Healthy people with nature in mind

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: The global disease burden resulting from climate change is likely to be substantial and will put further strain on public health systems that are already struggling to cope with demand. An up- stream solution, that of preventing climate change and associated adverse health effects, is a promising approach, which would create win-win-situations where both the environment and human health benefit. One such solution would be to apply methods of behaviour change to prompt pro-environmentalism, which in turn benefits health and wellbeing. DISCUSSION: Based on evidence from the behavioural sciences, we suggest that, like many social behaviours, pro- environmental behaviour can be automatically induced by internal or external stimuli. A potential trigger for such automatic pro-environmental behaviour would be natural environments themselves. Previous research has demonstrated that natural environments evoke specific psychological and physiological reactions, as demonstrated by self-reports, epidemiological studies, brain imaging techniques, and various biomarkers. This suggests that exposure to natural environments could have automatic behavioural effects, potentially in a pro-environmental direction, mediated by physiological reactions. Providing access and fostering exposure to natural environments could then serve as a public health tool, together with other measures, by mitigating climate change and achieving sustainable health in sustainable ecosystems. However, before such actions are implemented basic research is required to elucidate the mechanisms involved, and applied investigations are needed to explore real world impacts and effect magnitudes. As environmental research is still not sufficiently integrated within medical or public health studies there is an urgent need to promote interdisciplinary methods and investigations in this critical field. Health risks posed by anthropogenic climate change are large, unevenly distributed, and unpredictable. To ameliorate negative impacts, pro-environmental behaviours should be fostered. Potentially this could be achieved automatically through exposure to favourable natural environments, with an opportunity for cost-efficient nature-based solutions that provide benefits for both the environment and public health

QCD and strongly coupled gauge theories : challenges and perspectives

We highlight the progress, current status, and open challenges of QCD-driven physics, in theory and in experiment. We discuss how the strong interaction is intimately connected to a broad sweep of physical problems, in settings ranging from astrophysics and cosmology to strongly coupled, complex systems in particle and condensed-matter physics, as well as to searches for physics beyond the Standard Model. We also discuss how success in describing the strong interaction impacts other fields, and, in turn, how such subjects can impact studies of the strong interaction. In the course of the work we offer a perspective on the many research streams which flow into and out of QCD, as well as a vision for future developments.Peer reviewe

Sustainable drainage system site assessment method using urban ecosystem services

The United Kingdom's recently updated approach to sustainable drainage enhanced biodiversity and amenity objectives by incorporating the ecosystem approach and the ecosystem services concept. However, cost-effective and reliable methods to appraise the biodiversity and amenity values of potential sustainable drainage system (SuDS)sites and their surrounding areas are still lacking, as is a method to enable designers to distinguish and link the amenity and biodiversity benefits that SuDS schemes can offer. In this paper, therefore, the authors propose two ecosystem services- and disservices-based methods (i.e. vegetation structure cover-abundance examination and cultural ecosystem services and disservices variables appraisal) to aid SuDS designers to distinguish and link amenity and biodiversity benefits, and allow initial site assessments to be performed in a cost-effective and reliable fashion. Forty-nine representative sites within Greater Manchester were selected to test the two methods. Amenity and biodiversity were successfully assessed and habitat for species, carbon sequestration, recreation and education ecosystem services scores were produced,which will support SuDS retrofit design decision-making. Large vegetated SuDS sites with permanent aquatic features were found to be most capable of enhancing biodiversity- and amenity-related ecosystem services. Habitat for species and recreation ecosystem services were also found to be positively linked to each other. Finally, waste bins on site were found to help reduce dog faeces and litter coverage. Overall, the findings presented here enable future SuDS retrofit designs to be more wildlife friendly and socially inclusive

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants

BACKGROUND: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. METHODS: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. FINDINGS: We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. INTERPRETATION: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. FUNDING: Wellcome Trust

