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Climate change might catalyze and exacerbate the trend of outmigration from low-lying atoll islands. There is speculation that migration away from atolls may not stop until such islands are abandoned. Yet migration creates both opportunities and risks for the sustainability of atoll communities. There is a trade-off between reduced demographic pressure on increasingly fragile atoll island environments and the financial and human resources necessary to adapt to climate change that can result from migration. Here we propose and analyze belonging as the centripetal force that makes migration a process that enhances the sustainability of atoll populations. We examine the relationship between migration, belonging, and the sustainability of populations on atoll islands based on data collected in three atoll islands in the Pacific: the island state of Niue; Namdrik Atoll in the Republic of the Marshall Islands; and Budibudi atoll (Laughlan Islands) in Papua New Guinea. In each case, belonging binds the people who live in and migrate from these places into a collective commitment to their continuity, yet it does so to different degrees according to the economic opportunities available to migrants and the infrastructure that enables extended communities to remain connected.

The significant body of research on the distribution of international finance for climate change adaptation shows that it is not well correlated to the vulnerability of countries. Vulnerability differs greatly within countries as well, yet very few studies examine subnational flows of adaptation finance. Here, we present evidence of the subnational allocation of international adaptation finance within the Republic of the Marshall Islands (RMI). The RMI is a highly salient case as it is a small island developing state comprised solely of low-lying atolls that is both in need of and a recipient of adaptation finance. We describe patterns of adaptation finance in the RMI between 2015 and 2019 based on analysis of a comprehensive government database of bilateral and multilateral aid projects. We find that flows of adaptation finance were heavily skewed towards a small number of large-scale civil works projects in urban areas funded by multilateral institutions. Rural areas attracted smaller scale projects funded largely by bilateral donors. The overall distribution of adaptation finance across islands is highly sporadic, with hotspots of activity and areas of neglect. Our results suggest the allocation of adaptation finance to the RMI is insufficient relative to needs, poorly coordinated, and fails to reach places where it is most needed.

The human immunoglobulin heavy chain (IGH) locus on chromosome 14 includes more than 40 functional copies of the variable gene (IGHV).

There is a growing body of research documenting Indigenous Peoples and Local Communities' observations of changes in climate. The accuracy, efficacy, and transferability of this research depends on its motives and methods. In this paper, we report on research to produce a working knowledge of changes in climate and its impacts on local biophysical systems in the Tiwi Islands in Northern Australia. Interviews with 52 Tiwi people were combined with diverse forms of aerial data to produce a nuanced understanding of climate change in these remote islands. These data show changes in climate‐sensitive biophysical systems that would otherwise remain undetected by instruments conventionally used for monitoring climate change. These include changes in shorelines, which are causing concerns about damage to buildings that are important for Tiwi well‐being, and changes in the marine environment and wetlands, which are causing concerns about damage to natural heritage. We discuss the implications of these findings, arguing that systematic observations collected by networks of people “on Country” can provide excellent monitoring of climate change impacts, and that Indigenous people's interests in the effects of climate change overlap with those of non‐Indigenous people, as do their rights to support from the State for adaptation.

Creating more sustainable forms of marine governance is a matter of path creation, and as such is constrained by the historical evolution of institutions. Yet knowledge of the path dependence of contemporary marine governance institutions is rare. This paper presents an analysis of the evolution of coastal and marine governance in Indonesia and explains how it has hindered change towards more sustainable marine governance. Using historical institutionalism as the analytical lens, through analysis of archival materials, policies and regulations, and media articles, we describe the history of coastal and marine governance over the past 300 years. This analysis shows that the institutions that govern marine areas in Indonesia have been shaped by and appropriated to support extractive land-based economic activities. Strongly imbued by colonial ideologies, the sea has been seen as and acted on as a source of rent for the elite, and a resource for rapid economic development. This analysis helps explain why marine governance that is inclusive of local people's and environmental values is proving difficult in Indonesia, and more broadly in other postcolonial countries where formal marine governance institutions were established to facilitate resource capture and commodification.

Atoll societies have adapted their environments and social systems for thousands of years, but the rapid pace of climate change may bring conditions that exceed their adaptive capacities. There is growing interest in the use of 'nature-based solutions' to facilitate the continuation of dignified and meaningful lives on atolls through a changing climate. However, there remains insufficient evidence to conclude that these can make a significant contribution to adaptation on atolls, let alone to develop standards and guidelines for their implementation. A sustained programme of research to clarify the potential of nature-based solutions to support the habitability of atolls is therefore vital. In this paper, we provide a prospectus to guide this research programme: we explain the challenge climate change poses to atoll societies, discuss past and potential future applications of nature-based solutions and outline an agenda for transdisciplinary research to advance knowledge of the efficacy and feasibility of nature-based solutions to sustain the habitability of atolls. This article is part of the theme issue 'Nurturing resilient marine ecosystems'.

The consequences of climate change and responses to climate change interact with multiple dimensions of human well-being in ways that are emerging or invisible to decision makers. We examine how elements of well-being-health, safety, place, self and belonging-are at risk from climate change. We propose that the material impacts of a changing climate, discourses and information on future and present climate risks, and policy responses to climate change affect all these elements of well-being. We review evidence on the scale and scope of these climate change consequences for well-being and propose policy and research priorities that are oriented towards supporting well-being though a changing climate.

