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Reassembling ecological communities and rebuilding habitats through active restoration treatments require curating the selection of plant species to use in seeding and planting mixes. Ideally, these mixes should be assembled based on attributes that support ecosystem function and services, promote plant and animal species interactions and ecological networks in restoration while balancing project constraints. Despite these critical considerations, it is common for species mixes to be selected opportunistically. Reframing the selection of seed mixes for restoration around ecological objectives is essential for success but accessible methods and tools are needed to support this effort. We developed a framework to optimize species seed mixes based on prioritizing plant species attributes to best support different objectives for ecosystem functions, services and trophic relationships such as pollination, seed dispersal and herbivory. We compared results to approaches where plant species are selected to represent plant taxonomic richness, dominant species and at random. We tested our framework in European alpine grasslands by identifying 176 plant species characteristic of the species pool, and identified 163 associated attributes affiliated to trophic relationships, ecosystem functions and services. In all cases, trophic relationships, ecosystem functions and services can be captured more efficiently through objective-based prioritization using the functional identity of plant species. Solutions (plant species lists) can be compared quantitatively, in terms of costs, species or objectives. We confirm that a random draw of plant species from the regional plant species pool cannot be assumed to support other trophic groups and ecosystem functions and services. Synthesis and Applications. Our framework is presented as a proof-of-concept to help restoration practitioners better apply quantitative decision support to plant species selection to efficiently meet ecological restoration outcomes. Our approach may be tailored to any restoration initiative, habitat or restoration targets where seeding or planting mixes will be applied in active treatments. As global priority and resources are increasingly placed into restoration, this approach could be advanced to help make efficient decisions for many stages of the restoration process.

All aspects of biodiversity research, from taxonomy to conservation, rely on data associated with species names. Effective integration of names across multiple fields is paramount and depends on coordination and organization of taxonomic data. We review current efforts and find that even key applications for well-studied taxa still lack taxonomic elements required for interoperability and use. We identify opportunities offered by a metadata structure that supports improved access and integration of taxonomic backbone data, better connects taxonomic communities, and highlights broken linkages that limit the current research capacity. We recommend ways forward to improve interoperability of taxonomic data and resultant downstream use in broad biodiversity research and conservation applications.

The ocean contains unique biodiversity, provides valuable food resources and is a major sink for anthropogenic carbon. Marine protected areas (MPAs) are an effective tool for restoring ocean biodiversity and ecosystem services1,2, but at present only 2.7% of the ocean is highly protected3. This low level of ocean protection is due largely to conflicts with fisheries and other extractive uses. To address this issue, here we developed a conservation planning framework to prioritize highly protected MPAs in places that would result in multiple benefits today and in the future. We find that a substantial increase in ocean protection could have triple benefits, by protecting biodiversity, boosting the yield of fisheries and securing marine carbon stocks that are at risk from human activities. Our results show that most coastal nations contain priority areas that can contribute substantially to achieving these three objectives of biodiversity protection, food provision and carbon storage. A globally coordinated effort could be nearly twice as efficient as uncoordinated, national-level conservation planning. Our flexible prioritization framework could help to inform both national marine spatial plans4 and global targets for marine conservation, food security and climate action. Using a globally coordinated strategic conservation framework to plan an increase in ocean protection through marine protected areas can yield benefits for biodiversity, food provisioning and carbon storage.

Incentivized debt conversion is a financing mechanism that can assist countries with a heavy debt burden to bolster their long‐term domestic investment in nature conservation. The Nature Conservancy, an international conservation‐based nongovernmental organization, is adapting debt conversions to support marine conservation efforts by small island developing states and coastal countries. Prioritizing debt conversion opportunities according to their potential return on investment can increase the impact and effectiveness of this finance mechanism. We developed guidance on how to do so with a decision‐support approach that relies on a novel threat‐based adaptation of cost‐effectiveness analysis. We constructed scenarios by varying parameters of the approach, including enabling conditions, expected benefits, and threat classifications. Incorporating both abatable and unabatable threats affected priorities across planning scenarios. Similarly, differences in scenario construction resulted in unique solution sets for top priorities. We show how environmental organizations, private entities, and investment banks can adopt structured prioritization frameworks for making decisions about conservation finance investments, such as debt conversions. Our guidance can accommodate a suite of social, ecological, and economic considerations, making the approach broadly applicable to other conservation finance mechanisms or investment strategies that seek to establish a transparent process for return‐on‐investment decision‐making., Article Impact Statement: Prioritizations that explicitly incorporate abatable and unabatable threats can improve conservation return on investment decision‐making.

1. Globally, protected areas are being established to protect biodiversity and to promote ecosystem resilience. The typical spatial conservation planning process leading to the creation of these protected areas focuses on representation and replication of ecological features, often using decision support tools such as Marxan. Yet, despite the important role ecological connectivity has in metapopulation persistence and resilience, Marxan currently requires manual input or specialized scripts to explicitly consider connectivity. 2. ‘Marxan Connect’ is a new open source, open access Graphical User Interface (GUI) tool designed to assist conservation planners with the appropriate use of data on ecological connectivity in protected area network planning. 3. Marxan Connect can facilitate the use of estimates of demographic connectivity (e.g. derived from animal tracking data, dispersal models, or genetic tools) or structural landscape connectivity (e.g. isolation by resistance). This is accomplished by calculating metapopulation‐relevant connectivity metrics (e.g. eigenvector centrality) and treating those as conservation features or by including the connectivity data as a spatial dependency amongst sites in the prioritization process. 4. Marxan Connect allows a wide group of users to incorporate directional ecological connectivity into conservation planning with Marxan. The solutions provided by Marxan Connect, combined with ecologically relevant post‐hoc testing, are more likely to support persistent and resilient metapopulations (e.g. fish stocks) and provide better protection for biodiversity.

