another profession (27.1%; mean interruptions/hour rate: 2.04), by ED colleagues of the same profession (24.1%; 1.81) and by telephone/beeper (21%; 1.57). Concerning the contents of interruption events, interruptions most frequently occurred referring to a parallel case under care (30.3%, 2.07), concerning the current case (19.1%; 1.28), or related to coordination activities (18.2%, 1.24). Regression analyses revealed that interruptive communication related to parallel cases significantly increased ED providers’ stress levels (β=0.24, P=0.03). This association remained significant after controlling for ED workload. Discussion Interruptions that refer to parallel cases under care were associated with increased stress among ED physicians and nurses. Our approach to distinguish between sources and contents of interruptions contributes to an improved understanding of potential benefits and risks of workflow interruptions in ED work environments. Despite some limitations, our findings add to future research on the implications of interruptions for effective and safe patient care and work in complex and dynamic care environments.

Description: Aim The aim was to decipher Europe‐wide spatio‐temporal patterns of forest growth dynamics and their associations with carbon isotope fractionation processes inferred from tree rings as modulated by climate warming. Location Europe and North Africa (30‒70° N, 10° W‒35° E). Time period 1901‒2003. Major taxa studied Temperate and Euro‐Siberian trees. Methods We characterize changes in the relationship between tree growth and carbon isotope fractionation over the 20th century using a European network consisting of 20 site chronologies. Using indexed tree‐ring widths (TRWi), we assess shifts in the temporal coherence of radial growth across sites (synchrony) for five forest ecosystems (Atlantic, boreal, cold continental, Mediterranean and temperate). We also examine whether TRWi shows variable coupling with leaf‐level gas exchange, inferred from indexed carbon isotope discrimination of tree‐ring cellulose (Δ13Ci). Results We find spatial autocorrelation for TRWi and Δ13Ci extending over a maximum of 1,000 km among forest stands. However, growth synchrony is not uniform across Europe, but increases along a latitudinal gradient concurrent with decreasing temperature and evapotranspiration. Latitudinal relationships between TRWi and Δ13Ci (changing from negative to positive southwards) point to drought impairing carbon uptake via stomatal regulation for water saving occurring at forests below 60° N in continental Europe. An increase in forest growth synchrony over the 20th century together with increasingly positive relationships between TRWi and Δ13Ci indicate intensifying impacts of drought on tree performance. These effects are noticeable in drought‐prone biomes (Mediterranean, temperate and cold continental). Main conclusions At the turn of this century, convergence in growth synchrony across European forest ecosystems is coupled with coordinated warming‐induced effects of drought on leaf physiology and tree growth spreading northwards. Such a tendency towards exacerbated moisture‐sensitive growth and physiology could override positive effects of enhanced leaf intercellular CO2 concentrations, possibly resulting in Europe‐wide declines of forest carbon gain in the coming decades.

Description: We present the first European network of tree ring delta(13)C and delta(18)O, containing 23 sites from Finland to Morocco. Common climate signals are found over broad climatic-ecological ranges. In temperate regions we find positive correlations with summer maximum temperatures and negative correlations with summer precipitation and Palmer Drought Severity Indices (PDSI) with no obvious speciesspecific differences. Regional delta(13)C and delta(18)O chronologies share high common variance in year-to-year variations. Long-term variations, however, exhibit differences that may reflect spatial variability in environmental forcings, age trends and/or plant physiological responses to increasing atmospheric CO(2) concentration. Rotated principal component analysis (RPCA) and climate field correlations enable the identification of four sub-regions in the delta(18)O network - northern and eastern Central Europe, Scandinavia and the western Mediterranean. Regional patterns in the delta(13)C network are less clear and are timescale dependent. Our results indicate that future reconstruction efforts should concentrate on delta(18)O data in the identified European regions.

Description: The Earth’s carbon and hydrologic cycles are intimately coupled by gas exchange through plant stomata. However, uncertainties in the magnitude and consequences of the physiological responses of plants to elevated CO2 in natural environments hinders modelling of terrestrial water cycling and carbon storage. Here we use annually resolved long-term δ13C tree-ring measurements across a European forest network to reconstruct the physiologically driven response of intercellular CO2 (Ci) caused by atmospheric CO2 (Ca) trends. When removing meteorological signals from the δ13C measurements, we find that trees across Europe regulated gas exchange so that for one ppmv atmospheric CO2 increase, Ci increased by ~0.76 ppmv, most consistent with moderate control towards a constant Ci/Ca ratio. This response corresponds to twentieth-century intrinsic water-use efficiency (iWUE) increases of 14 ± 10 and 22 ± 6% at broadleaf and coniferous sites, respectively. An ensemble of process-based global vegetation models shows similar CO2 effects on iWUE trends. Yet, when operating these models with climate drivers reintroduced, despite decreased stomatal opening, 5% increases in European forest transpiration are calculated over the twentieth century. This counterintuitive result arises from lengthened growing seasons, enhanced evaporative demand in a warming climate, and increased leaf area, which together oppose effects of CO2-induced stomatal closure. Our study questions changes to the hydrological cycle, such as reductions in transpiration and air humidity, hypothesized to result from plant responses to anthropogenic emissions.

Description: In this study we have analyzed the variability of tree-ring widths and stable isotopes (δ13C and δ18O) of a single sessile oak tree (Quercus petraea (Matt.) Liebl.) since these parameters are critical in reconstructing the environment, particularly climatic conditions. Tree rings were separated into early- and latewood (EWt; LWt), tree ring (TRt), and transfer tree ring (TTRt, the latter being the latewood plus the earlywood of the subsequent year. Mean sensitivity, simple correlation, partial correlation and autocorrelation analyses were applied to describe data and relationships. Although this research focused on a single tree, the results compared well with average site data. Widths and δ18O values showed generally low autocorrelation for all tree-ring components, whereas δ13C revealed highly significant autocorrelations for most tree-ring components. Mean sensitivity of the standardized values turned out to be high for δ18O, marginally lower for width and the lowest for δ13C. Correlation analyses have proven that the relationships within the tree-ring widths or within the isotope parameters are much stronger than across widths and isotope parameters. The study demonstrates the unique potential of all measured tree-ring data to be used as climate proxies.