Transient social-ecological dynamics reveal signals of decoupling in a highly disturbed Anthropocene landscape.

Understanding the transient dynamics of interlinked social-ecological systems (SES) is imperative for assessing sustainability in the Anthropocene. However, how to identify critical transitions in real-world SES remains a formidable challenge. In this study, we present an evolutionary framework to characterize these dynamics over an extended historical timeline. Our approach leverages multidecadal rates of change in socioeconomic data, paleoenvironmental, and cutting-edge sedimentary ancient DNA records from China's Yangtze River Delta, one of the most densely populated and intensively modified landscapes on Earth. Our analysis reveals two significant social-ecological transitions characterized by contrasting interactions and feedback spanning several centuries. Initially, the regional SES exhibited a loosely connected and ecologically sustainable regime. Nevertheless, starting in the 1950s, an increasingly interconnected regime emerged, ultimately resulting in the crossing of tipping points and an unprecedented acceleration in soil erosion, water eutrophication, and ecosystem degradation. Remarkably, the second transition occurring around the 2000s, featured a notable decoupling of socioeconomic development from ecoenvironmental degradation. This decoupling phenomenon signifies a more desirable reconfiguration of the regional SES, furnishing essential insights not only for the Yangtze River Basin but also for regions worldwide grappling with similar sustainability challenges. Our extensive multidecadal empirical investigation underscores the value of coevolutionary approaches in understanding and addressing social-ecological system dynamics.

Social-ecological vulnerability and risk of China's marine capture fisheries to climate change.

Climate change is a new disrupter to global fisheries systems and their governance frameworks. It poses a pressing management challenge, particularly in China, which is renowned as the world's largest fishing country and seafood producer. As climate change continues to intensify in the region and climate awareness grows within the country's national policy, the need to understand China's fisheries' resilience to the escalating climate crisis becomes paramount. In this study, we conduct an interdisciplinary analysis to assess the vulnerability and risk of China's marine capture fisheries in response to climate change. This study employs a spatially explicit, indicator-based approach with a coupled social-ecological framework, focusing on 67 species and 11 coastal regions. By integrating diverse sets of climatic, ecological, economic, societal, and governance indicators and information, we elucidate the factors that could hinder climate adaptation, including a limited understanding of fish early life stages, uncertainty in seafood production, unequal allocation and accessibility of resources, and inadequate consideration of inclusive governance and adaptive management. Our results show that species, which have managed to survive the stress of overfishing, demonstrate a remarkable ability to adapt to climate change. However, collapsing stocks such as large yellow croaker face a high risk due to the synergistic effects of inherent biological traits and external management interventions. We emphasize the imperative to build institutional, scientific, and social capacity to support fisheries adaptation. The scientific insights provided by this study can inform fisheries management decisions and promote the operationalization of climate-resilient fisheries in China and other regions.

Unraveling complex causal processes that affect sustainability requires more integration between empirical and modeling approaches.

Scientists seek to understand the causal processes that generate sustainability problems and determine effective solutions. Yet, causal inquiry in nature-society systems is hampered by conceptual and methodological challenges that arise from nature-society interdependencies and the complex dynamics they create. Here, we demonstrate how sustainability scientists can address these challenges and make more robust causal claims through better integration between empirical analyses and process- or agent-based modeling. To illustrate how these different epistemological traditions can be integrated, we present four studies of air pollution regulation, natural resource management, and the spread of COVID-19. The studies show how integration can improve empirical estimates of causal effects, inform future research designs and data collection, enhance understanding of the complex dynamics that underlie observed temporal patterns, and elucidate causal mechanisms and the contexts in which they operate. These advances in causal understanding can help sustainability scientists develop better theories of phenomena where social and ecological processes are dynamically intertwined and prior causal knowledge and data are limited. The improved causal understanding also enhances governance by helping scientists and practitioners choose among potential interventions, decide when and how the timing of an intervention matters, and anticipate unexpected outcomes. Methodological integration, however, requires skills and efforts of all involved to learn how members of the respective other tradition think and analyze nature-society systems.

Ten facts about land systems for sustainability.