Assessing and addressing biodiversity needs are of critical and time-sensitive importance, with the post-2020 Global Biodiversity Framework’s Global Taxonomy Initiative underscoring the need to build capacity in how we conceptualize biodiversity (Abrahamse et al. 2021). Species—as biological units—and their names are the backbone for the data integration and synthesis needed for biodiversity research and conservation decision-making (Grace et al. 2021). In integrating name sources for a single taxonomic group, barriers frequently limit linking species names across regional and global authoritative sources. In response to such challenges, we present a case study testing a Globally Integrated Structure of Taxonomy (GIST) to ensure the integration of taxonomy in biodiversity and conservation sciences. This framework characterizes the components enabling transparent association of species names through synonymy (alternate names or spellings), authorship, specimens, versions and timestamps, and taxonomic relationships in space and time. Taxonomy provides a critical link between biodiversity data types and databases. Efforts towards global taxonomic integration are confounded by insufficient connectivity between taxonomic assemblages, with implications for research, monitoring, and conservation practice (Christie et al. 2021, Jetz et al. 2019, McClure et al. 2020). In attempting to match multiple taxonomic groups across databases, we highlight current progress and remaining challenges to produce and use a GIST. We evaluate the standardized, comprehensive taxonomies of mammals, birds, reptiles, amphibians, dragonflies and damselflies, butterflies, ants, plants, and crabs produced for the Map of Life project (Jetz et al. 2012), identifying which missing components impede their utility. We show that for terrestrial mammals, GIST standards are almost fulfilled, but for invertebrate taxa, such as butterflies, GIST standards are unmet, resulting in broken taxonomic links between aggregators of genetic, spatial, functional, and physical data. We find that even the comprehensive taxonomies we examine do not harmonize well with taxonomies of global genetics, phylogenetics, macroecology, and conservation databases. This is because current taxonomic data infrastructures on biodiversity respositories lack the necessary structural components, searchability, and name source transparency to fully integrate taxonomies, as different independently advancing data sources lack standard metadata practices and operable interfaces. The GIST components enable data linkage and provide clear sourcing and metadata, enabling taxonomic data accessibility, reuse, and interoperability. This structure can act as a step toward open and FAIR (Findable, Accessible, Interoperable, and Reusable) data practice as it relates to taxon names (Wilkinson et al. 2016). Without transparent, integrated, accessible, and updated taxonomic information, macroecological inferences and conservation decisions for even charismatic groups are impeded.

Innovation has the potential to enable conservation science and practice to keep pace with the escalating threats to global biodiversity, but this potential will only be realized if such innovations are designed and developed to fulfill specific needs and solve well-defined conservation problems. We propose that business-world strategies for assessing the practicality of innovation can be applied to assess the viability of innovations, such as new technology, for addressing biodiversity conservation challenges. Here, we outline a five-step, "lean start-up" based approach for considering conservation innovation from a business-planning perspective. Then, using three prominent conservation initiatives - Marxan (software), Conservation Drones (technology support), and Mataki (wildlife-tracking devices) - as case studies, we show how considering proposed initiatives from the perspective of a conceptual business model can support innovative technologies in achieving desired conservation outcomes.

Advancing technology represents an unprecedented opportunity to enhance our capacity to conserve the Earth's biodiversity. However, this great potential is failing to materialize and rarely endures. We contend that unleashing the power of technology for conservation requires an internationally coordinated strategy that connects the conservation community and policy-makers with technologists. We argue an international conservation technology entity could (1) provide vision and leadership, (2) coordinate and deliver key services necessary to ensure translation from innovation to effective deployment and use of technology for on-the-ground conservation across the planet, and (3) help integrate innovation into biodiversity conservation policy from local to global scales, providing tools to monitor outcomes of conservation action and progress towards national and international biodiversity targets. This proposed entity could take the shape of an international alliance of conservation institutions or a formal intergovernmental institution. Active and targeted uptake of emerging technology can help society achieve biodiversity conservation goals.

Spatial prioritization is a critical step in conservation planning, a process designed to ensure that limited resources are applied in ways that deliver the highest possible returns for biodiversity and human wellbeing. In practice, many spatial prioritizations fall short of their potential by focusing on places rather than actions, and by using data of snapshots of assets or threats rather than estimated impacts. We introduce spatial action mapping as an approach that overcomes these shortfalls. This approach produces a spatially explicit view of where and how much a given conservation action is likely to contribute to achieving stated conservation goals. Through seven case examples, we demonstrate simple to complex versions of how this method can be applied across local to global scales to inform decisions about a wide range of conservation actions and benefits. Spatial action mapping can support major improvements in efficient use of conservation resources and will reach its full potential as the quality of environmental, social, and economic datasets converge and conservation impact evaluations improve.

