Embedding ecosystem services in coastal planning leads to better outcomes for people and nature.

Recent calls for ocean planning envision informed management of social and ecological systems to sustain delivery of ecosystem services to people. However, until now, no coastal and marine planning process has applied an ecosystem-services framework to understand how human activities affect the flow of benefits, to create scenarios, and to design a management plan. We developed models that quantify services provided by corals, mangroves, and seagrasses. We used these models within an extensive engagement process to design a national spatial plan for Belize's coastal zone. Through iteration of modeling and stakeholder engagement, we developed a preferred plan, currently under formal consideration by the Belizean government. Our results suggest that the preferred plan will lead to greater returns from coastal protection and tourism than outcomes from scenarios oriented toward achieving either conservation or development goals. The plan will also reduce impacts to coastal habitat and increase revenues from lobster fishing relative to current management. By accounting for spatial variation in the impacts of coastal and ocean activities on benefits that ecosystems provide to people, our models allowed stakeholders and policymakers to refine zones of human use. The final version of the preferred plan improved expected coastal protection by >25% and more than doubled the revenue from fishing, compared with earlier versions based on stakeholder preferences alone. Including outcomes in terms of ecosystem-service supply and value allowed for explicit consideration of multiple benefits from oceans and coasts that typically are evaluated separately in management decisions.

Applied science facilitates the large-scale expansion of protected areas in an Amazonian hot spot.

Meeting international commitments to protect 17% of terrestrial ecosystems worldwide will require >3 million square kilometers of new protected areas and strategies to create those areas in a way that respects local communities and land use. In 2000-2016, biological and social scientists worked to increase the protected proportion of Peru's largest department via 14 interdisciplinary inventories covering >9 million hectares of this megadiverse corner of the Amazon basin. In each landscape, the strategy was the same: convene diverse partners, identify biological and sociocultural assets, document residents' use of natural resources, and tailor the findings to the needs of decision-makers. Nine of the 14 landscapes have since been protected (5.7 million hectares of new protected areas), contributing to a quadrupling of conservation coverage in Loreto (from 6 to 23%). We outline the methods and enabling conditions most crucial for successfully applying similar campaigns elsewhere on Earth.

Urinary incontinence in the elderly.

Preview The incidence of incontinence in elderly men and women is high, and the personal and social costs of the problem are enormous. But thoughtful diagnostic evaluation can lead to treatment that in many cases results in an improvement in symptoms or even a return to continence. Dr Rosenthal and Dr McMurtry discuss five main types of incontinence and their causes and treatment and describe the components of a targeted medical evaluation.