Land use is central to addressing sustainability issues, including biodiversity conservation, climate change, food security, poverty alleviation, and sustainable energy. In this paper, we synthesize knowledge accumulated in land system science, the integrated study of terrestrial social-ecological systems, into 10 hard truths that have strong, general, empirical support. These facts help to explain the challenges of achieving sustainability in land use and thus also point toward solutions. The 10 facts are as follows: 1) Meanings and values of land are socially constructed and contested; 2) land systems exhibit complex behaviors with abrupt, hard-to-predict changes; 3) irreversible changes and path dependence are common features of land systems; 4) some land uses have a small footprint but very large impacts; 5) drivers and impacts of land-use change are globally interconnected and spill over to distant locations; 6) humanity lives on a used planet where all land provides benefits to societies; 7) land-use change usually entails trade-offs between different benefits-"win-wins" are thus rare; 8) land tenure and land-use claims are often unclear, overlapping, and contested; 9) the benefits and burdens from land are unequally distributed; and 10) land users have multiple, sometimes conflicting, ideas of what social and environmental justice entails. The facts have implications for governance, but do not provide fixed answers. Instead they constitute a set of core principles which can guide scientists, policy makers, and practitioners toward meeting sustainability challenges in land use.

A quantitative framework for identifying the role of individual species in Nature's Contributions to People.

It is widely acknowledged that biodiversity change is affecting human well-being by altering the supply of Nature's Contributions to People (NCP). Nevertheless, the role of individual species in this relationship remains obscure. In this article, we present a framework that combines the cascade model from ecosystem services research with network theory from community ecology. This allows us to quantitatively link NCP demanded by people to the networks of interacting species that underpin them. We show that this "network cascade" framework can reveal the number, identity and importance of the individual species that drive NCP and of the environmental conditions that support them. This information is highly valuable in demonstrating the importance of biodiversity in supporting human well-being and can help inform the management of biodiversity in social-ecological systems.

Social Ecological Influences on Nicotine/Tobacco Use Among Gender-Varying and Gender-Stable Adolescents and Adults in the USA.

BACKGROUND AND PURPOSE: Our study examined individual-, interpersonal-, community-, and policy-level associations with nicotine/tobacco use among gender-varying and gender-stable U.S. individuals. METHODS: Data from Waves 2-4 (2014/15-2016/18) of the Population Assessment of Tobacco and Health (n = 33,197 U.S. adolescents and adults aged ≥14 years) and state-level gender minority policy data were used. Using multivariable logistic regression, the odds of past-30-day nicotine/tobacco use at W4 were estimated as a function of gender stability/variability, psychological distress, number of tobacco products used by family/friends, anti-tobacco marketing exposure, and change in gender minority-related policies from 2015 to 2017. RESULTS: Gender-varying individuals had higher odds of nicotine/tobacco use compared with gender-stable individuals (AOR range = 1.7-2.3, p < .01). In the overall sample, positive change in gender minority policy protections (tallied from medium to high) was associated with lower odds of any nicotine/tobacco, other tobacco, and poly-tobacco use (AOR = 0.8, p < .05) compared to states with no change in their negative policies. Anti-tobacco marketing exposure was associated with lower odds of any tobacco, cigarette, e-cigarette, and poly-tobacco use compared with those who had no anti-tobacco marketing exposure (AOR = 0.9, p < .05). Higher psychological distress (AOR range = 1.7-2.4, p < .001) and an increasing number of tobacco products used by family/friends (AOR range = 1.1-1.3, p < .001) were associated with increased odds of nicotine/tobacco use. CONCLUSIONS: Multilevel prevention and intervention strategies are needed to reduce the risk of nicotine/tobacco use among gender-varying and gender-stable individuals.

Prior work has shown that individuals whose gender identity changes over time (i.e., gender-varying) have higher risk for nicotine/tobacco use compared with individuals whose gender identity remains consistent over time (i.e., gender-stable). This study examined individual-, interpersonal-, community-, and policy-level associations with nicotine/tobacco use among gender-varying and gender-stable U.S. adolescents and adults. We analyzed data from Waves 2­4 (2014/15­2016/18) of the Population Assessment of Tobacco and Health study (n = 33,197 U.S. adolescents and adults aged 14 years and above) and state-level gender identity policy data from the Movement Advancement Project. Among the overall sample, we found that a positive change in state-level policy protections was associated with lower odds of any nicotine/tobacco, other tobacco, and poly-tobacco use compared with states that had no change in their negative policies. Exposure to anti-tobacco marketing was associated with lower odds of any tobacco, cigarette, e-cigarette, and poly-tobacco use compared with those who had no exposure to anti-tobacco marketing. Higher psychological distress and an increasing number of tobacco products used by close friends and family were associated with increased odds of nicotine/tobacco use. Multilevel prevention and intervention strategies are needed to reduce the risk of nicotine/tobacco use among gender-varying and gender-stable individuals.