Sinking atolls are an enduring symbol of the power of climate change to destroy inhabited places. Climate impact science and the media share a panoptic gaze on atoll islands seeing them as being small, inert and passive in the face of rising seas. The focus in these accounts is on the power of water as the agent of destruction, while the agency of the assemblage of human and non‐human actors that is the (is)land itself is ignored. Thus, atolls are said to be vulnerable, and the prevailing ideas of adaptation are either international relocation to avoid the sea or seawalls to contain it. Based on qualitative field research in Pacific atolls, this paper examines the connections between island peoples and their terrestrial environments, and the work that they are doing in response to the impacts of climate change. It shows how land is conceived symbolically, socio‐culturally and legally, and considers its role in sustaining livelihoods and anchoring identities through a changing climate.

This progress report reviews research on climate change adaptation through a political economy lens, explaining the way ideas, institutions and interests enable diverse forms of adaptation practice. It reviews research on community-based adaptation, and spatial planning and investments in capital works for the purposes of adaptation. The analysis explains how practices that reduce vulnerability to climate change come into being, though it is as yet unclear if these existing political economies of adaptation are able to bring about the kind of (re)assembling of environments, technologies and practices over space and time necessary to sustain human needs and values through a dramatically changed climate.

Purpose: The optic nerve head (ONH) is a part of the brain that can be easily studied through the transparent medium of the eye. We explored the relationship between the properties of the optic nerve head, the retinal nerve fiber layer (RNFL) and cognitive function. Methods: Participants of the Northern Finland Birth Cohort (NFBC) 1966 underwent an ophthalmic and cognitive assessment after randomization at age 46. The ophthalmological parameters obtained were the disc area and the neuroretinal rim volume of the ONH and the average RNFL thickness. The surrogates used for cognitive function were the paired associates learning test (PAL), level of education, grade point average (GPA) and Humphrey 24–2 perimetric test time (HFA). We did exploratory research between the ophthalmological parameters and the surrogates for cognition and the correlations between the surrogates for cognition. Results: We found that a larger disc area was associated with a higher level of education, faster accomplishment of the HFA (R = −0.065) but a lower GPA (R = −0.084). An increase in neuroretinal rim volume was associated with fewer errors in the PAL test (R = −0.056), higher level of education, higher GPA (R = 0.072) and faster accomplishment of the HFA (R = −0.047). A thicker RNFL was associated with faster accomplishment of the HFA (R = −0.047). Conclusion: We were able to find statistically significant associations between the parameters of the optic nerve head, the RNFL and cognition in the NFBC Eye study. However, the correlations were negligible at best and of limited predictive value.

Human immunoglobulin heavy chain (IGH) locus on chromosome 14 includes more than 40 functional copies of the variable gene (IGHV), which are critical for the structure of antibodies that identify and neutralize pathogenic invaders as a part of the adaptive immune system. Because of its highly repetitive sequence composition, the IGH locus has been particularly difficult to assemble or genotype when using standard short-read sequencing technologies. Here, we introduce ImmunoTyper-SR, an algorithmic tool for the genotyping and CNV analysis of the germline IGHV genes on Illumina whole-genome sequencing (WGS) data using a combinatorial optimization formulation that resolves ambiguous read mappings. We have validated ImmunoTyper-SR on 12 individuals, whose IGHV allele composition had been independently validated, as well as concordance between WGS replicates from nine individuals. We then applied ImmunoTyper-SR on 585 COVID patients to investigate the associations between IGHV alleles and anti-type I IFN autoantibodies, which were previously associated with COVID-19 severity.

AIMS: The Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups worldwide. Due to its proximity and close links to China, Southeast Asia was one of the first regions to be affected by the outbreak. The aim of this systematic review was to evaluate the prevalence of anxiety, depression and insomnia in the general adult population and healthcare workers (HCWs) in Southeast Asia during the course of the first year of the pandemic. METHODS: Several literature databases were systemically searched for articles published up to February 2021 and two reviewers independently evaluated all relevant studies using pre-determined criteria. The prevalence rates of mental health symptoms were calculated using a random-effect meta-analysis model. RESULTS: In total, 32 samples from 25 studies with 20 352 participants were included. Anxiety was assessed in all 25 studies and depression in 15 studies with pooled prevalence rates of 22% and 16%, respectively. Only two studies assessed insomnia, which was estimated at 19%. The prevalence of anxiety and depression was similar among frontline HCWs (18%), general HCWs (17%), and students (20%) while being noticeably higher in the general population (27%). CONCLUSIONS: This is the first systematic review to investigate the mental health impact of the Covid-19 pandemic in Southeast Asia. A considerable proportion of the general population and HCWs reported mild to moderate symptoms of anxiety and depression; the pooled prevalence rater, however, remain significantly lower than those reported in other areas such as China and Europe.

The purpose of this study was to explore the association of cognition with hazardous drinking and alcohol-related disorder in persons with bipolar disorder (BD). The study population included 1268 persons from Finland with bipolar disorder. Alcohol use was assessed through hazardous drinking and alcohol-related disorder including alcohol use disorder (AUD). Hazardous drinking was screened with the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) screening tool. Alcohol-related disorder diagnoses were obtained from the national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on A tablet computer: the 5-choice serial reaction time task, or reaction time (RT) test and the Paired Associative Learning (PAL) test. Depressive symptoms were assessed with the Mental Health Inventory with five items (MHI-5). However, no assessment of current manic symptoms was available. Association between RT-test and alcohol use was analyzed with log-linear regression, and eβ with 95% confidence intervals (CI) are reported. PAL first trial memory score was analyzed with linear regression, and β with 95% CI are reported. PAL total errors adjusted was analyzed with logistic regression and odds ratios (OR) with 95% CI are reported. After adjustment of age, education, housing status and depression, hazardous drinking was associated with lower median and less variable RT in females while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores in females. Our findings of positive associations between alcohol use and cognition in persons with bipolar disorder are difficult to explain because of the methodological flaw of not being able to separately assess only participants in euthymic phase.

