The worldwide costs of marine protected areas

Declines in marine harvests, wildlife, and habitats have prompted calls at both the 2002 World Summit on Sustainable Development and the 2003 World Parks Congress for the establishment of a global system of marine protected areas (MPAs). MPAs that restrict fishing and other human activities conserve habitats and populations and, by exporting biomass, may sustain or increase yields of nearby fisheries. Here we provide an estimate of the costs of a global MPA network, based on a survey of the running costs of 83 MPAs worldwide. Annual running costs per unit area spanned six orders of magnitude, and were higher in MPAs that were smaller, closer to coasts, and in high-cost, developed countries. Models extrapolating these findings suggest that a global MPA network meeting the World Parks Congress target of conserving 20–30% of the world’s seas might cost between $5 billion and$19 billion annually to run and would probably create around one million jobs. Although substantial, gross network costs are less than current government expenditures on harmful subsidies to industrial fisheries. They also ignore potential private gains from improved fisheries and tourism and are dwarfed by likely social gains from increasing the sustainability of fisheries and securing vital ecosystem services

(−)‐[ 18 F]Flubatine: evaluation in rhesus monkeys and a report of the first fully automated radiosynthesis validated for clinical use

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101867/1/jlcr3069.pd

Work Package Report 6: Shared, plural and cultural values of ecosystems – Summary