Aquaculture is the fastest growing food production industry in the world yet research and guidance demonstrating strategic multi-objective zoning for sector expansion is scarce. Quantifying and mitigating conflicts and impact on sensitive coastal environments through jointly-optimized objectives for aquaculture and biodiversity simultaneously has not been tested yet. We here develop and evaluate six alternative planning scenarios for one of the European Union’s highest priority mussel aquaculture areas, the Emilia-Romagna Region in Italy. We i) develop an aquaculture profitability surface as a function of the distance from main ports, and in parallel build a fine-scale aquaculture suitability distribution surface for important commercial species using multi-criteria analysis; ii) prioritize protected areas for biodiversity while testing how different considerations of human impacts influence priorities; iii) simultaneously plan for aquaculture and biodiversity while minimizing impacts on other maritime activities. We compare results from different scenarios according to how well they capture suitable aquaculture habitats and minimize impacts. We introduce a new evaluation method for scenario comparison in spatial optimization using a nearest-neighbour analysis for spatial pattern similarities. Lastly, we test the “value of information” provided by our investment in developing the fine-scale suitability surface to improve efficiencies. We find that an integrated multi-objective zoning approach, which simultaneously optimizes for biodiversity and aquaculture, supports more efficient planning than traditional sector specific growth strategies. We also discovered that the fine-scale suitability model delivered an 8% more efficient solution than the simple distance function, highlighting the role of proxy surfaces and diminished returns from investing in comprehensive habitat suitability analysis in regions without much variation in key parameters. We offer evidence of improved efficiency and practical guidance for integrated planning in Blue Growth agendas. Our analysis can be applied in any context where multiple objectives occur for aquaculture sector growth and biodiversity conservation., This is a preprint (pre-peer reviewed) version of the following paper: "Chiara Venier, Stefano Menegon, Hugh P. Possingham, Elena Gissi, Andrea Zanella, Daniel Depellegrin, Alessandro Sarretta, Andrea Barbanti, Jennifer McGowan, Multi-objective zoning for aquaculture and biodiversity", in Science of the Total Environment, Volume 785 (2021) 146997 https://doi.org/10.1016/j.scitotenv.2021.146997.

Marine protected areas (MPAs) are key to averting continued loss of species and ecosystem services in our oceans, but concerns around economic trade-offs hamper progress. Here we provide optimized planning scenarios for global MPA networks that secure species habitat while minimizing impacts on fisheries revenues. We found that MPA coverage requirements differ vastly among nations, and that two-thirds of nations benefit economically from a collaborative approach. Immediate global protection of marine biodiversity habitat comes with losses of ~19% of total fisheries revenues, but international cooperation in concert with high seas protection improves economic losses for most countries, safeguards all species, and could save ~5B USD annually worldwide. Nations and fishery economies both share benefits from a coordinated approach to conserving marine biodiversity, with direct relevance to current international policies.

Reassembling ecological communities and rebuilding habitats through active restoration treatments requires curating the selection of plant species to use in seeding and planting mixes. Ideally, these mixes should be assembled based on attributes that support ecosystem function and services, promote plant and animal species interactions and ecological networks in restoration while balancing project constraints. Despite these critical considerations, it is common for species mixes to be selected opportunistically. Reframing the selection of seed mixes for restoration around ecological objectives is essential for success but accessible methods and tools are needed to support this effort.We developed a framework to optimize species seed mixes based on prioritizing plant species attributes to best support different objectives for ecosystem functions, services, and trophic relationships such as pollination, seed dispersal, and herbivory. We compared results to approaches where plant species are selected to represent plant taxonomic richness, dominant species, and at random. We tested our framework for 176 plant species found in European alpine grasslands and identified 163 associated attributes affiliated to trophic relationships, ecosystem functions, and services.In all cases, trophic relationships, ecosystem functions, and services can be captured more efficiently through objective-based prioritization using the functional identity of plant species. Solutions (plant species lists) can be compared quantitatively, in terms of costs, species, or objectives. We confirm that a random draw of plant species from the regional plant species pool cannot be assumed to support other trophic groups and ecosystem functions and services.Synthesis and Applications. Our framework is presented as a proof of concept to help restoration practitioners better apply quantitative decision–support to plant species selection in order to meet ecological restoration outcomes. Our approach may be tailored to any restoration initiative and habitat where seeding or planting mixes will be applied in active treatments. As global priority and resources are increasingly placed into restoration, this approach could be advanced to help make efficient decisions for many stages of the restoration process.

On January 27, 2021, President Biden signed an executive order, Tackling the Climate Crisis at Home and Abroad, committing the United States to various goals within his campaign’s major climate policy, the Biden Plan for a Clean Energy Revolution and Environmental Justice. Included in this executive order is a commitment to “conserving at least 30 percent of [the United States’] lands and oceans by 2030.” This ambitious conservation target signals a promising direction for biodiversity in the United States. However, while the executive order outlines several goals for climate mitigation, the ‘30×30’ target remains vague in its objectives, actions, and implementation strategies for protecting biodiversity. Biodiversity urgently needs effective conservation action, but it remains unclear where and what this 30% target will be applied to. Achieving different climate and biodiversity objectives will require different strategies and, in combination with the associated costs of implementation, will lead to different priority areas for conservation actions. Here, we illustrate what the 30% target could look like across four objectives reflective of the ambitious goals outlined in the executive order. We compile several variations of terrestrial protected area networks guided by these different objectives and examine the trade-offs in costs, ecosystem representation, and climate mitigation potential between each. We find little congruence in priority areas across objectives, emphasizing just how crucial it will be for the Biden administration to develop clear objectives and establish appropriate performance metrics from the outset to maximize both conservation and climate outcomes in support of the 30×30 target. We discuss important considerations that must guide the administration’s conservation strategies in order to ensure meaningful conservation outcomes can be achieved over the next decade.