Environmental peacebuilding is the integration of natural resource management into conflict prevention, resolution and recovery so as to support peace and environmental sustainability. Most studies have been of cases where there is significant involvement of external (usually international) actors. They thus provide implicit support for liberal peacebuilding practice, which is itself the subject of much critique. Conversely, documented examples of environmental peacebuilding from below are rare. We analyse an endogenously emerging environmental peacebuilding institution, the customary tara bandu process in Timor-Leste. We explain the way tara bandu is used bottom-up to promote the sustainable use of natural resources and more peaceful relations. Tara bandu proves to be a successful, locally diverse environmental peacebuilding institution. We further show how recent attempts by international peacebuilders and state institutions to employ tara bandu have somewhat ignored the way it is deeply interwoven with local social and spiritual relations, and in so doing have jeopardized its legitimacy and efficacy. This suggests that attempts from outside actors to facilitate environmental peacebuilding may be constrained by a mismatch between theorized norms of social and environmental relations (such as ‘shared interests’) and local cultural particularities.

Little is known in the international academic community about Chinese‐language research on water management. To remedy this deficit, this paper reviews current mainland Chinese understandings of the role of large‐scale water infrastructures as tools of water resources management. We reviewed 461 papers published in mainland Chinese journals by Chinese scholars. This review suggests that the dominant approach to water management reflects the confines of government priorities—large‐scale, concrete‐heavy, infrastructure‐based means of moving water around the country so as to meet demands and stimulate economic growth. Suppression of critical voices means that infrastructure is generally rendered apolitical: the critiques are about practical issues, such as technological, managerial, or administrative problems. There are exceptions to this characterization that adopt more critical frames; however, they reflect on water management elsewhere or in the past rather than on contemporary China. While these more critical papers are interesting and important contributions to our understanding of the politics of hydraulic infrastructures, the literature as a whole says little about the politics of infrastructure in China now. In effect, much of the literature in Chinese on water management in China simply acts as an arm of a machine—a network of corporations, universities, international institutions, and arms of the government, together tasked with identifying and framing what are water management issues, formulating standardized procedures for tackling those issues, and then constructing solutions to them. This article is categorized under: Engineering Water > Planning Water Human Water > Water Governance

Research shows that community-based adaptation (CBA) can empower grassroots agents to determine their preferred responses to climate change. After two decades of practice, recent analysis is highlighting that CBA has its limits, which we argue is in part because it is predicated on an idea of ‘the communal’ as being local, static, and spatially distinct. We investigate the relationship between the nature of community and the successful implementation of CBA through an ethnographic longitudinal study in Namdrik in the Republic of the Marshall Islands. We show that the Namdrik community is best understood as a spatially dynamic network of actors whose sense of shared purpose and capacity to act varies over time in response to demographic, economic and political circumstances. These processes at times weaken the shared commitment necessary for collective action on adaptation, especially as the material support and leadership that initiated CBA in Namdrik has waned. In such circumstances, the success of CBA is spatiotemporally contingent, and depends heavily on the persistence of factors that sustain shared commitment to the task, which most often means ongoing financial and technical support for activities and for community leaders.

Adaptation to climate change is inescapably influenced by processes of social identity-how people perceive themselves, others, and their place in the world around them. Yet there is sparse evidence into the specific ways in which identity processes shape adaptation planning and responses. This paper proposes three key ways to understand the relationship between identity formation and adaptation processes: (a) how social identities change in response to perceived climate change risks and threats; (b) how identity change may be an objective of adaptation; and (c) how identity issues can constrain or enable adaptive action. It examines these three areas of focus through a synthesis of evidence on community responses to flooding and subsequent policy responses in Somerset county, UK and the Gippsland East region in Australia, based on indepth longitudinal data collected among those experiencing and enacting adaptation. The results show that adaptation policies are more likely to be effective when they give individuals confidence in the continuity of their in-groups, enhance the self-esteem of these groups, and develop their sense of self-efficacy. These processes of identity formation and evolution are therefore central to individual and collective responses to climate risks.

Environmental peacebuilding is the integration of natural resource management into conflict prevention, resolution and recovery so as to support peace and environmental sustainability. Most studies have been of cases where there is significant involvement of external (usually international) actors. They thus provide implicit support for liberal peacebuilding practice, which is itself the subject of much critique. Conversely, documented examples of environmental peacebuilding from below are rare. We analyse an endogenously emerging environmental peacebuilding institution, the customary tara bandu process in Timor-Leste. We explain the way tara bandu is used bottom-up to promote the sustainable use of natural resources and more peaceful relations. Tara bandu proves to be a successful, locally diverse environmental peacebuilding institution. We further show how recent attempts by international peacebuilders and state institutions to employ tara bandu have somewhat ignored the way it is deeply interwoven with local social and spiritual relations, and in so doing have jeopardized its legitimacy and efficacy. This suggests that attempts from outside actors to facilitate environmental peacebuilding may be constrained by a mismatch between theorized norms of social and environmental relations (such as ‘shared interests’) and local cultural particularities.