Key findings: Finding 1: Shared values resulting from deliberative, group-based valuation are different from individual values. Case study evidence suggests that they are more informed, considered, confident and reflective of participants’ deeper-held, transcendental values. Deliberated, group-based monetary values may be a better reflection of real welfare impacts than non-deliberated individual values, if derived through a carefully designed and managed process. Although more research is needed to expand the currently small evidence base on deliberative monetary methods, group deliberation has the potential to significantly enhance elicitation of values. Finding 2: The ethical, moral and justice dimensions of many environmental issues necessitate approaches that allow for the elicitation of shared and plural values. Key ethical concerns include: 1) providing a space and opportunity for people to identify values that they may find difficult to articulate (e.g. spiritual, identity); 2) recognising that some values cannot be traded without discussion and negotiation (e.g. the legal or felt rights of local people, intrinsic values of other species); and 3) understanding that it is often difficult to isolate valuation from decision-making processes because people feel there are strong ethical or moral issues at stake that need to be debated (e.g. the justice of the process, fairness in the distribution of benefits or disbenefits, responsibility, and issues of sustainability and future generations). Finding 3: Catalyst and/or conflict points can play a key role in the emergence and articulation of values at a societal or community level that have not previously been outwardly or explicitly articulated. Catalyst and conflict points can be symbolic and are often linked to wider contested issues and meanings about who is involved in decision-making, whose voice counts and who receives the benefits or disbenefits of environmental change. These catalyst points can potentially be connected to feelings of powerlessness that give rise to concern and protest. By recognising transcendental societal and communal values (the deeper-held and overarching values held by society and communities), it becomes possible to make these values explicit and incorporate them in decision-making to better anticipate and manage conflicts. Finding 4: There is a diversity of ways in which shared, plural, cultural and social values are used, but they are rarely conceptualised. The UK NEAFO provides a clear theoretical framework that distinguishes and categorises different dimensions and types of shared values. The proposed range of value types was both identifiable and distinguishable within case study results. This suggests that the framework provides a useful basis for operationalizing shared values for decision-making. Finding 5: Shared and social values in the sense of value to society is conceptualised very differently by conventional economics and other disciplines. Neoclassical economists have generally undertaken valuation by equating social value with the aggregate of individual values. They consider values as fundamentally commensurable. In contrast, literature from other disciplines consistently considers values as plural, not just in the sense that multiple things have value, but also that there are multiple dimensions to value that cannot necessarily be captured in a single metric. Within mainstream economics, the difficulties associated with commensurability and aggregating values have long been recognised, but have also been neglected. An interesting area for future debate between economic and non-economic views on values may be the normative nature of value-aggregation. Finding 6: A mixed method approach is required to elicit the multiple dimensions of shared values and to translate deeper-held, transcendental values into contextual values and preferences. Monetary valuation is limited to quantifying values. Other methods are needed to understand their meaning or content, and the communal, societal and transcendental values that underpin them. Psychometric, non-analytical and interpretive methods (e.g. storytelling) can reveal those shared values. They can be combined with deliberative-analytical methods (e.g. deliberative monetary valuation and multi-criteria analysis) to provide a comprehensive valuation that can quantify values, understand their individual and shared meanings and significance, and better include ethical dimensions. Finding 7: Deliberative and social learning processes help people to understand the values held by others; they can lead to increased sharing of values and/or to greater acceptance of the decisions emerging from such processes. Deliberation clearly affects what values participants express compared to non-deliberated processes. There is also a growing body of theoretical and empirical research suggesting that deliberation has the potential to affect how people understand and shape the values of others. Although rarely considered in the economic literature, the concept of social learning helps to explain some of the processes involved in deliberation. The extent to which deliberation or social learning helps participants express and shape values will depend upon the frequency and depth of interactions and the timescale over which interactions occur. Only a shift in cultural values (e.g. less emphasis on material wealth), reflected in other societal institutions (e.g. changes in the indicators used to measure national progress) is likely to achieve sustainable outcomes in the long-term. Finding 8: Media analysis is a promising avenue for characterising different types of shared values at a large scale, as well as assessing the conflicts between the communal values of different sectors of society. There has been a marked increase in public interest in environmental issues over the last decade, which is reflected in their increased media coverage. Media content and discourse analysis is able to distinguish and characterise the plurality of cultural, societal and transcendental values and their interrelationships, and can offer a picture of the self- and other-regarding values that underpin environmental issues and conflicts. Social media can provide a further forum for understanding societal and communal values surrounding environmental issues. Finding 9: Aesthetic and spiritual values of ecosystems have a strong non-instrumental component. While they benefit human well-being, they should not simply be classified as just ‘services’ or ‘benefits’. Many spiritual discourses about nature resist talk of consequentialist benefits and economic analysis. These discourses counter assertions of the disenchantment of the world, which is associated with an instrumental environmental ethic and the commodification of nature. Allowing the possibility of enchantment can be a richer way of understanding our experience of nature and alerts us to the limitations of using economic models for valuation and informing decisions about these profound cultural ecosystem ‘services’. Faith communities have experience of using these non-utilitarian values in their own decision-making and provide models that could be adapted for use in environmental decision-making. Finding 10: Subjective well-being measures provide a useful means of assessing ‘intangible’ cultural ecosystem services and their benefits. Different user groups associate common elements of subjective well-being with environmental settings, providing opportunities for development of standardised measures. In the UK NEAFO, key facets of well-being associated with places in nature across different user groups included: engagement with nature (incorporating elements of connectedness, getting to know nature and the beauty of nature, and taking care of a place); therapeutic benefits (including physical and mental aspects of health); place identity (including a sense of place and belonging); spiritual value (in the sense of feeling connected or responsible to something larger than oneself); social bonding with others; and transformative and memorable experiences. Further empirical work with different user groups and environmental settings would allow for the continued development of a standardised tool for large-scale non-monetary assessment of cultural ecosystem services

Implementing a quality improvement programme in palliative care in care homes: a qualitative study