BACKGROUND Disproportionally high rates of COVID-19 have been noted among communities with limited English proficiency (LEP), resulting in an unmet need for improved multilingual care and interpreter services. To enhance multilingual care, we created a freely available web app (RadTranslate™) that provides multilingual radiology exam instructions. The purpose of this study was to evaluate the implementation of this intervention in radiology. METHODS The device-agnostic web app leverages artificial-intelligence text-to-speech to provide standardized, human-like spoken exam instructions in the patient’s preferred language. Standardized phrases were collected from a consensus group consisting of technologists, radiologists, and ancillary staff. RadTranslate was piloted in Spanish for chest radiographs (CXR) performed at a COVID-19 triage outpatient center that served a predominantly Spanish-speaking Latine community. Implementation included a tablet displaying the app in the CXR room. Imaging appointment duration (IAD) was measured and compared between pre- and post-implementation groups. RESULTS In the 63-day test period following launch, there were 1267 app uses, with technologists voluntarily switching exclusively to RadTranslate for Spanish-speaking patients. The most used phrases were a general explanation of the exam (30% of total) followed by instructions to disrobe and remove any jewelry (12%). There was no significant difference in the IAD, 11±7 min (mean ± standard deviation) and 12±3 for standard-of-care versus RadTranslate, respectively; however, variability was significantly lower when RadTranslate was used (p=0.003). CONCLUSION AI-aided multilingual audio instructions were successfully integrated into imaging workflows, reducing strain on medical interpreters and variance in throughput resulting in more reliable average exam length., RadTranslate (www.radtranslate.com), a web-based tool, allows standardized audio imaging exam instructions to be given in a patient’s native language via a simple interface, and reduces variability in exam times among non-English patients receiving chest radiographs.

To meet the ambitious objectives of biodiversity and climate conventions, the international community requires clarity on how these objectives can be operationalized spatially and how multiple targets can be pursued concurrently. To support goal setting and the implementation of international strategies and action plans, spatial guidance is needed to identify which land areas have the potential to generate the greatest synergies between conserving biodiversity and nature’s contributions to people. Here we present results from a joint optimization that minimizes the number of threatened species, maximizes carbon retention and water quality regulation, and ranks terrestrial conservation priorities globally. We found that selecting the top-ranked 30% and 50% of terrestrial land area would conserve respectively 60.7% and 85.3% of the estimated total carbon stock and 66% and 89.8% of all clean water, in addition to meeting conservation targets for 57.9% and 79% of all species considered. Our data and prioritization further suggest that adequately conserving all species considered (vertebrates and plants) would require giving conservation attention to ~70% of the terrestrial land surface. If priority was given to biodiversity only, managing 30% of optimally located land area for conservation may be sufficient to meet conservation targets for 81.3% of the terrestrial plant and vertebrate species considered. Our results provide a global assessment of where land could be optimally managed for conservation. We discuss how such a spatial prioritization framework can support the implementation of the biodiversity and climate conventions.

BackgroundInterventions to modify school environments are effective in promoting young people’s health across outcomes, but mechanisms are poorly understood. We assessed mediation in a trial of the Learning Together intervention, building on the recent publication of results of effectiveness for reducing bullying and benefits across secondary outcomes and generally good implementation fidelity.MethodsWithin a cluster-randomised trial involving 40 English schools, we examined student-reported and staff-reported school climate and student-reported involvement with delinquent peers at 24-month and 36-month follow-up, assessing the reliability of measures and whether these mediated health outcomes at a final follow-up.ResultsResponse rates and reliability were good for student-reported but not staff-reported measures. The intervention increased student-reported but not staff-reported-positive school climate but, like effects on student health outcomes, these manifested only at a final follow-up. The intervention reduced student-reported contact with delinquent peers at an interim follow-up. Student-reported potential mediators measured at the interim follow-up were associated with most health outcomes at the final follow-up. Adjustment for student-reported school climate and contact with delinquent peers at the interim follow-up did not reduce the associations between trial arm and our health outcomes.ConclusionDespite being constrained by imperfect measures and by the late manifestation of impacts on student-reported school climate undermining ability to assess mediation, our study for the first time provides tentative evidence that mediation of intervention effects via improved climate and disengagement from delinquent peers is plausible. Our study provides the first evidence from a trial that whole-school interventions may work by modifying school environments and student relationships.Trial registration numberISRCTN10751359.

Global conservation targets (e.g. Aichi Target 11) have helped drive a dramatic expansion of the global protected area (PA) network. Credible metrics have an important role to play in evaluating and expanding PAs to achieve conservation outcomes and objectives. For metrics to be useful and adopted, they need to be transparent, easy to understand, and easy to implement. We present two complementary metrics, “mean protection gap” and “mean target achievement”, for evaluating representation target achievement in PA networks along with the R package “ConsTarget” that calculates and plots both metrics. We use Australia's proposed Commonwealth Marine Reserve network as a case study to demonstrate the application of these metrics. We recommend the metrics be used to evaluate the progress towards building representative PA networks in line with Aichi target 11's goals.

Effective conservation management interventions must combat threats and deliver benefits at costs that can be achieved within limited budgets. Considerable effort has focused on measuring the potential benefits of conservation interventions, but explicit quantification of the financial costs of implementation is rare. Even when costs have been quantified, haphazard and inconsistent reporting means published values are difficult to interpret. This reporting deficiency hinders progress toward a collective understanding of the financial costs of management interventions across projects and thus limits the ability to identify efficient solutions to conservation problems or attract adequate funding. We devised a standardized approach to describing financial costs reported for conservation interventions. The standards call for researchers and practitioners to describe the objective and outcome, context and methods, and scale of costed interventions and to state which categories of costs are included and the currency and date for reported costs. These standards aim to provide enough contextual information that readers and future users can interpret the cost data appropriately. We suggest these standards be adopted by major conservation organizations, conservation science institutions, and journals so that cost reporting is comparable among studies. This would support shared learning and enhance the ability to identify and perform cost‐effective conservation.