The purpose of this study was to explore the association of cognition with hazardous drinking Polygenic Scores (PGS) in 2649 schizophrenia, 558 schizoaffective disorder, and 1125 bipolar disorder patients in Finland. Hazardous drinking PGS was computed using the LDPred program. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: the 5-choice serial reaction time task, or Reaction Time (RT) test, and the Paired Associative Learning (PAL) test. The association between hazardous drinking PGS and cognition was measured using four cognition variables. Log-linear regression was used in Reaction Time (RT) assessment, and logistic regression was used in PAL assessment. All analyses were conducted separately for males and females. After adjustment of age, age of onset, education, household pattern, and depressive symptoms, hazardous drinking PGS was not associated with reaction time or visual memory in male or female patients with schizophrenia, schizoaffective, and bipolar disorder.

The purpose of this study was to explore the association between cognition and hazardous drinking and alcohol use disorder in schizophrenia and schizoaffective disorder. Cognition is more or less compromised in schizophrenia, and schizoaffective disorder and alcohol use might aggravate this phenomenon. The study population included 3362 individuals from Finland with diagnoses of schizophrenia or schizoaffective disorder. Hazardous drinking was screened with the AUDIT-C (Alcohol Use Disorders Identification Test for Consumption) screening tool. Alcohol use disorder (AUD) diagnoses were obtained from national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: The Five-Choice Serial Reaction Time Task (5-CSRTT) or the reaction time (RT) test and the Paired Associative Learning (PAL) test. The association between alcohol use and the RT and PAL tests was analyzed with log-linear regression and logistic regression, respectively. After adjustment for age, education, housing status, and the age at which the respondents had their first psychotic episodes, hazardous drinking was associated with a lower median RT in females and less variable RT in males, while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores (TEASs) in females. Our findings of positive associations between alcohol and cognition in schizophrenia and schizoaffective disorder are unique.

Chalcogenide phase change materials reversibly switch between non-volatile states with vastly different optical properties, enabling novel active nanophotonic devices. However, a fundamental understanding of their laser-switching behavior is lacking and the resulting local optical properties are unclear at the nanoscale. Here, we combine infrared scattering-type scanning near-field optical microscopy (SNOM) and Kelvin probe force microscopy (KPFM) to investigate four states of laser-switched Ge3Sb2Te6 (as-deposited amorphous, crystallized, reamorphized, and recrystallized) with nanometer lateral resolution. We find SNOM especially sensitive to differences between crystalline and amorphous states, while KPFM has higher sensitivity to changes introduced by melt-quenching. Using illumination from a free-electron laser, we employ that far-infrared (THz) SNOM is more sensitive to free charge carriers compared to mid-infrared SNOM and prove that the local conductivity of crystalline states depends on the switching process. This insight into the local switching of optical properties is essential for developing active nanophotonic devices.

China’s South–NorthWater Transfer Project (SNWTP) is a vast and still expanding network of infrastructure and institutions that moves water from the Yangtze River and its tributaries to cities in North China. This article aims to assess the SNWTP’s impacts by beginning to answer seven questions about the project: How is the management of the SNWTP evolving? What are the problems to be resolved when managing SNWTP water within jurisdictions? What are the status and management of water quality in the SNWTP? What are the consequences of resettlements caused by the SNWTP? How is increased water supply affecting regional development? Is the SNWTP achieving its stated environmental goals? What are the sustainability credentials of the SNWTP? Drawing on primary and secondary data, the article demonstrates oth that the opportunities and burdens characterising the project are highly uneven and that management systems are evolving rapidly in an attempt to enforce strict water quality targets. Furthermore, while the SNWTP may be helping to resolve groundwater overexploitation in Beijing, it is highly energy intensive, raising questions about its sustainability. Our analysis highlights the need to continue to interrogate the socioeconomic, ,environmental, and political implications of such schemes long after they are officially completed.

Research on social vulnerability and adaptation to climate change assumes that increasing amounts of adaptive capacity increase the likelihood of actions to adapt to climate change.Wetest this assumption as it applies at the scale of households, through a study of the relationship between adaptive capacity and household actions to adapt to wildfire risk in Mount Dandenong, Australia. Here we show a weak relationship exists between adaptive capacity and adaptation, such that high adaptive capacity does not clearly result in a correspondingly high level of adaptation. Three factors appear to mediate the relationship between household adaptive capacity and adaptation: their attitude to risk, their experience of risk, and their expectations of authorities. The findings suggest that to understand the adaptation practices of households, greater attention needs to be paid to socio-psychological factors that trigger people to apply their available capacities.

The unprecedented global heatwave of 2014–2017 was a defining event for many ecosystems. Widespread degradation caused by coral bleaching, for example, highlighted the vulnerability of hundreds of millions of people dependent on reefs for their livelihoods, well-being, and food security. Scientists and policy makers are now reassessing long-held assumptions about coping with anthropogenic climate change, particularly the assumption that strong local institutions can maintain ecological and social resilience through ecosystem-based management, adaptation, and restoration. Governance is struggling to address the new normal as ecosystem assemblages transform to novel configurations. A central challenge for policy makers in the Anthropocene is navigating environmental crises and coping with societal insecurity and change. Ecosystem governance needs a new paradigm to embrace rapid change and shape future trajectories. In this Perspective, we focus on coral reefs as vanguards for governance transformation. We explain the spatial, temporal, and political dynamics of reefs as they respond to climate change and outline a new governance paradigm applicable to all ecosystems.

