Conserving socio-ecological landscapes: An analysis of traditional and responsive management practices for floodplain meadows in England

Contemporary practice in the conservation of socio-ecological landscapes draws on both a model of responsive management, and also on ideas about historic management. This study considered what evidence might exist for the exercise of these approaches to management in the conservation of floodplain meadows in England, in order to inform understanding and knowledge of conservation management and assessment practice. Evidence for a model of responsive management was limited, with managing stakeholders often alternating between this model and an alternative approach, called here the ‘traditional management approach’, based on ideas, narratives and prescriptions of long-established land management practices. Limited monitoring and assessment appeared to undermine the former model, whilst uncertainty over past long-standing management practices undermined the latter. As a result of the relative power of conservation actors over farmers delivering site management, and their framings of meadows as ‘natural’ spaces, management tended to oscillate between aspects of these two approaches in a sometimes inconsistent manner. Conservation managers should consider the past motivating drivers and management practices that created the landscapes they wish to conserve, and bear in mind that these are necessarily implicated in aspects of the contemporary landscape value that they wish to maintain. They should ensure that assessment activity captures a broad range of indicators of site value and condition, not only biological composition, and also record data on site management operations in order to ensure management effectiveness

Impact of the COVID-19 pandemic on the management of chronic heart failure

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge. Meeting this has resulted in changes to working practices and the impact on the management of patients with heart failure with reduced ejection fraction (HFrEF) is largely unknown. We performed a retrospective, observational study contrasting patients diagnosed with HFrEF attending specialist heart failure clinics at a UK hospital, whose subsequent period of optimisation of medical therapy was during the COVID-19 pandemic, with patients diagnosed the previous year. The primary outcome was the change in equivalent dosing of ramipril and bisoprolol at 6-months. Secondary outcomes were the number and type of follow-up consultations, hospitalisation for heart failure and all-cause mortality. In total, 60 patients were diagnosed with HFrEF between 1 December 2019 and 30 April 2020, compared to 54 during the same period of the previous year. The absolute number of consultations was higher (390 vs 270; p = 0.69), driven by increases in telephone consultations, with a reduction in appointments with hospital nurse specialists. After 6-months, we observed lower equivalent dosing of ramipril (3.1 ± 3.0 mg vs 4.4 ± 0.5 mg; p = 0.035) and similar dosing of bisoprolol (4.1 ± 0.5 mg vs 4.9 ± 0.5 mg; p = 0.27), which persisted for ramipril (mean difference 1.0 mg, 95% CI 0.018–2.09; p = 0.046) and bisoprolol (mean difference 0.52 mg, 95% CI -0.23–1.28; p = 0.17) after adjustment for baseline dosing. We observed no differences in the proportion of patients who died (5.0% vs 7.4%; p = 0.59) or were hospitalised with heart failure (13.3% vs 9.3%; p = 0.49). Our study suggests the transition to telephone appointments and re-deployment of heart failure nurse specialists was associated with less successful optimisation of medical therapy, especially renin-angiotensin inhibitors, compared with usual care

Do charismatic species groups generate more cultural ecosystem service benefits?

The relationship between nature and cultural ecosystem service (CES) benefits is well accepted but poorly understood, as is the potential role of biodiversity in the relationship. By means of a public questionnaire survey in Wiltshire, UK, the relationship between the presence of a range of common species groups, species group ‘charisma’, group abundance in the landscape, and the benefit that people felt that they derived from the species groups was investigated for a lowland multifunctional landscape. Findings showed that species group charisma influenced the benefit reported by respondents for current abundance levels, and influenced their response to potential increases or decreases in abundance. Respondents reported high levels of benefit from species groups hypothesised to be charismatic (birds, flowering plants, butterflies) and there was high consistency in the pattern of response. Respondents reported less benefit from groups hypothesised to be less charismatic (beetles/bugs, brambles and nettles), the latter response patterns showing much greater variation. These results could be used to promote a more holistic understanding of the value of biodiversity by educating and informing the public so that they derive benefit not just from the charismatic, but also from the everyday, the commonplace and less obviously charismatic species

Leisure activities and social factors influence the generation of cultural ecosystem service benefits