Aim To assess the efficacy of marine reserves in Australia for shy albatross, using long‐term tracking data. Location Albatross Island, Tasmania, and south Australian waters. Methods We integrated a tracking dataset consisting of 111 individuals collected over 23 years and generated Brownian bridge kernel density estimations to identify important habitat. We quantified the overlap between the foraging distribution of early incubating adults and post‐fledgling juveniles with management boundaries and marine reserves. We compared the extent of coverage of albatross foraging areas by Marine Protection Areas (MPAs) relative to a randomly designed network of the same size to determine whether the spatial protection measures are likely to be effective. Results Incubating adults consistently foraged in waters to the northwest of Tasmania while post‐fledglings occupied shelf waters around Tasmania and South Australia. We show that our sample of 99 incubating adults adequately represented the population but that our sample of 12 post‐fledgling birds was insufficient, thereby limiting the confidence in our results for this life stage. The Commonwealth Government has the majority of management responsibility for shy albatross at‐sea, containing 88% and 90% of the area occupied most intensively by adult and post‐fledgling shy albatross, respectively. Randomly designed reserve networks outperformed the current MPA network for both life stages, such that the mean protection by a random reserve system was 30% and 12% higher than the actual protection for adults and juveniles in Commonwealth waters. Main conclusions Important foraging habitat of shy albatross from Albatross Island is mostly within Commonwealth‐managed waters. The current MPA network, the only spatial protection measure for shy albatross, provides less coverage for this species than a randomly placed network. An increase in the representation of productive shelf waters in MPA networks would benefit the conservation of shy albatross through reducing fisheries interactions and protecting habitat in these regions.

The Adriatic and Ionian Region is an important area for both strategic maritime development and biodiversity conservation in the European Union (EU). However, given that both EU and non-EU countries border the sea, multiple legal and regulatory frameworks operate at different scales, which can hinder the coordinated long-term sustainable development of the region. Transboundary marine spatial planning can help overcome these challenges by building consensus on planning objectives and making the trade-offs between biodiversity conservation and its influence on economically important sectors more explicit. We address this challenge by developing and testing 4 spatial prioritization strategies with the decision-support tool Marxan, which meets targets for biodiversity conservation while minimizing impacts to users. We evaluated these strategies in terms of how priority areas shift under different scales of target setting (e.g., regional vs. country level). We also examined the trade-off between cost-efficiency and how equally solutions represent countries and maritime industries (n = 14) operating in the region with the protection-equality metric. We found negligible differences in where priority conservation areas were located when we set targets for biodiversity at the regional versus country scale. Conversely, the prospective impacts on industries, when considered as costs to be minimized, were highly divergent across scenarios and biased the placement of protection toward industries located in isolation or where there were few other industries. We recommend underpinning future marine spatial planning efforts in the region through identification of areas of national significance, transboundary areas requiring cooperation between countries, and areas where impacts on maritime industries require careful consideration of the trade-off between biodiversity conservation and socioeconomic objectives.

Introduction: Higher levels of anxiety and depression have been found to be associated with greater difficulty in stopping smoking. This raises the question as to whether mood disturbance may be associated with exposure to, and use of, quitting support.Aims: This study examined whether General Practitioner (GP) advice and/or offer of support, or stop-smoking service use differed between smokers reporting or not reporting depression/anxiety.Methods: Data came from the Smoking Toolkit Study. Participants were 1,162 English adults who reported currently smoking or having stopped within the past 12 months, aged 40+ years, surveyed between April and September 2012. Anxiety/depression was assessed by the mood disturbance item of the EuroQol five dimensions questionnaire (EQ-5D). This was compared to recall of GP quit advice and/or support, and stop-smoking aid use adjusting for age, gender, and social grade.Results/Findings: Smokers reporting depression/anxiety were more likely to recall being offered advice and support to stop smoking by their GP (OR = 1.50, 95% C.I. = 1.05–2.13). However, there were no significant differences in use of stop-smoking aids during the past year.Conclusions: Smokers reporting depression/anxiety are more likely to be offered stop-smoking support by their GPs, but this does not appear to translate into stop-smoking aid use, despite high motivation to quit. Given higher nicotine dependence in this group, mental health specific support may need to be offered, and more needs to be done to make this offer of aid attractive.

Summary Background Bullying, aggression, and violence among children and young people are some of the most consequential public mental health problems. We tested the Learning Together intervention, which involved students in efforts to modify their school environment using restorative practice and by developing social and emotional skills. Methods We did a cluster randomised trial, with economic and process evaluations, of the Learning Together intervention compared with standard practice (controls) over 3 years in secondary schools in south-east England. Learning Together consisted of staff training in restorative practice; convening and facilitating a school action group; and a student social and emotional skills curriculum. Primary outcomes were self-reported experience of bullying victimisation (Gatehouse Bullying Scale; GBS) and perpetration of aggression (Edinburgh Study of Youth Transitions and Crime (ESYTC) school misbehaviour subscale) measured at 36 months. We analysed data using intention-to-treat longitudinal mixed-effects models. This trial was registered with the ISRCTN registry (10751359). Findings We included 40 schools (20 in each group); no schools withdrew. 6667 (93·6%) of 7121 students participated at baseline and 5960 (83·3%) of 7154 at 36 months. Mean GBS bullying score at 36 months was 0·34 (SE 0·02) in the control group versus 0·29 (SE 0·02) in the intervention group, with a significant adjusted mean difference (−0·03, 95% CI −0·06 to −0·001; adjusted effect size −0·08). Mean ESYTC score at 36 months was 4·33 (SE 0·20) in the control group versus 4·04 (0·21) in the intervention group, with no evidence of a difference between groups (adjusted difference −0·13, 95% CI −0·43 to 0·18; adjusted effect size −0·03). Costs were an additional £58 per pupil in intervention schools than in control schools. Interpretation Learning Together had small but significant effects on bullying, which could be important for public health, but no effect on aggression. Interventions to promote student health by modifying the whole-school environment are likely to be one of the most feasible and efficient ways of addressing closely related risk and health outcomes in children and young people. Funding National Institute for Health Research, Educational Endowment Foundation.