Though rarely described as such, vulnerability to climate change is fundamentally a matter of political economy. This progress report provides a reading of contemporary research on vulnerability to climate change through a political economic lens. It interprets the research as explaining the interplay between ideas about vulnerability, the institutions that create vulnerability, and those actors with interests in vulnerability. It highlights research that critiques the idea of vulnerability, and that demonstrates the agency of those at risk as they navigate the intersecting, multi-scalar and teleconnected institutions that shape their choices in adapting to climate change. The report also highlights research that is tracking the way powerful institutions and interests that create vulnerability are themselves adapting by appropriating the cause of the vulnerable, depoliticising the causes of vulnerability, and promoting innovations in finance and markets as solutions. In these ways, political and economic institutions are sustaining themselves and capitalising on the opportunities presented by climate change at the expense of those most at risk.

Marine protected areas (MPAs) are the preferred tool for preventing marine biodiversity loss, as reflected in international protected area targets. Although the area covered by MPAs is expanding, there is a concern that opposition from resource users is driving them into already low-use locations, whereas high-pressure areas remain unprotected, which has serious implications for biodiversity conservation. We tested the spatial relationships between different human-induced pressures on marine biodiversity and global MPAs. We used global, modeled pressure data and the World Database on Protected Areas to calculate the levels of 15 different human-induced pressures inside and outside the world's MPAs. We fitted binomial generalized linear models to the data to determine whether each pressure had a positive or negative effect on the likelihood of an area being protected and whether this effect changed with different categories of protection. Pelagic and artisanal fishing, shipping, and introductions of invasive species by ships had a negative relationship with protection, and this relationship persisted under even the least restrictive categories of protection (e.g., protected areas classified as category VI under the International Union for Conservation of Nature, a category that permits sustainable use). In contrast, pressures from dispersed, diffusive sources (e.g., pollution and ocean acidification) had positive relationships with protection. Our results showed that MPAs are systematically established in areas where there is low political opposition, limiting the capacity of existing MPAs to manage key drivers of biodiversity loss. We suggest that conservation efforts focus on biodiversity outcomes and effective reduction of pressures rather than prescribing area-based targets, and that alternative approaches to conservation are needed in areas where protection is not feasible.

State/market interactions in water governance have long been interpreted in terms of the contradiction between water as a commons and water as a commodity. Recent challenges to this dichotomisation claim that it cannot provide a useful lens through which to interpret the complexity of water resources and their management. This paper provides evidence from China to show that a dichotomous interpretation of state/market interactions has little power to explain the formulation and evolution of water governance regimes. Through an analysis of China's water policy development over the 1998–2018 period, the paper outlines how state control and marketisation are complementary rather than contradictory, collectively contributing to a governance regime that serves broader political and economic goals as much as water management ones. We argue that better understanding of the roles of state and market in water governance requires moving beyond an ‘either-or’ point of departure, and paying greater attention to the ‘both-and’ hybridisation increasingly observed in water management.

BACKGROUND: Climate change is anticipated to have profound effects on mental health, particularly among populations that are simultaneously ecologically and economically vulnerable to its impacts. Various pathways through which climate change can impact mental health have been theorised, but the impacts themselves remain understudied. PURPOSE: In this article we applied psychological methods to examine if climate change is affecting individuals' mental health in the Small Island Developing State of Tuvalu, a Pacific Island nation regarded as exceptionally vulnerable to climate change. We determined the presence of psychological distress and associated impairment attributed to two categories of climate change-related stressors in particular: 1) local environmental impacts caused or exacerbated by climate change, and 2) hearing about global climate change and contemplating its future implications. METHODS: The findings draw on data collected in a mixed-method study involving 100 Tuvaluan participants. Data were collected via face-to-face structured interviews that lasted 45 min on average and were subjected to descriptive, correlational, and between-group analyses. RESULTS: The findings revealed participants' experiences of distress in relation to both types of stressor, and demonstrated that a high proportion of participants are experiencing psychological distress at levels that reportedly cause them impairment in one or more areas of daily life. CONCLUSIONS: The findings lend weight to the claim that climate change represents a risk to mental health and obliges decision-makers to consider these risks when conceptualizing climate-related harms or tallying the costs of inaction.

Background: Depression has been known to affect memory and other cognitive domains. The objective of this longitudinal cohort study was to investigate longitudinal associations between depressive symptoms at age 31 years and visual memory and new learning at the age of 46 years. We investigated whether depressive symptoms at age 31 predicted visual memory deficits at age 46 years, and whether changes in depressive symptoms between 31 and 46 years predicted visual memory at age 46. Methods: Participants were members of the Northern Finland Birth Cohort 1966. Depressive symptoms were assessed with the Symptom Checklist-25 (SCL-25) on both occasions. Visual memory and new learning were assessed using Paired Associative Learning (PAL) test at the age 46 follow-up. PAL total errors adjusted and first trial memory score were used as outcomes and basic educational level, relationship status, physical activity and diet at baseline were considered as confounding factors in linear regression analysis. Results: A total of 5029 (57% female) participants were included in the main analysis. No associations were found between depressive symptoms or change in depressive symptoms and visual memory and new learning scores. The result did not change following cut-offs 1.55 and 1.75 for depression. Limitations: SCL-25 only measures symptoms during the past week. Only one cognitive domain was assessed. Conclusions: Contrary to our hypothesis, neither baseline depressive symptoms nor change in depressive symptoms predicted visual memory scores 15 years later. It appears that sub-clinical depressive symptoms do not effect this cognitive domain in the middle-aged population.