Free satellite data key to conservation

Biodiversity is in crisis, with extinction rates orders of magnitude higher than background levels ([ 1 ][1]). Underfunded conservationists need to target their limited resources effectively. Over the past decade, satellite remote sensing has revolutionized our ability to monitor biodiversity globally, and is now used routinely, especially by nongovernmental organizations, to detect changes, set priorities, and target conservation action. The U.S. Geological Survey (USGS) unlocked high-resolution Landsat data in 2008 ([ 2 ][2]), making data available online ([ 3 ][3]), and the Copernicus program from the European Commission subsequently made their data available as well ([ 4 ][4]). These resources have been instrumental to biodiversity research. Assessments of environmental changes such as deforestation are now readily available. The current spatial and spectral resolution of Landsat data make them appropriate to many conservation applications, and although they are not always ideal, pragmatic researchers with limited resources use them regularly. Conservationists have already called for these data to remain free ([ 5 ][5]). Consequently, the news that USGS may charge for data ([ 6 ][6]) is deeply troubling. USGS has recently convened an advisory committee to determine whether users would be prepared to pay for increased spectral and spatial resolution images ([ 7 ][7]). Requiring users to pay would put these images beyond the reach of conservationists. It would halt time-series analyses that have been useful in monitoring the effects of climate change, land-cover change, and ocean surfaces, likely hindering the achievement of the Sustainable Development Goals ([ 8 ][8]). We urge the USGS to reconsider their position and continue to provide data from the Landsat program freely to all users. 1. [↵][9]1. J. DeVos et al ., Cons. Biol. 29, 452 (2015). [OpenUrl][10] 2. [↵][11]1. C. Woodcock et al . Science 320, 1011 (2008). [OpenUrl][12][CrossRef][13][PubMed][14] 3. [↵][15]USGS, Earth Explorer ([https://earthexplorer.usgs.gov/][16]). 4. [↵][17]European Commission, Copernicus (). 5. [↵][18]1. W. Turner et al ., Biol. Conserv. 182, 173 (2015). [OpenUrl][19] 6. [↵][20]1. G. Popkin , Nature 556, 417 (2018). [OpenUrl][21] 7. [↵][22]USGS, Landsat Advisory Group undertakes a Landsat Cost Recovery Study (2018); [www.usgs.gov/center-news/landsat-advisory-group-undertakes-a-landsat-cost-recovery-study][23]. 8. [↵][24]Sustainable Development Goals ([https://sustainabledevelopment.un.org/?menu=1300][25]). [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #ref-5 [6]: #ref-6 [7]: #ref-7 [8]: #ref-8 [9]: #xref-ref-1-1 "View reference 1 in text" [10]: {openurl}?query=rft.jtitle%253DCons.%2BBiol.%26rft.volume%253D29%26rft.spage%253D452%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: #xref-ref-2-1 "View reference 2 in text" [12]: {openurl}?query=rft.jtitle%253DScience%26rft.volume%253D320%26rft.spage%253D1011%26rft_id%253Dinfo%253Adoi%252F10.1126%252Fscience.320.5879.1011a%26rft_id%253Dinfo%253Apmid%252F18497274%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [13]: /lookup/external-ref?access_num=10.1126/science.320.5879.1011a&link_type=DOI [14]: /lookup/external-ref?access_num=18497274&link_type=MED&atom=%2Fsci%2F361%2F6398%2F139.2.atom [15]: #xref-ref-3-1 "View reference 3 in text" [16]: http://earthexplorer.usgs.gov/ [17]: #xref-ref-4-1 "View reference 4 in text" [18]: #xref-ref-5-1 "View reference 5 in text" [19]: {openurl}?query=rft.jtitle%253DBiol.%2BConserv.%26rft.volume%253D182%26rft.spage%253D173%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [20]: #xref-ref-6-1 "View reference 6 in text" [21]: {openurl}?query=rft.jtitle%253DNature%26rft.volume%253D556%26rft.spage%253D417%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [22]: #xref-ref-7-1 "View reference 7 in text" [23]: http://www.usgs.gov/center-news/landsat-advisory-group-undertakes-a-landsat-cost-recovery-study [24]: #xref-ref-8-1 "View reference 8 in text" [25]: http://sustainabledevelopment.un.org/?menu=130

Urban and Peri-urban Agroforestry as Multifunctional Land Use

In this era of global changes, rapid urbanization rates, climate change impacts and growing socio-environmental concerns are negatively impacting on various aspects of urban life, such as human health and well-being, urban economy stability, biodiversity levels, land productivity and natural resources availability. In this context, cities - having become the main centres of consumption and production worldwide - need to move towards more sustainable and resilient urban development models, considering novel approaches aimed at integrating grey and green infrastructure, economic growth and environmental concerns, knowledge diffusion and poverty and hunger eradication. In this regard, the implementation of urban and peri-urban agroforestry (UPAF) systems - associated with the integration of urban food systems into urban planning - can greatly support the provision of ecosystem services to urban dwellers, thus contributing to the improvement of their livelihood through increased food and nutrition security, energy and fresh water availability, regulation of local climate, carbon sequestration, maintenance of genetic diversity, recreation opportunities and health improvement. In this sense, UPAF is emerging as a new urban practice addressed to promote sustainable land use as well as the integration between urban and rural development. However, its implementation in urban contexts presents several key challenges, such as land tenure conflicts, lack of integration with urban policies and plans and technical knowledge, as well as necessity of innovative governance models. In this context, the aim of this chapter is to outline, through a review of the relevant literature and case studies from both developed and developing countries, the benefits deriving from the implementation of UPAF systems and highlight how these practices can support the improvement of urban sustainability and resilience, particularly in terms of enhancement of provisioning, cultural, regulating and supporting ecosystem services

Optical Imaging of Bacterial Infections

The rise in multidrug resistant (MDR) bacteria has become a global crisis. Rapid and accurate diagnosis of infection will facilitate antibiotic stewardship and preserve our ability to treat and cure patients from bacterial infection. Direct in situ imaging of bacteria offers the prospect of accurately diagnosing disease and monitoring patient outcomes and response to treatment in real-time. There have been many recent advances in the field of optical imaging of infection; namely in specific probe and fluorophore design. This combined with the advances in imaging device technology render direct optical imaging of infection a feasible approach for accurate diagnosis in the clinic. Despite this, there are currently no licensed molecular probes for clinical optical imaging of infection. Here we report some of the most promising and interesting probes and approaches under development for this purpose, which have been evaluated in in vivo models within the laboratory setting

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years