Facilitators and Barriers to Adherence to Anti-Retroviral Treatment Among Pregnant or Breastfeeding Women Living with HIV and Perinatally Infected Infants: A Scoping Review.

In 2022, 54% of 1.5 million children (age 0-14) living with HIV had access to anti-retroviral medication (ART). Adherence to ART for pregnant or breastfeeding HIV + women is critical for maintaining their personal health and to prevent mother-to-child-transmission (MTCT). For HIV + infants, adherence is essential to establish early viremic control and is contingent on caregiver administration. We conducted a scoping review to systematically identify and categorize the influences on ART adherence for pregnant or breastfeeding HIV + women and their HIV + infants. We searched databases in June 2023 and employed the Social-Ecological Model (SEM) to organize facilitators and barriers to adherence referenced in published articles. All articles published before 2016 were excluded due to updated guidelines from WHO on MTCT and ART. Our analysis included 52 articles. 50/52 took place in Africa and used cross-sectional and mixed-methods design. Barriers to adherence for pregnant or breastfeeding HIV + women included maternal education, self-efficacy, social support, and social/economic context. Barriers to infant adherence included development, nutrition, age of treatment initiation, disclosure, and ART side effects. Additional facilitators and barriers to adherence are presented at family, extra-familial, and socio-cultural SEM levels. Stigma was the most salient barrier referenced across the entire continuum of HIV care and all SEM levels. This review revealed a dearth of literature focusing on HIV + infants who are dependent on their caregivers for ART adherence and lack of a standard adherence measure. We identified multi-leveled influences on adherence impacting both the mother and infant and are amenable to public health intervention.

The dynamic feasibility of resisting (R), accepting (A), or directing (D) ecological change.

Ecological transformations are occurring as a result of climate change, challenging traditional approaches to land management decision-making. The resist-accept-direct (RAD) framework helps managers consider how to respond to this challenge. We examined how the feasibility of the choices to resist, accept, and direct shifts in complex and dynamic ways through time. We considered 4 distinct types of social feasibility: regulatory, financial, public, and organizational. Our commentary is grounded in literature review and the examples that exist but necessarily has speculative elements because empirical evidence on this newly emerging management strategy is scarce. We expect that resist strategies will become less feasible over time as managers encounter situations where resisting is ecologically, by regulation, financially, or publicly not feasible. Similarly, we expect that as regulatory frameworks increasingly permit their use, if costs decrease, and if the public accepts them, managers will increasingly view accept and direct strategies as more viable options than they do at present. Exploring multiple types of feasibility over time allows consideration of both social and ecological trajectories of change in tandem. Our theorizing suggested that deepening the time horizon of decision-making allows one to think carefully about when one should adopt different approaches and how to combine them over time.

La viabilidad dinámica de resistir (R), aceptar (A) o dirigir (D) el cambio ecológico Resumen Las transformaciones ecológicas ocurren por el cambio climático, lo que representa un reto para los enfoques tradicionales para decidir en torno a la gestión de tierras. El marco resistir­aceptar­dirigir (RAD) ayuda a los gestores a considerar cómo responder a este reto. Analizamos cómo la viabilidad de las opciones para resistir, aceptar y dirigir cambia de manera compleja y dinámica con el tiempo. Consideramos cuatro tipos distintos de viabilidad: regulatoria, económica, pública y de organización. Nuestro comentario está basado en la revisión bibliográfica y los ejemplos que existen, pero por necesidad tiene elementos especulativos ya que la evidencia empírica sobre esta estrategia emergente de gestión es escasa. Esperamos que las estrategias de resistir se vuelvan menos viables con el tiempo conforme los gestores encuentren situaciones en las que resistir no es viable de forma ecológica, económica, pública o por regulación. Al igual esperamos que cada vez más los marcos regulatorios permitan su uso, si el costo disminuye, y si el público los acepta, los gestores verán cada vez más viables las estrategias de aceptar y dirigir que las que utilizan actualmente. La exploración de varios tipos de viabilidad a lo largo del tiempo permite considerar las trayectorias sociales y ecológicas del cambio en conjunto. Nuestra teoría sugiere que profundizar en el horizonte temporal de las decisiones permite que se analice con cuidado sobre cuando se deben adoptar enfoques diferentes y cómo combinarlos con el tiempo.

