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Executive SummaryThe Marine Strategy Framework Directive (MSFD) aims to achieve Good Environmental Status (GES) withinEuropean Commission waters through an ecosystem‐based approach. The MSFD requires Member Statessharing a marine region or sub‐region to cooperate to ensure that the Directive’s objectives are achievedWorking towards an ecosystem perspective: Proposals for the integration of pelagic, benthic and food web indicatorsand to coordinate their actions through Regional Seas Conventions e.g. the OSPAR Commission for theNorth‐East Atlantic. As part of the ‘applying an Ecosystem Approach to (sub) Regional Habitat Assessments’(EcApRHA) project, integration of indicators under Descriptor 1 (biodiversity), 4 (food webs) and 6 (seafloorintegrity), relating to pelagic and benthic habitats and food webs have been forwarded to work towards anecosystem’s approach in assessing habitats regionally. The content of this report covers differentapproaches developed to integrate indicators forwarded within the project.Five methods are described, four of which were developed to integrate indicators developed under theEcApRHA project. The fifth, OSPAR’s cumulative effect approach has also been summarised as an additionalapproach to integrate indicators. For each method, management implications; the advantages anddisadvantages in relation to being able to work toward assessment of GES; and the confidence in theassessments, are highlighted. The time it would take for the approach to become fully operational, itsfeasibility and costs are also discussed.From the five methods described, three main approaches are discussed:I. A quantitative method to draw links between indicators to assess pressures that have effectson the different aspects of the marine ecosystem (Chapters 3‐4).II. Use of the Nested Environmental status Assessment Tool (NEAT) to integrate differentindicators to provide an overall assessment (Chapters 5 and 6).III. Use of an industry led risk assessment tool (Bow‐Tie

Background: The role of inflammation in mood disorders has received increased attention. There is substantial evidence that cytokine therapies, such as interferon alpha (IFN-alpha), can induce depressive symptoms. Indeed, proinflammatory cytokines change brain function in several ways, such as altering neurotransmitters, the glucocorticoid axis, and apoptotic mechanisms. This study aimed to evaluate the impact on mood of initiating IFN-alpha and ribavirin treatment in a cohort of patients with chronic hepatitis C. We investigated clinical, personality, and functional genetic variants associated with cytokine-induced depression.; Methods: We recruited 344 Caucasian outpatients with chronic hepatitis C, initiating IFN-alpha and ribavirin therapy. All patients were euthymic at baseline according to DSM-IV-R criteria. Patients were assessed at baseline and 4, 12, 24, and 48 weeks after treatment initiation using the Patient Health Questionnaire (PHQ), the Hospital Anxiety and Depression Scale ( HADS), and the Temperament and Character Inventory (TCI). We genotyped several functional polymorphisms of interleukin-28 (IL28B), indoleamine 2,3-dioxygenase (IDO-1), serotonin receptor-1A (HTR1A), catechol-O-methyl transferase (COMT), glucocorticoid receptors (GCR1 and GCR2), brain-derived neurotrophic factor (BDNF), and FK506 binding protein 5 (FKBP5) genes. A survival analysis was performed, and the Cox proportional hazards model was used for the multivariate analysis.; Results: The cumulative incidence of depression was 0.35 at week 24 and 0.46 at week 48. The genotypic distributions were in Hardy-Weinberg equilibrium. Older age (p = 0.018, hazard ratio [HR] per 5 years = 1.21), presence of depression history (p = 0.0001, HR = 2.38), and subthreshold depressive symptoms at baseline (p = 0.005, HR = 1.13) increased the risk of IFN-induced depression. So too did TCI personality traits, with high scores on fatigability (p = 0.0037, HR = 1.17), impulsiveness (p = 0.0200 HR = 1.1, Peer Reviewed, Postprint (published version)