Objective: We conducted a multimodal coordinate-based meta-analysis (CBMA) to investigate structural and functional brain alterations in first-degree relatives of schizophrenia patients (FRs). Methods: We conducted a systematic literature search from electronic databases to find studies that examined differences between FRs and healthy controls using whole-brain functional magnetic resonance imaging (fMRI) or voxel-based morphometry (VBM). A CBMA of 30 fMRI (754 FRs; 959 controls) and 11 VBM (885 FRs; 775 controls) datasets were conducted using the anisotropic effect-size version of signed differential mapping. Further, we conducted separate meta-analyses about functional alterations in different cognitive tasks: social cognition, executive functioning, working memory, and inhibitory control. Results: FRs showed higher fMRI activation in the right frontal gyrus during cognitive tasks than healthy controls. In VBM studies, there were no differences in gray matter density between FRs and healthy controls. Furthermore, multi-modal meta-analysis obtained no differences between FRs and healthy controls. By utilizing the BrainMap database, we showed that the brain region which showed functional alterations in FRs (i) overlapped only slightly with the brain regions that were affected in the meta-analysis of schizophrenia patients and (ii) correlated positively with the brain regions that exhibited increased activity during cognitive tasks in healthy individuals. Conclusions: Based on this meta-analysis, FRs may exhibit only minor functional alterations in the brain during cognitive tasks, and the alterations are much more restricted and only slightly overlapping with the regions that are affected in schizophrenia patients. The familial risk did not relate to structural alterations in the gray matter.

IntroductionLow quality of life is common in cancer survivors. Increasing physical activity, improving diet, supporting psychological well-being and weight loss can improve quality of life in several cancers and may limit relapse. The aim of the randomised controlled trial outlined in this protocol is to examine whether a digital intervention (Renewed), with or without human support, can improve quality of life in cancer survivors. Renewed provides support for increasing physical activity, managing difficult emotions, eating a healthier diet and weight management.Methods and analysisA randomised controlled trial is being conducted comparing usual care, access to Renewed or access to Renewed with brief human support. Cancer survivors who have had colorectal, breast or prostate cancer will be identified and invited through general practice searches and mail-outs. Participants are asked to complete baseline measures immediately after screening and will then be randomised to a study group; this is all completed on the Renewed website. The primary outcome is quality of life measured by the European Organization for Research and Treatment of Cancer QLQ-c30. Secondary outcomes include anxiety and depression, fear of cancer recurrence, general well-being, enablement and items relating to costs for a health economics analysis. Process measures include perceptions of human support, intervention usage and satisfaction, and adherence to behavioural changes. Qualitative process evaluations will be conducted with patients and healthcare staff providing support.Ethics and disseminationThe trial has been approved by the NHS Research Ethics Committee (Reference 18/NW/0013). The results of this trial will be published in peer-reviewed journals and through conference presentations.

BACKGROUND: Obesity is a major challenge for people with schizophrenia.AimsWe assessed whether STEPWISE, a theory-based, group structured lifestyle education programme could support weight reduction in people with schizophrenia. METHOD: In this randomised controlled trial (study registration: ISRCTN19447796), we recruited adults with schizophrenia, schizoaffective disorder or first-episode psychosis from ten mental health organisations in England. Participants were randomly allocated to the STEPWISE intervention or treatment as usual. The 12-month intervention comprised four 2.5 h weekly group sessions, followed by 2-weekly maintenance contact and group sessions at 4, 7 and 10 months. The primary outcome was weight change after 12 months. Key secondary outcomes included diet, physical activity, biomedical measures and patient-related outcome measures. Cost-effectiveness was assessed and a mixed-methods process evaluation was included. RESULTS: Between 10 March 2015 and 31 March 2016, we recruited 414 people (intervention 208, usual care 206) with 341 (84.4%) participants completing the trial. At 12 months, weight reduction did not differ between groups (mean difference 0.0 kg, 95% CI -1.6 to 1.7, P = 0.963); physical activity, dietary intake and biochemical measures were unchanged. STEPWISE was well-received by participants and facilitators. The healthcare perspective incremental cost-effectiveness ratio was £246 921 per quality-adjusted life-year gained. CONCLUSIONS: Participants were successfully recruited and retained, indicating a strong interest in weight interventions; however, the STEPWISE intervention was neither clinically nor cost-effective. Further research is needed to determine how to manage overweight and obesity in people with schizophrenia.Declaration of interestR.I.G.H. received fees for lecturing, consultancy work and attendance at conferences from the following: Boehringer Ingelheim, Eli Lilly, Janssen, Lundbeck, Novo Nordisk, Novartis, Otsuka, Sa