© 2017 British HIV Association.Objectives: We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. Methods: We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. Results: PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P

Designing landscapes to accommodate both humans and nature poses huge challenges, but is increasingly recognised as an essential component of conservation and land management. The land-sparing land-sharing framework has been proposed as a tool to address this challenge. However, it has been largely criticised for its simplicity. We provide a new conceptual framework amenable to the application of structured decision-making that moves beyond the dichotomy of land-sparing or land-sharing. Using this new framework, we present a general system model that can be used to make land management decisions for the conservation of species, ecosystem services and production land at different spatial scales. The model can be parameterised for specific systems using information about: the current state of the landscape, the rates of change between landscape states, and the cost and effectiveness of taking actions. To demonstrate the utility of the model we apply it to three different landscape types. Across our three case studies, we show that investment into one of three management actions (varying degrees of management and restoration) can move the system towards more biodiversity or more managed land depending on the objectives of the land manager. We show that the dynamic and flexible nature of the landscape is important to take into account rather than a static snapshot in time. Rather than focusing on establishing the perfect landscape with a set proportion dedicated to production and to biodiversity conservation, we argue that a more useful approach is to establish incremental movements towards a landscape that meets the goals of multiple objectives. Our framework can be used to illustrate to decision makers the costs and trade-offs of different actions and help them determine land management policy.

As the source providing units for several goods and services required for human survival (e.g. food, fuel, fiber, water provision and purification, etc.) ecosystems must be sustainably managed. This will require a globally comprehensive and detailed understanding of the distribution of ecosystems on Earth. While there have been several attempts to partition the planet into large ecologically meaningful areas (ecoregions), a high spatial resolution map of Earth's terrestrial ecosystems at the on-the-ground occurrences (patch) level has heretofore been lacking. A new, high resolution (250 m) map of data-derived World Terrestrial Ecosystems is characterized, and its utility for assessing policy-mandated ecosystem conservation targets is described.

Summary paragraphTo meet the ambitious objectives of biodiversity and climate conventions, countries and the international community require clarity on how these objectives can be operationalized spatially, and multiple targets be pursued concurrently1. To support governments and political conventions, spatial guidance is needed to identify which areas should be managed for conservation to generate the greatest synergies between biodiversity and nature’s contribution to people (NCP). Here we present results from a joint optimization that maximizes improvements in species conservation status, carbon retention and water provisioning and rank terrestrial conservation priorities globally. We found that, selecting the top-ranked 30% (respectively 50%) of areas would conserve 62.4% (86.8%) of the estimated total carbon stock and 67.8% (90.7%) of all clean water provisioning, in addition to improving the conservation status for 69.7% (83.8%) of all species considered. If priority was given to biodiversity only, managing 30% of optimally located land area for conservation may be sufficient to improve the conservation status of 86.3% of plant and vertebrate species on Earth. Our results provide a global baseline on where land could be managed for conservation. We discuss how such a spatial prioritisation framework can support the implementation of the biodiversity and climate conventions.

International audience; Climate change threatens Earth's biodiversity, although its impacts are variable and depend on the capacity of species and ecosystems to cope with the magnitude and speed of change. Natural protected areas (NPAs) constitute potential refugia for species' persistence and for sustaining the provisioning of ecosystem services. Biosphere reserves are NPAs that are less altered by human actions and provide habitat to endemic, threatened or endangered species. Here, we aim to evaluate the threat imposed by climate change on the network of biosphere reserves in Mexico. Focusing on five bioclimatic variables, we computed the climatic space – measured as an n-dimensional hypervolume – of 40 NPAs. Increases in temperature are predicted for all NPAs by 2050, whereas decreases in annual rainfall are predicted for 30 NPAs. By 2050, 31 NPAs that provide habitat to 22,866 recorded species are predicted to lose 100% of their baseline climatic space, shifting to completely novel climates. On average, the other nine NPAs are predicted to lose 55.7% (SD = 26.7%) of their baseline climatic space, while 54.5% (SD = 32.5%) of the future climatic space will be novel. Seventeen NPAs may lose climate variability (homogenization), decreasing species' niches. The extent to which non-analogue conditions will remain within the tolerance of species and ecosystems is currently unknown. Finally, we propose a vulnerability index to categorise NPAs based on their loss of existing climatic space, total geographic area, species richness, and uniqueness of species composition, finding los Tuxtlas and Tiburon Ballena as the most and least vulnerable NPAs, respectively.