Black women's perspectives on bladder health: Social-ecological and life course contexts.

AIMS: This paper explores Black women's perspectives on bladder health using a social-ecological conceptual framework and life course perspective. METHODS: We conducted a directed content analysis of data from the Study of Habits, Attitudes, Realities, and Experiences (SHARE), a focus group study by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Analysis was conducted on data from five focus groups and a member-checking session where all participants self-identified as Black or African American. RESULTS: Forty-two participants aged 11-14 or 45+ years reported life course experiences with their bladder. The intersection of race and gender was the lens through which participants viewed bladder health. Participants' accounts of their perspectives on bladder health explicitly and implicitly revealed structural racism as an explanatory overarching theme. Participants described (a) historically-rooted and still pervasive practices of discrimination and segregation, engendering inequitable access to quality medical care and public facilities, (b) institutional barriers to toileting autonomy in educational and occupational settings, promoting unhealthy voiding habits, (c) internalized expectations of Black women's stereotyped role as family caregiver, compromising caregiver health, (d) lack of reliable information on bladder health, leading to unhealthy bladder behaviors, and (e) potentially stress-related comorbid chronic conditions and associated medication use, causing or exacerbating bladder problems. CONCLUSIONS: Bladder health promotion interventions should address social-ecological and life course factors shaping Black women's bladder health, including social and structural barriers to accessing equitable health information and medical care.

Spatio-temporal dynamics and socio-ecological determinants of ecosystem service interplays in Shandong Province's coastal region (2000-2020): Implications for environmental protection and sustainable ecosystem management.

The sustainable management of multiple concurrent ecosystem services (ESs) requires a comprehensive understanding of the interconnections between various ESs. In this study, we develop spatial maps for six distinct ESs using a variety of models, and we quantify their trade-offs, synergies, and bundling patterns through spatial mapping and statistical methodologies. We further delve into the antagonistic and synergistic dynamics between different ESs within each Ecosystem Service Bundle (ESB), and employ GeoDetector to pinpoint the key drivers of each ES. Our findings reveal that: (1) The spatial distributions of ESs are heterogeneous, with most ESs exhibiting a downward trend except for GP and SC, which are on the rise. CS shows positive correlations with all other five ES indicators. HQ exhibits positive correlations with SC and RS, whereas negative correlations are observed between HQ-GP and WC-RS. Six ES pairs demonstrate a decline in synergistic relationships, but an increase in trade-off relationships. (2) We distinguish six types of ESBs, each differing in their combination and extent of ES provision. The trade-offs and synergies within these distinct ESBs display both commonalities and differences. In certain ESBs, supply services display synergistic relationships with other ESs. We leverage ES bundles as the foundation for studying spatial planning zoning, revealing a diversity in the interactions between different ES pairs and the driving factors of ES. Therefore, we establish the theoretical basis for formulating spatial planning on the interrelationships and drivers of ES under spatial and temporal changes. We anticipate that our findings will offer valuable scientific insight for the development of future ecological conservation and spatial planning strategies in the region.

Current Practices in Operationalizing and Addressing Racial Equity in the Provision of Type 1 Diabetes Care: Insights from the Type 1 Diabetes Exchange Quality Improvement Collaborative Health Equity Advancement Lab.

OBJECTIVE: Medical racism contributes to adverse health outcomes. Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QI) is a large population-based cohort engaged in data sharing and quality improvement to drive system changes in T1D care. The annual T1DX-QI survey included questions to evaluate racial equity in diabetes care and practices to promote equity. METHODS: The annual T1DX-QI survey was administered to participating clinics in fall 2022 and had a 93% response rate. There were 50 responses (pediatric: 66% and adult: 34%). Questions, in part, evaluated clinical resources and racial equity. Response data were aggregated, summarized, and stratified by pediatric/adult institutions. RESULTS: Only 21% pediatric and 35% adult institutions felt that all their team members can articulate how medical racism contributes to adverse diabetes outcomes. Pediatric institutions reported more strategies to address medical racism than adult (3.6 vs 3.1). Organizational strategies to decrease racial discrimination included employee trainings, equity offices/committees, patient resources, and hiring practices. Patient resources included interpreter services, transportation, insurance navigation, and housing and food assistance. Hiring practices included changing prior protocols, hiring from the community, and diversifying workforces. Most institutions have offered antiracism training in the last year (pediatric: 85% and adult: 72%) and annually (pediatric: 64% and adult: 56%). Pediatric teams felt that their antiracism training was effective more often (pediatric: 60% and adult: 45%) and more commonly, they were provided resources (pediatric: 67% and adult: 47%) to help address inequities. CONCLUSION: Despite increased antiracism training, insufficient institutional support and perceived subeffective training still represent obstacles, especially in adult institutions. Sharing effective strategies to address medical racism will help institutions take steps to mitigate inequities.

