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Abstract Coordinated policies and effective global environmental governance are needed to address the global biodiversity crisis. Human dimensions like geopolitics influence conservation decision‐making and outcomes. The importance of considering these complex social factors is heightened in an era of renewed great‐power politics, as the intensifying US–China rivalry has direct implications for environmental governance and biodiversity outcomes. Can the US–China rivalry and its confrontational dynamics be channeled into conservation policymaking to improve biodiversity outcomes? Drawing from international relations and policy studies, policy diffusion theory can provide conservationists with useful insights into the interdependency of policy decisions. Here, we examine the four mechanisms—competition, coercion, learning, and emulation—of the classic model of policy diffusion theory in the context of environmental policymaking. We explore a case study for each mechanism to illustrate how it can benefit biodiversity conservation, and point to examples of relevant policies and actions that could improve outcomes. To operationalize this concept for conservation, we present a decision tree that conservationists can use to determine the most relevant policy diffusion mechanism in different policy contexts. Upon determining the appropriate mechanism, conservationists can take further steps to intentionally trigger the mechanism and catalyze conservation policy diffusion across jurisdictions.

Abstract Background The Emergency Department (ED) is not always the optimal place for people with palliative care needs but is the most common route for treatment when urgent care is sought. The aim of this study,’’REasons for PalLIative Care Admissions (REPLICA)’ was to explore the perspectives of ED healthcare professionals of hospital admission or discharge via ED for palliative care patients. Methods This is a sequential mixed methods study comprising (i) quantitative descriptive analysis of Hospital Episode Statistics (HES) of palliative care patients (code Z51.5) who were admitted through ED in a West Midlands Hospital and for the rest of England; (ii) in-depth semi-structured interviews with 17 ED staff which were analysed using thematic content analysis. Results Over the four years (2013–2017), 430,116 people admitted through ED were identified with a Z51.5 diagnosis code, 0.6% (n = 2736) of whom were from the West Midlands Hospital. The most common reasons for palliative care patients’ admission to hospitals across England were for care of chronic kidney disease, cancers and urinary tract infections. Five themes were elicited from the qualitative analysis: (1) Providing palliative care in ED is challenging, due to factors including lack of training in palliative care and the unsuitable environment. (2) Patients go to ED due to challenges in community management such as inappropriate referrals and no care plan in place. (3) Health system influences admission and discharge decisions, including bed availability and being unable to set up community services out-of-hours. (4) Discussion with patient about treatment and end of life care needs to be outside of ED whilst the patient is still well enough to express their wishes. (5) Improving services for patients with palliative care needs. Recommendations include short training sessions for ED staff and accessing palliative care professionals 24/7. Conclusions A large number of palliative care patients visit ED and are admitted to hospital for care; there is an urgent need to prevent patients attending the hospital through the establishment of a coordinated and dedicated service to support palliative care patients in the community.

Recruitment and retention in cancer trials are long-standing issues, exacerbated by the COVID-19 pandemic. The UK National Institute of Health Research and leading clinicians have emphasised the urgency to achieve and surpass prepandemic levels of participation.Data from a recent UK trial demonstrated the impact of COVID-19 and highlighted factors that limited recruitment. In response to this worldwide problem, studies have identified strategies for remediation at the levels of funding, the research environment, study design and trial team-related aspects, yet evidence of progress is lacking.Equality, diversity and inclusivity have become central to UK health and social policy during the 2000s. The need for greater inclusivity in trials has become a particular concern for cancer researchers and funders in the UK and in the USA, in recognition of potential bias in results. In the UK trials, the lack of standardised recording of ethnicity data renders interpretation difficult and caution is required in comparisons with the USA.Recently, the focus of concern has shifted away from the impact of deprivation and low socioeconomic status on trial participation. Barriers created by these factors and their frequent intersection with ethnicity should not be overlooked.The UK has adopted an advisory approach to broadening recruitment, publishing policy documents, guidance and toolkits. In the USA, by contrast, action on inclusion is increasingly mandated. Within the UK paradigm, the cancer research community is strongly encouraged to adopt a coordinated approach towards standardised digital data collection and embed and evaluate innovative, cocreated, locally relevant strategies.

Ongoing concerns regarding the morbidity and mortality from cancer-associated thrombosis led the European Cancer Patient Coalition (ECPC), the voice of cancer patients across Europe, to create a pan-European cancer-associated awareness patient survey to assess cancer-associated thrombosis (CAT) knowledge among a large population of patients with cancer. The ECPC survey represents the largest of its kind among patients/caregivers with CAT. It identified significant gaps in patient awareness and knowledge of CAT as well as a need for educational CAT-related discussions and interventions between healthcare professionals and patients with cancer and their caregivers. The aim of this paper is to highlight these gaps and to provide awareness of what/when information should be shared with patients/caregivers. Notably, the importance of providing information on how to reduce their risk of CAT, the role of anticoagulant prophylaxis and treatment (short- and long-term) including possible side-effects, and finally how to identify CAT symptoms early. Here we outline what type of information should be provided, as well as when and how to best discuss CAT with our oncology patients and their caregivers along the cancer care continuum, to reduce the risk of CAT and associated complications with a goal of improving patient outcomes.