The relationship between cultural ecosystem services (CES) and the many diverse aspects of biodiversity is complex and multi-faceted. A large public survey in Wiltshire, UK, was used to assess associations between public benefits from certain species groups in the local countryside, and (i) social antecedents, (ii) engagement in different outdoor leisure activities (iii) indirect nature experience via media-related activities and (iv) species group charisma and abundance. Practitioners of leisure activities with a nature-related theme, whether outdoor activities or indoor media-related activities, reported significantly higher levels of benefit from named species groups, as did respondents whose personal background demonstrated an elevated degree of nature-relatedness. Benefits were also related to the charisma of the species group: enhanced benefit through nature-related activities and social factors was significant for less charismatic species, but inconclusive for more charismatic species. Respondents who participated in outdoor leisure activities without a nature focus were unlikely to report enhanced benefits from species groups in the local landscape. To maximise people’s CES benefits from broader aspects of biodiversity it may be necessary to encourage an active interest in biodiversity, leading people to participate or seek knowledge and understanding, and in turn develop a stronger sense of connectedness to nature

Assessing preferences for cultural ecosystem services in the English countryside using Q methodology

Cultural Ecosystem Services (CES) are difficult to assess due to the subjective and diverse way in which they are experienced. This can make it difficult to apply CES research to enhance human experience of nature. This study applies Q methodology to group people according to their preferences for CES. The Q methodology survey was carried out with 47 local residents and tourists in Wiltshire, in South West England. Four groups of respondents were identified drawing value from nature through: (1) spiritual benefits and mental well-being (Group 1—Inspired by nature); (2) nature and biodiversity conservation (Group 1—Conserving nature); (3) cultural heritage in multifunctional landscapes (Group 3—Countryside mix); and (4) opportunities for outdoor activities (Group 4—Outdoor pursuits). All four groups stated that benefits from nature were enhanced by actually visiting the countryside, through a better understanding of nature itself, and through a range of sensory experiences. They particularly identified relaxation opportunities as a very important CES benefit. These findings, and the demonstrated use of the Q methodology, could support local planning and landscape management in order to provide accessible and functional landscapes that can provide a range of different CES benefits to people.Natural Environment Research Council (NERC): NE/J014710/1 European Union fundin

Effect of disease-modifying agents and their association with mortality in multi-morbid patients with heart failure with reduced ejection fraction

Aims An increasing proportion of patients with heart failure with reduced ejection fraction (HFrEF) have co‐morbidities. The effect of these co‐morbidities on modes of death and the effect of disease‐modifying agents in multi‐morbid patients is unknown. Methods and results We performed a prospective cohort study of ambulatory patients with HFrEF to assess predictors of outcomes. We identified four key co‐morbidities—ischaemic aetiology of heart failure, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD)—that were highly prevalent and associated with an increased risk of all‐cause mortality. We used these data to explore modes of death and the utilization of disease‐modifying agents in patients with and without these co‐morbidities. The cohort included 1789 consecutively recruited patients who had an average age of 69.6 ± 12.5 years, and 1307 (73%) were male. Ischaemic aetiology of heart failure was the most common co‐morbidity, occurring in 1061 (59%) patients; 503 (28%) patients had diabetes mellitus, 283 (16%) had COPD, and 140 (8%) had CKD stage IV/V. During mean follow‐up of 3.8 ± 1.6 years, 737 (41.5%) patients died, classified as progressive heart failure (n = 227, 32%), sudden (n = 112, 16%), and non‐cardiovascular deaths (n = 314, 44%). Multi‐morbid patients were older (P 2.5‐fold and 1.5‐fold increased risk of sudden death, whilst higher doses of beta‐adrenoceptor antagonists were protective (hazard ratio per milligram 0.92, 95% confidence interval 0.86–0.98, P = 0.009). Each milligram of bisoprolol‐equivalent beta‐adrenoceptor antagonist was associated with 9% (P = 0.001) and 11% (P = 0.023) reduction of sudden deaths in patients with <2 and ≥2 co‐morbidities, respectively. Conclusions Higher doses of beta‐adrenoceptor antagonist are associated with greater protection from sudden death, most evident in multi‐morbid patients. Patients with COPD who appear to be at the highest risk of sudden death are prescribed the lowest doses and less likely to be implanted with implantable cardioverter defibrillators, which might represent a missed opportunity to optimize safe and proven therapies for these patients