<p>Abstract</p> <p>Background</p> <p>An increasing number of older people reach the end of life in care homes. The aim of this study is to explore the perceived benefits of, and barriers to, implementation of the Gold Standards Framework for Care Homes (GSFCH), a quality improvement programme in palliative care.</p> <p>Methods</p> <p>Nine care homes involved in the GSFCH took part. We conducted semi-structured interviews with nine care home managers, eight nurses, nine care assistants, eleven residents and seven of their family members. We used the Framework approach to qualitative analysis. The analysis was deductive based on the key tasks of the GSFCH, the 7Cs: communication, coordination, control of symptoms, continuity, continued learning, carer support, and care of the dying. This enabled us to consider benefits of, and barriers to, individual components of the programme, as well as of the programme as a whole.</p> <p>Results</p> <p>Perceived benefits of the GSFCH included: improved symptom control and team communication; finding helpful external support and expertise; increasing staff confidence; fostering residents' choice; and boosting the reputation of the home. Perceived barriers included: increased paperwork; lack of knowledge and understanding of end of life care; costs; and gaining the cooperation of GPs. Many of the tools and tasks in the GSFCH focus on improving communication. Participants described effective communication within the homes, and with external providers such as general practitioners and specialists in palliative care. However, many had experienced problems with general practitioners. Although staff described the benefits of supportive care registers, coding predicted stage of illness and advance care planning, which included improved communication, some felt the need for more experience of using these, and there were concerns about discussing death.</p> <p>Conclusions</p> <p>Most of the barriers described by participants are relevant to other interventions to improve end of life care in care homes. There is a need to investigate the impact of quality improvement programmes in care homes, such as the GSFCH, on a wider range of outcomes for residents and their families, and to monitor the sustainability of any resulting improvements. It is also important to explore the impact of the different components of these complex interventions.</p

Bereavement and palliative care: A public health perspective

In recent years there has been an increasing emphasis upon public health perspectives that place palliative care in the context of end-of-life services across whole populations. There is little corresponding public health interest in bereavement. Yet if we have to develop relevant, coherent, and comprehensive end-of-life care policies and practices, public health approaches to palliative care need to be accompanied by public health approaches to bereavement care. We argue here that palliative care services should match their commitment to providing a good death with a commitment to supporting good grief, and that this means investing their efforts principally in developing community capacity for bereavement care rather than seeking to deliver specialized bereavement services to relatives and friends of those who have received palliative care services

What are shared and social values of ecosystems?

The theoretical framework outlined in this paper was developed initially through a series of expert workshops as part of the Valuing Nature Network — BRIDGE: From Values to Decisions project, funded by the UK Natural Environment Research Council (NERC). It was developed further through the follow-on phase of the UK National Ecosystem Assessment (Work Package 6: Shared, Plural and Cultural Values) funded by the UK Department of the Environment, Food and Rural Affairs (Defra), the Welsh Government, NERC, the Economic and Social Research Council (ESRC), and the Arts and Humanities Research Council (AHRC).Peer reviewedPublisher PD

Multiple roles for NaV1.9 in the activation of visceral afferents by noxious inflammatory, mechanical, and human disease-derived stimuli.

Chronic visceral pain affects millions of individuals worldwide and remains poorly understood, with current therapeutic options constrained by gastrointestinal adverse effects. Visceral pain is strongly associated with inflammation and distension of the gut. Here we report that the voltage-gated sodium channel subtype NaV1.9 is expressed in half of gut-projecting rodent dorsal root ganglia sensory neurons. We show that NaV1.9 is required for normal mechanosensation, for direct excitation and for sensitization of mouse colonic afferents by mediators from inflammatory bowel disease tissues, and by noxious inflammatory mediators individually. Excitatory responses to ATP or PGE2 were substantially reduced in NaV1.9(-/-) mice. Deletion of NaV1.9 substantially attenuates excitation and subsequent mechanical hypersensitivity after application of inflammatory soup (IS) (bradykinin, ATP, histamine, PGE2, and 5HT) to visceral nociceptors located in the serosa and mesentery. Responses to mechanical stimulation of mesenteric afferents were also reduced by loss of NaV1.9, and there was a rightward shift in stimulus-response function to ramp colonic distension. By contrast, responses to rapid, high-intensity phasic distension of the colon are initially unaffected; however, run-down of responses to repeat phasic distension were exacerbated in NaV1.9(-/-) afferents. Finally colonic afferent activation by supernatants derived from inflamed human tissue was greatly reduced in NaV1.9(-/-) mice. These results demonstrate that NaV1.9 is required for persistence of responses to intense mechanical stimulation, contributes to inflammatory mechanical hypersensitivity, and is essential for activation by noxious inflammatory mediators, including those from diseased human bowel. These observations indicate that NaV1.9 represents a high-value target for development of visceral analgesics