Shanghai is experiencing drinking water supply problems that are caused by heavy pollution of its raw water supply, deficiencies in its treatment processes, and water quality deterioration in the distribution system. However, little attention has been paid these problems of water quality in raw water, water treatment, and household drinking water. Based on water quality data from 1979 to 2016, we show that microbes (TBC), eutrophication (TP, TN, and NH3–N), heavy metals (Fe, Mn, and Hg), and organic contamination (chemical oxygen demand (COD), detergent (Linear Alklybenzene Sulfonate, LAS), and volatile phenols (VP)) pollute the raw water sources of the Huangpu River and the Changjiang (Yangtze River) estuary. The average concentrations of these contaminants in the Huangpu River are almost double that of the Changjiang estuary, forcing a rapid shift to the Changjiang estuary for raw water. In spite of filtering and treatment, TN, NH3–N, Fe, COD, and chlorine maxima of the treated water and drinking water still exceed the Chinese National Standard. We determine that the relevant threats from the water source to household water in Shanghai are: (1) eutrophication arising from highly concentrated TN, TP, COD, and algal density in the raw water; (2) increasing salinity in the river estuary, especially at the Qingcaosha Reservoir (currently the major freshwater source for Shanghai); (3) more than 50% of organic constituents and by-products remain in treated water; and, (4) bacteria and turbidity increase in the course of water delivery to users. The analysis presents a holistic assessment of the water quality threats to metropolitan Shanghai in relation to the city’s rapid development.

A social practice approach to household consumption examines socially produced patterns of practice, and understands these to be composed of technology, knowledge and meaning. This approach challenges many of the assumptions made about how consumers who are supposedly economically rational behave in large-scale municipal water supply systems. Yet for an emerging body of scholarship that is sensitive to the effects of context, research on social practices is notably short of studies beyond wealthy liberal democracies. In this paper we examine the key practices of daily water consumption for households in Shanghai, China. We identify boiling water, filtering water, and buying water as the three key practices associated with daily water consumption in the home, and explain the way each is the result of combinations of knowledge, meaning and technology. We also consider short-term and longer-term shifts in practices, and explain the influence of the materiality of pollution, information and trust on these changing practices.

Development of schizophrenia relates to both genetic and environmental factors. Functional deficits in many cognitive domains, including the ability to communicate in social interactions and impaired recognition of facial expressions, are common for patients with schizophrenia and might also be present in individuals at risk of developing schizophrenia. Here we explore whether an individual’s polygenic risk score (PRS) for schizophrenia is associated with the degree of interregional similarities in blood oxygen level–dependent (BOLD) signal and gray matter volume of the face-processing network and whether the exposure to early adversity moderates this association. A total of 90 individuals (mean age 22 years, both functional and structural data available) were used for discovery analyses, and 211 individuals (mean age 26 years, structural data available) were used for replication of the structural findings. Both samples were drawn from the Northern Finland Birth Cohort 1986. We found that the degree of interregional similarities in BOLD signal and gray matter volume vary as a function of PRS; lowest interregional correlation (both measures) was observed in individuals with high PRS. We also replicated the gray matter volume finding. We did not find evidence for an interaction between early adversity and PRS on the interregional correlation of BOLD signal and gray matter volume. We speculate that the observed group differences in PRS-related correlations in both modalities may result from differences in the concurrent functional engagement of the face-processing regions over time, eg, via differences in exposure to social interaction with other people.

[No abstract available]

Critics have argued that the evidence of an association between climate change and conflict is flawed because the research relies on a dependent variable sampling strategy1,2,3,4. Similarly, it has been hypothesized that convenience of access biases the sample of cases studied (the ‘streetlight effect’5). This also gives rise to claims that the climate–conflict literature stigmatizes some places as being more ‘naturally’ violent6,7,8. Yet there has been no proof of such sampling patterns. Here we test whether climate–conflict research is based on such a biased sample through a systematic review of the literature. We demonstrate that research on climate change and violent conflict suffers from a streetlight effect. Further, studies which focus on a small number of cases in particular are strongly informed by cases where there has been conflict, do not sample on the independent variables (climate impact or risk), and hence tend to find some association between these two variables. These biases mean that research on climate change and conflict primarily focuses on a few accessible regions, overstates the links between both phenomena and cannot explain peaceful outcomes from climate change. This could result in maladaptive responses in those places that are stigmatized as being inherently more prone to climate-induced violence.

Women are particularly vulnerable to anxiety and depressive disorders. This greater vulnerability has been partly attributed to post-pubertal sex hormone fluctuations, estradiol and progesterone, as well as gender-specific tendencies to engage in maladaptive forms of emotion regulation, particularly rumination. To date, no research has investigated whether sex hormones are associated with emotion regulation in women. In the present study, 61 women participated in a sad mood induction task, involving the viewing of an emotive film. Negative affect was assessed immediately and following recovery, along with self-reported use of rumination, reappraisal, and suppression. Serum levels of estradiol and progesterone were assessed through a blood sample taken at the end of the experiment. Regression analyses were used to examine the relationship between serum hormones and self-reported emotional regulation strategy use, and between serum hormones and the impact of these strategies on negative affect. Estradiol levels positively predicted rumination, but not suppression or reappraisal use. Moreover, estradiol and progesterone interacted with emotion regulation strategies to predict negative affect following the sad mood induction. Reappraisal was associated with greater negative affect only in women with high estradiol, and in women with high progesterone. Conversely, rumination was associated with greater negative affect only in women with low estradiol. Together, these results suggest that sex hormone concentration may be an endogenous contextual factor that is associated with the selection and consequences of emotion regulation strategies in women.

Chapter 6 examines in detail the effects of the interaction of river and infrastructures on the quality of water in Shanghai. The specific risk analysed is that of salt intrusions into the estuary of the Changjiang, through which the water at Shanghai’s intake points becomes more saline than can be made potable in the water treatment plants. The chapter calculates the historical risks of salt intrusions severe enough to threaten Shanghai’s water supply and then examines how the constructions and operation of the Three Gorges Dam and the South–North Water Transfer Project are modifying those risks. Depending on the operating rules of these infrastructures, the risk of an intrusion that could disrupt Shanghai’s water supply has been more than doubled by these constructions.