BackgroundBullying, aggression and violence among children and young people are some of the most consequential public mental health problems.ObjectivesThe INCLUSIVE (initiating change locally in bullying and aggression through the school environment) trial evaluated the Learning Together intervention, which involved students in efforts to modify their school environment using restorative approaches and to develop social and emotional skills. We hypothesised that in schools receiving Learning Together there would be lower rates of self-reported bullying and perpetration of aggression and improved student biopsychosocial health at follow-up than in control schools.DesignINCLUSIVE was a cluster randomised trial with integral economic and process evaluations.SettingForty secondary schools in south-east England took part. Schools were randomly assigned to implement the Learning Together intervention over 3 years or to continue standard practice (controls).ParticipantsA total of 6667 (93.6%) students participated at baseline and 5960 (83.3%) students participated at final follow-up. No schools withdrew from the study.InterventionSchools were provided with (1) a social and emotional curriculum, (2) all-staff training in restorative approaches, (3) an external facilitator to help convene an action group to revise rules and policies and to oversee intervention delivery and (4) information on local needs to inform decisions.Main outcome measuresSelf-reported experience of bullying victimisation (Gatehouse Bullying Scale) and perpetration of aggression (Edinburgh Study of Youth Transitions and Crime school misbehaviour subscale) measured at 36 months. Intention-to-treat analysis using longitudinal mixed-effects models.ResultsPrimary outcomes – Gatehouse Bullying Scale scores were significantly lower among intervention schools than among control schools at 36 months (adjusted mean difference –0.03, 95% confidence interval –0.06 to 0.00). There was no evidence of a difference in Edinburgh Study of Youth Transitions and Crime scores. Secondary outcomes – students in intervention schools had higher quality of life (adjusted mean difference 1.44, 95% confidence interval 0.07 to 2.17) and psychological well-being scores (adjusted mean difference 0.33, 95% confidence interval 0.00 to 0.66), lower psychological total difficulties (Strengths and Difficulties Questionnaire) score (adjusted mean difference –0.54, 95% confidence interval –0.83 to –0.25), and lower odds of having smoked (odds ratio 0.58, 95% confidence interval 0.43 to 0.80), drunk alcohol (odds ratio 0.72, 95% confidence interval 0.56 to 0.92), been offered or tried illicit drugs (odds ratio 0.51, 95% confidence interval 0.36 to 0.73) and been in contact with police in the previous 12 months (odds ratio 0.74, 95% confidence interval 0.56 to 0.97). The total numbers of reported serious adverse events were similar in each arm. There were no changes for staff outcomes. Process evaluation – fidelity was variable, with a reduction in year 3. Over half of the staff were aware that the school was taking steps to reduce bullying and aggression. Economic evaluation – mean (standard deviation) total education sector-related costs were £116 (£47) per pupil in the control arm compared with £163 (£69) in the intervention arm over the first two facilitated years, and £63 (£33) and £74 (£37) per pupil, respectively, in the final, unfacilitated, year. Overall, the intervention was associated with higher costs, but the mean gain in students’ health-related quality of life was slightly higher in the intervention arm. The incremental cost per quality-adjusted life year was £13,284 (95% confidence interval –£32,175 to £58,743) and £1875 (95% confidence interval –£12,945 to £16,695) at 2 and 3 years, respectively.LimitationsOur trial was carried out in urban and periurban settings in the counties around London. The large number of secondary outcomes investigated necessitated multiple statistical testing. Fidelity of implementation of Learning Together was variable.ConclusionsLearning Together is effective across a very broad range of key public health targets for adolescents.Future workFurther studies are required to assess refined versions of this intervention in other settings.Trial registrationCurrent Controlled Trials ISRCTN10751359.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 18. See the NIHR Journals Library website for further project information. Additional funding was provided by the Educational Endowment Foundation.

We evaluate the extent of climate change adaptation in the global protected seascape, and identify ways to further advance it., The impacts of climate change and the socioecological challenges they present are ubiquitous and increasingly severe. Practical efforts to operationalize climate-responsive design and management in the global network of marine protected areas (MPAs) are required to ensure long-term effectiveness for safeguarding marine biodiversity and ecosystem services. Here, we review progress in integrating climate change adaptation into MPA design and management and provide eight recommendations to expedite this process. Climate-smart management objectives should become the default for all protected areas, and made into an explicit international policy target. Furthermore, incentives to use more dynamic management tools would increase the climate change responsiveness of the MPA network as a whole. Given ongoing negotiations on international conservation targets, now is the ideal time to proactively reform management of the global seascape for the dynamic climate-biodiversity reality.

Background While employment and education rates have been extensively studied, little is known about how general well-being through early-late adolescence impacts well-being into adulthood. Utilising participant-led research, we mapped the presence and trajectories of ‘assets’ identified by young people (YP) as important during their adolescence to ‘success’ in early adulthood. Methods YP identified four ‘assets’: ‘appropriate skills’, ‘social capital’, ‘financial support’ and ‘emotional support’, which were mapped across early(T1: age 13–15), mid(T2: 16–17), and late(T3: 18–20) adolescence. Four adult (age 25–26) outcomes were also identified: ‘suitable/rewarding work’, ‘satisfactory housing’, ‘good relationships’, and ‘healthy habits’. The presence of these were identified using binary measures, developed from the ‘Next Steps’ dataset - a yearly longitudinal study following English individuals born in 1989/1990(N=15,770). Trajectories were categorised as an asset being ‘stable high’, ‘stable low’, ‘late rising’ (T3), ‘early rising’ (T2), ‘late falling’, ‘early falling’, and ‘unstable’. Results A complete case analysis was performed. Data was weighted using the standard LSYPE weightings. Assets were reported by 90% (emotional support) – 20% (confidence and connections) of young people, and generally decreased in prevalence over adolescence (ps Using regression analyses adjusted for sex and ethnicity, we identified that attaining ‘suitable/rewarding work’ at age 25/26 was associated with the presence of ‘skills’ (T1:Coef=1.36, 95% CI=1.18–1.58; T2:Coef=1.30, 95% CI=1.13–1.49); T3:Coef=1.29, 95%CI=1.10–1.51, ps Conclusion The assets available to adolescents impact their young adult outcomes across distinct pathways, but not all assets are commonly available to YP. The stability of these assets across adolescence is of particular importance to adult outcomes, as is their presence in early-mid adolescence.

Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy and is characterized by insulin resistance and decreased circulating glucagon-like peptide-1 (GLP-1). GDM resolves rapidly after delivery implicating the placenta in the disease. This study examines the biological functions that cause this pathology. The placenta releases syncytiotrophoblast-derived extracellular vesicles (STB-EVs) into the maternal circulation, which is enhanced in GDM. Dipeptidyl peptidase IV (DPPIV) is known to play a role in type 2 diabetes by breaking down GLP-1, which in turn regulates glucose-dependent insulin secretion. STB-EVs from control and GDM women were analysed. We show that normal human placenta releases DPPIV-positive STB-EVs and that they are higher in uterine than paired peripheral blood, confirming placental origin. DPPIV-bound STB-EVs from normal perfused placentae are dose dependently inhibited with vildagliptin. DPPIV-bound STB-EVs from perfused placentae are able to breakdown GLP-1 in vitro. STB-EVs from GDM perfused placentae show greater DPPIV activity. Importantly, DPPIV-bound STB-EVs increase eightfold in the circulation of women with GDM. This is the first report of STB-EVs carrying a biologically active molecule that has the potential to regulate maternal insulin secretion.

Human demands on natural resources result in habitat degradation, resource exploitation, prey competition, pollution, and threats to species viability. Halting the decline of biodiversity and alleviating human threats requires investing in conservation actions such as restoration, protection, and management of species and ecosystems. As funding for conservation is often limited, strategies are needed to ensure investments are allocated to places that will best deliver conservation outcomes. However, the development and execution of such strategies are confounded by our limited knowledge of natural systems and uncertainty about both the state of the systems we aim to conserve, and the costs and feasibility of our conservation efforts. Tools to inform decision-making exist, having emerged from fields such as economics, operations research, and mathematics, but are not often tailored and applied to solve conservation challenges. In this thesis, I examine a broad spectrum of applications around problem-based conservation prioritisations to illustrate their utility for decision-making. I chose a diversity of problems linked by this common theme deliberately. In chapters 2 and 3, I investigated common approaches to collecting and collating data for conservation decision-making. In chapter 2, I challenged the notion that all data are useful for conservation and argued that unless new data changes a decision about an action in space or time, it is of limited utility for conservation decision-making. I present a conceptual framework of the types of impacts new data delivers to conservation. My primary message was to urge scientists collecting data with the motivation of informing conservation to examine which uncertainties (e.g. uncertainty about habitat condition or aspects of species demography) are the most important to reduce. I drew from the emerging field of animal telemetry to argue my case. Finally, I provide a decision tree to illustrate when new information should be pursued as opposed to managing with uncertainty and suggest value of information analysis as a tool to address this challenge. In chapter 3, I evaluated one of the most comprehensive species-focused spatial datasets available for the global oceans, BirdLife International’s Important Bird and Biodiversity Areas (IBAs). IBAs are intended to delineate the most important marine habitats for conservation. Using Australia’s Exclusive Economic Zone as a case-study, I first tested the ability of the Australian IBA inventory to act as effective surrogates for other known biodiversity (e.g. known seabird ranges, ecoregions and benthic habitats) and then examined how various treatments of IBAs influenced the cost-efficiency of marine reserve networks. Based on my findings, I present the first “best practice” guidelines for including IBAs into systematic conservation planning processes. Chapters 4 and 5 focused on the development of decision-support tools for two different aspects of marine conservation, spatial planning policy and global prioritisation strategies, respectively. In chapter 4, I developed a system model that optimizes marine zoning allocations for three actions; establishing: no-take marine reserves, managed fishing areas and open-access fishing zones. My aim was to develop a simple, purpose driven model to inform decisions about how to optimally partition marine systems into different zones that maximise a conservation benefit (e.g. standing stock biomass) given a fixed budget, while maintaining a minimum level of fisheries catch. I found that when management budgets are small, investing the entire budget into no-take protected areas is the optimal strategy. As the management budget increases, growing the size of the management zone enters into the optimal zoning allocation. This rule of thumb was robust to changes in parameters and provides a starting point for managers overseeing coastal resources in countries where over-fishing and exploitation are concerns, to better tailor policy around proportional zoning allocations. In chapter 5, I developed a novel, flexible decision-support tool to inform a specific conservation financing mechanism called “Debt for Nature” swaps – the conversion of country’s debt in exchange for a commitment to protect nature. Small Island Developing States (SIDS) often have significant financial constraints (high debt ratios) that make it difficult to finance conservation. Thus, there is a need to prioritise future Debt for Nature swaps in those countries that can achieve the greatest return on investment. The tool leads users through a prioritisation protocol of enabling factors, the consideration of abatable (e.g. fishing) and unabatable (e.g. sea level rise) threats, benefits, weightings, costs and the likelihood of success to rank countries on their cost-effectiveness to inform global investment strategies. I provide a proof-of-concept to demonstrate the tool using Caribbean SIDS and coastal nations.I conclude that solving complex conservation challenges requires clearly defined problems and user-inspired decision support tools that link actions (e.g. what can be done) to objectives, threats, and costs. Translating the hopes, dreams and fears of end-users is a timeconsuming and challenging task. But in the end, it is only through a deep and detailed understanding of end-user needs that we can deliver the best decision-support tools for conservation.