Objective: Although much has been documented about the experience of breast cancer, the accounts of young women have been relatively neglected, despite that around 20% of the breast cancer diagnoses occur in women under the age of 50. In particular, the voices of young women diagnosed during pregnancy are missing from research. Breast cancer is the most common cancer associated with pregnancy, and it is diagnosed in about 1 in 3000 pregnancies. Methods: This study presents data from three women drawn from a larger study of women who had been diagnosed under the age of 45 and had completed their treatment for breast cancer. Semi-structured qualitative interviews were undertaken, with a methodology informed by social constructionist grounded theory and feminism. Results: The findings here report the ways that having breast cancer during pregnancy disrupted taken-for-granted assumptions about their pregnancies, new motherhood, and their future life course, and how this occurred within the context of gendered ideas about femininity and motherhood. Conclusions: Breast cancer during pregnancy has a far-reaching impact on young women's lives, and women affected may need practical support in caring for young children, and counselling may be appropriate. Further research is needed in this important area.

Coordinated policies and effective global environmental governance are needed to address the global biodiversity crisis. Human dimensions like geopolitics influence conservation decision‐making and outcomes. The importance of considering these complex social factors is heightened in an era of renewed great‐power politics, as the intensifying US–China rivalry has direct implications for environmental governance and biodiversity outcomes. Can the US–China rivalry and its confrontational dynamics be channeled into conservation policymaking to improve biodiversity outcomes? Drawing from international relations and policy studies, policy diffusion theory can provide conservationists with useful insights into the interdependency of policy decisions. Here, we examine the four mechanisms—competition, coercion, learning, and emulation—of the classic model of policy diffusion theory in the context of environmental policymaking. We explore a case study for each mechanism to illustrate how it can benefit biodiversity conservation, and point to examples of relevant policies and actions that could improve outcomes. To operationalize this concept for conservation, we present a decision tree that conservationists can use to determine the most relevant policy diffusion mechanism in different policy contexts. Upon determining the appropriate mechanism, conservationists can take further steps to intentionally trigger the mechanism and catalyze conservation policy diffusion across jurisdictions. [ABSTRACT FROM AUTHOR]

In the contemporary era, a few global North countries have been dominant actors in global environmental governance. However, as their approach has resulted in an imbalance of benefits and costs across regions, there has been an increasing effort to incorporate socio-economic and livelihoods aspects into wildlife protection strategies. Within this ongoing discussion, I explore how China, as a rising power, approached the environmental norms of protecting endangered marine species in the last decades. By tracing its policy development from 2003 to 2019, I find that China has changed its policy from challenging to reconciling and finally to reconfiguring its governance practice. Drawing upon socialization scholarship, I argue that China's policy adaptation demonstrates selective socialization, where an actor makes issue-specific decisions involving reconciling the discrepancy between international norms and domestic interests. This study has far-reaching implications on China's potential role and influence in global governance on protecting wildlife. First, its marine biodiversity policy reaches beyond existing approaches and represents values and interests with regard to marine species. Second and relatedly, China's socialization processes are bidirectional, generating alternative approaches to international norms within existing governance practice. [ABSTRACT FROM AUTHOR]

As a significant actor in global governance, China has become increasingly active in addressing global environmental challenges. However, Chinese fishing practices do not conform with its policies. How do we understand China's apparently incoherent stance? Using the case of illegal, unreported, and unregulated (IUU) fishing governance, we explore why China shifted its approach from reluctance to engagement while still allowing the Chinese fleet's IUU fishing activities to some extent. We find that China safeguards its self-interest by shaping domestic and international rules on anti-IUU fishing while pursuing means of legitimising its actions and intangible aspects of power in the oceans. Our findings have far-reaching implications. First, China's notion of environmental responsibility is likely to remain within the scope of its interests and what China can control. Second, China's global environmental approach can be understood as the pursuit of intangible aspects of great power status in addition to its tangible interests. [ABSTRACT FROM AUTHOR]

This study explores the conditions under which China complies with the international norms of banning the trade in endangered species using tiger bones and ivory cases. Why did China ban the ivory trade but attempt to allow the trade in tiger derivatives? The authors traced the key policies formulated by Chinese policymakers during 1981–2018. Drawing upon norm localization theory, the authors find that domestic policy preferences played a key role in linking domestic and international norms. Chinese policymakers actively chose ideas to advance their policy preferences, and this localization process reaches beyond a static fitting process between domestic-international norms. This finding has implications for wildlife policies in developing countries and sheds light on China's wildlife policy development following the outbreak of coronavirus. [ABSTRACT FROM AUTHOR]

In trade negotiations, developed countries have been frontrunners in advocating environmental protection whereas developing countries were reluctant to link environmental protection to their trade agreements. However, the recent trend of including environmental provisions (EPs) in free trade agreements (FTAs) shows a policy change in some of the emerging economies. Not only did they adopt EPs but they also actively introduced a comprehensive set of EPs – environmental chapters. Using the Republic of Korea (Korea)'s FTAs, this study explores why emerging economies come to include environmental chapters in their FTAs. Existing studies have offered explanations focusing on domestic politics. Yet, they do not specify the impact of the interaction between domestic and international politics. Through the lens of the two-level games, this study finds that the combination of domestic and international pressures plays an important role in making green FTAs. First, Korea has been pursuing environmental leadership at the world stage during the Korea-US FTA (KORUS) negotiation. Against this background, the US' proposal to include an environmental chapter has reverberated within domestic politics. Second, the costs of implementing this environmental chapter were low. After the KORUS, Korea has been including similar environmental chapters because these chapters were cost-effective ways to promote its enduring environmental leadership. This finding has far-reaching implications for facilitating emerging economies' green FTAs. [ABSTRACT FROM AUTHOR]