This chapter brings together the physical hydrology of the river catchment and the estuary, population growth and water demand, management of wastewater and polluting behaviours, people’s trust in the government, and the styles of government decision-making to model the possible futures for Shanghai’s water supply using a Bayesian Belief Network. Three scenarios, each with two variants, are modelled: high growth rate with an authoritarian socio-political order; slower growth, authoritarian and inflexible; slower growth, flexible, participatory and pluralist. The variants are environmental states: (a) the environment imposes increasing challenges; (b) the environment is relatively benign. This model combines quantitative forecasting techniques with a qualitative understanding of broader structural changes. The results indicate that lower growth leads to a greater quantity of water in the Changjiang and that more inclusive forms of governance have additional benefits for water quality, water quantity and trust in the water that is delivered.

Shanghai is critically dependent on the Changjiang, China’s largest river, for its water supply. The flow is very stable from year to year but has strong seasonal variation with 70 per cent of flow in the summer season. The total flow is robust in the face of significant human influences. The annual flow is 900 billion cubic metres and only 0.55 per cent of this is taken for Shanghai’s water supply. No significant threats exist to the total volume of water available but there are threats from seasonal low flows, diversions of water to other users, deteriorating water quality and salt water intrusions that affect the main water supply intakes for Shanghai. The operation of the Three Gorges Dam has induced changes to the monthly flow regime, reducing flows in October to fill the dam before the low flow season and raising flows January to March as that water is used for power generation.

OBJECTIVE: To evaluate the effectiveness of a structured education programmes in women with polycystic ovary syndrome (PCOS). METHODS: Single-centre, randomised controlled trial, testing a single exposure to a group-based, face-to-face, structured education programme. Inclusion criteria were women with PCOS, aged 18-49 years inclusive and body mass index ≥23 kg/m2 for black and minority ethnicities or ≥25 kg/m2 for white Europeans. Primary outcome was step-count/day at 12 months. Secondary outcomes included indices of physical activity, cardiovascular risk factors, quality of life (QoL) and illness perception (IP). RESULTS: 161 women were included (78 control, 83 intervention); 69% white; mean age 33.4 (s.d. 7.6) years, of whom 100 (48 intervention; 52 control) attended their 12-month visit (38% attrition). 77% of the intervention arm attended the education programme. No significant change in step-count was observed at 12 months (mean difference: +351 steps/day (95% confidence interval -481, +1183); P = 0.40). No differences were found in biochemical or anthropometric outcomes. The education programme improved participants' IP in 2 dimensions: understanding their PCOS (P < 0.001) and sense of control (P < 0.01) and improved QoL in 3 dimensions: emotions (P < 0.05), fertility (P < 0.05), weight (P < 0.01) and general mental well-being (P < 0.01). DISCUSSION: A single exposure to structured education programme did not increase physical activity or improve biochemical markers in overweight and obese women with PCOS. However, providing a structured education in parallel to routine medical treatment can be beneficial for participants' understanding of their condition, reducing their anxiety and improving their QoL.

This chapter describes the major infrastructures that influence the discharge of the Changjiang, and the politics that underpinned their construction. Relying on the ideas of technopolitics, the chapter argues that technologies such as dams, levees and water diversions are social artefacts that have political roots but that nevertheless reflect understandings of the behaviour of the river. Three important infrastructures are described – the Three Gorges Dam, the Qingcaosha reservoir and the South–North Water Transfer Project. Each has a certain technical rationality – flood control, electricity production, water storage and providing water to relatively arid regions. Each, though, also has a political rationality – centralising political power, corporate revenue-seeking, inter-jurisdictional conflicts over water resources, and avoiding the need to directly control pollution. Engineering new infrastructures in each case has taken precedence over softer management options such as water demand management and pollution control.

This chapter analyses the demand for, and supply of, water to Shanghai in relation to water quality and variations in availability. The population of Shanghai is growing rapidly. This and declining water quality in its traditional water supply sources has forced Shanghai to become mainly reliant on water from the Changjiang. Since annual water demand is 0.55 per cent of the river’s flow, the Shanghai government does not manage demand for water in the city. Meeting rising demand is dependent on maintaining and expanding the extraction, treatment and supply systems that are ageing and not capable of delivering potable water to consumers. Low flows in the winter season raise the risk of saltwater intrusions, disrupting the system (which has limited storage capacity). The complex intergovernmental responsibilities for water allow other agencies to build water projects (e.g. the South–North Water Transfer System) that are detrimental to Shanghai without considering Shanghai’s situation.

Chapter 9 reinforces the central messages of this book. The Changjiang, government institutions, infrastructures and ordinary people comprise an assemblage of interacting actors. The river is a central actor that depends on inputs from the precipitation system, perhaps modified by land uses, dams, extractions and pollution. The river’s interactions with the tidal system produce a propensity to salt intrusions that can interrupt Shanghai’s water supply. Whether or not people drink this water depends on the cleanliness of the water but more on their willingness to trust the government bureaucracies to supply clean water. In other words, technical choices about forms of infrastructure and water management not only have political bases but also have political consequences. An important consequence of this conclusion is that policy models have different effects in different places: the management of water expresses hydrologic processes, and social–political–economic structures.