Search

Abstract Scientists have repeatedly argued that transformative, multiscale global scenarios are needed as tools in the quest to halt the decline of biodiversity and achieve sustainability goals. As a first step towards achieving this, the researchers who participated in the scenarios and models expert group of the Intergovernmental Science‐Policy Platform on Biodiversity and Ecosystem Services (IPBES) entered into an iterative, participatory process that led to the development of the Nature Futures Framework (NFF). The NFF is a heuristic tool that captures diverse, positive relationships of humans with nature in the form of a triangle. It can be used both as a boundary object for continuously opening up more plural perspectives in the creation of desirable nature scenarios and as an actionable framework for developing consistent nature scenarios across multiple scales. Here we describe the methods employed to develop the NFF and how it fits into a longer term process to create transformative, multiscale scenarios for nature. We argue that the contribution of the NFF is twofold: (a) its ability to hold a plurality of perspectives on what is desirable, which enables the development of joint goals and visions and recognizes the possible convergence and synergies of measures to achieve these visions and (b), its multiscale functionality for elaborating scenarios and models that can inform decision‐making at relevant levels, making it applicable across specific places and perspectives on nature. If humanity is to achieve its goal of a more sustainable and prosperous future rooted in a flourishing nature, it is critical to open up a space for more plural perspectives of human–nature relationships. As the global community sets out to develop new goals for biodiversity, the NFF can be used as a navigation tool helping to make diverse, desirable futures possible. A free Plain Language Summary can be found within the Supporting Information of this article.

Managing the cumulative effects (CE) that arise from human and natural stressors is one of the most urgent and complex problems facing coastal and marine decision makers today. In the absence of effective processes, models, and political will, decision-makers struggle to implement management strategies that effectively tackle cumulative effects. Emerging efforts to address cumulative effects provide a timely opportunity to assess the efficacy of a range of management strategies operating at different scales and in different legislative and cultural contexts. Using primarily qualitative methodologies including literature reviews, focus groups, and workshops, this paper compares cumulative effects approaches within the Reef 2050 Plan for the Great Barrier Reef Marine Park (GBRMP), Australia, with those in Aotearoa New Zealand (Aotearoa NZ). Both case studies illustrate that cumulative effects management is especially complicated by: fragmented legislative regimes and institutions that cannot account for cross-scale or cross-sector interactions; chronic data scarcity and high levels of uncertainty that make system-based assessments and predictions challenging; and often conflicting societal and economic expectations, values, and rights that are poorly integrated into management decision-making. By considering how these two cases align with transformational change characteristics, we draw several conclusions and establish priority actions regarding (1) how to mobilise resources and political will to address CE, (2) how to deal with data scarcity and uncertainty, and (3) how to promote comprehensive and inclusive CE management of coastal and marine areas.

Multistakeholder participatory processes are essential decision-making elements in contemporary contested marine spaces. Such processes have long time horizons, diverse interests, and complex objectives. Their complex and evolving nature make it difficult for participatory process proponents and participants to adequately plan their processes and to assess performance quality. We position the findings of this paper in the context of participation as place-based, long-term, emergent, and complex processes in Aotearoa New Zealand. We pose the question "what does success look like?" in marine participatory processes. We provide an indicative answer in the form of a rubric, which outlines key components for navigating participatory processes through ongoing formative evaluation. The relationship between criteria and phases of participatory processes is stressed as "success" challenges, and achievements are unlikely to be stable from phase to phase. The notion of "whose success" is critically reflected upon, as the politics and power of success discourses shape what might be considered success in any given context, marine space, or participatory process. We argue that self-defined, ongoing learning evaluation, where criteria are debated and created by participatory process users, contributes to an empowering notion of success. Success as seen in this way is not an externally imposed set of standards to achieve but cocreated by those involved to best meet their needs. In this way, metaphors of success can be recognized, negotiated, circulated, and institutionalized. The authors' journey to developing the rubric helps unpack the key components of participatory processes and outlines its relationship to evaluation literature. Finally, we touch on the tension involved in creating a rubric for both practice and as a high-level discursive artifact.

Complex problems often result from the multiple interactions between human activities and ecosystems. The interconnected nature of ecological and social systems should be considered if these "wicked problems" are to be addressed. Ecosystem service approaches provide an opportunity to link ecosystem function with social values, but in practice the essential role that social dynamics play in the delivery of outcomes remains largely unexplored. Social factors such as management regimes, power relationships, skills, and values, can dramatically affect the definition and delivery of ecosystem services. Input from a diverse group of stakeholders improves the capacity of ecosystem service approaches to address wicked problems by acknowledging diverse sets of values and accounting for conflicting world views. Participatory modeling can incorporate both social and ecological dynamics into decision making that involves stakeholders, but is itself a complex social undertaking that may not yield precise or predictable outcomes. We explore the efficacy of different types of participatory modeling in relation to the integration of social values into ecosystem services frameworks and the generation of four important elements of social capital needed to address wicked problems: enhancing social learning and capacity building; increasing transparency; mediating power; and building trust. Our findings indicate that mediated modeling, group mapping, and mental/conceptual modeling are likely to generate elements of social capital that can improve ecosystem service frameworks. Participatory simulation, system dynamic modeling, and Bayesian belief networks, if utilized in isolation, were found to have a low likelihood of generating the social capital needed to improve ecosystem services frameworks. Scenario planning, companion modeling, group model building, and participatory mapping all generate a moderate to high level of social capital elements that improve the capacity of ecosystem service frameworks to address wicked problems.

Objectives: To update the prevalence of smoking in people as they were diagnosed with non-small cell lung cancer (NSCLC) and to see whether smoking status at baseline and quitting are independently associated with 1-year survival., Design: A real-world cohort study following patients from diagnosis for up to 1 year or until death., Setting: UK multi-centre study (28 sites) based in secondary and primary care., Participants: 1124 patients with newly diagnosed NSCLC between 2010-2016., Main Outcome Measures: Smoking status was validated at diagnosis and at every routine and emergency hospital visit. Cancer treatments were offered according to local multi-disciplinary team decisions following UK guidelines and smoking cessation treatments offered according to local practice /availability. Survival analysis and Cox Proportional Hazards Modelling examined the associations of a) smoking at baseline and b) quitting smoking, on survival at 1 year., Results: 77% of never smokers, 60% of ex-smokers and 57% of current smokers, were alive at 1 year (p = 0.01). After adjusting for age, stage, EGOG, surgery and gender, ex smokers (adjusted HR 1.96, 95% CI 1.16-2.31) and current smokers (aHR 2.04, 1.19-3.48) were both more likely to die within one year. 23% of smokers with NSCLC quit within 3 months of diagnosis. At 1 year, 69% of those who quit were alive versus 53% of those who continued to smoke (p < 0.01). After adjusting the risk of dying was lower (aHR 0.75), in those who quit smoking, although this was not statistically significant (p = 0.23)., Conclusions: This is the largest prospective study that validates smoking in NSCLC; it shows a third of people are smoking at the time of diagnosis. Smokers have lower 12-month survival than never and ex -smokers. Quitting smoking was associated with 25% reduction in mortality which may be clinically important although not statistically significant, after adjusting for other factors., (Copyright © 2019 Elsevier B.V. All rights reserved.)

It is known that oxytocin stimulates steroidogenesis in several organs by modulating activity of 3β-hydroxysteroid dehydrogenases (HSD3B) and steroid 5α-reductases (SRD5A). However, this has not been established in prostate cancer where these enzymes, key to local production of androgens, are increased. Analysis of both HSD3B and SRD5A activities using a live cell in situ colourimetric assay demonstrated that in PC-3 cells HSD3B activity was significantly increased by oxytocin whilst SRD5A activity was unchanged. This was confirmed in ELISA based assays of conversion of pregnenolone to progesterone and testosterone to dihydrotestosterone in cell lysates following treatment. In contrast, oxytocin significantly inhibited HSD3B activity in LNCaPs, but significantly increased activity of SRD5A, as confirmed by ELISA assays. Analysis of both cell lines by microarray and qRT-PCR determined that these changes were not due to altered gene transcription. This study demonstrates differential effects of oxytocin on the activities of key de novo steroidogenic enzymes in prostate cancer cells., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Despite the fact that parents of infants with lethal anomalies may not want "full-blown" medical care for their infants after birth, most such infants die in neonatal intensive care units. Although neonatal nurses are trained to administer life-saving treatments, they may suffer from moral distress when faced with caring for babies with incompatible-with-life conditions. This article describes a Perinatal Comfort Care program in which (a) care is provided at the time of diagnoses/antenatally and includes home visits by members of an interdisciplinary hospice team; (b) care is collaborative, community-based, and family-centered, and takes place in labor and delivery and on the mother baby unit; and (c) follow-up to the family continues for 1 year after the death. Neonatal nurses can become involved either by initiating efforts to form a perinatal comfort care program or by joining an existing team.

While we appreciate that Barbara Woodcraft's amusing article 'Uplifting experience?' (Nursing Standard October 30) was intended as a humorous look at a serious problem, we were concerned to see that you accompanied by a photograph of two nurses performing the Australian, or Shoulder lift.