Integrating perceived physical environments and the theory of planned behaviors when explaining adherence to 24-hour movement guidelines in Chinese adolescents.

PURPOSES: Most adolescents worldwide do not meet 24-h movement guidelines, which recommend specific level of physical activity, sedentary behavior, and sleep for optimal health. Nevertheless, there remains a lack of understanding regarding how social cognitive and physical environmental factors influence adolescents' compliance with these guidelines. This prospective study aimed to examine the associations between perceived physical environments, constructs of the theory of planned behavior (TPB), habit strength, and adherence to 24-h movement guidelines in Chinese adolescents over a three-month period. METHODS: A total of 629 Chinese adolescents (Mage = 14.59 years, SD = 0.64) completed a set of questionnaires comprising perceived physical environmental characteristics, constructs of the TPB, habit strength, and 24-h movement behaviors at baseline and 3 months later. Data analysis was conducted using variance-based structural equation modeling. RESULTS: Attitude, subjective norm, and perceived behavioral control had a direct effect on intention and intention had a direct effect on number of the guidelines being met. Habit strength was a significant predictor of adherence to the guidelines, although its moderating effect on the intention-behavior relationship was not significant. Perceived neighborhood facility accessibility, school facility availability, and home physical activity equipment had significant indirect effects on intention through attitude, subjective norm, and perceived behavioral control. However, constructs of the TPB did not serve as mediators in the relationship between perceived physical environments and the number of guidelines being met. CONCLUSION: This study offers preliminary evidence supporting the integration of perceived physical environments and the TPB in predicting adolescents' adherence to 24-h movement guidelines. Future research should consider using experimental study designs with rigorous measures of 24-h movement behaviors to establish causal relationships.

Assessing spatiotemporal change in coral reef social-ecological systems.

Coral reef resilience is eroding at multiple spatial scales globally, with broad implications for coastal communities, and is thus a critical challenge for managing marine social-ecological systems (SESs). Many researchers believe that external stressors will cause key coral reefs to die by the end of the 21st century, virtually eliminating essential ecological and societal benefits. Here, we propose the use of resilience-based approaches to understand the dynamics of coral reef SESs and subsequent drivers of coral reef decline. Previous research has demonstrated the effectiveness of these methods, not only for tracking environmental change, but also for providing warning in advance of transitions, possibly allowing time for management interventions. The flexibility and utility of these methods make them ideal for assessing complex systems; however, they have not been used to study aquatic ecosystem dynamics at the global scale. Here, we evaluate these methods for examining spatiotemporal change in coral reef SESs across the global seascape and assess the subsequent impacts on coral reef resilience. We found that while univariate indicators failed to provide clear signals, multivariate resilience-based approaches effectively captured coral reef SES dynamics, unveiling distinctive patterns of variation throughout the global coral reef seascape. Additionally, our findings highlight global spatiotemporal variation, indicating patterns of degraded resilience. This degradation was reflected regionally, particularly in the Pacific Ocean and Indian Ocean SESs. These results underscore the utility of resilience-based approaches in assessing environmental change in SESs, detecting spatiotemporal variation at the global and regional scales, and facilitating more effective monitoring and management of coral reef SESs.

Identifying the Determinants of Hookah Smoking Among the Youth; A Mixed-Methods Study.

Hookahs have been rising in popularity in the United States (U.S.) especially among the youth yet not much research has been carried out to understand the various predictors of hookah use among youth. We have thus conducted a cross-sectional study with a mixed-methods triangulation design to identify the hookah use determinants at different levels of the Social Ecological Model among youth. Participants between the ages of 18-24 years were sampled purposively, between April to November 2023, following a snowballing technique from various communities in Virginia and California, United States. Data were collected via a survey, one-on-one interviews, and focus groups. The study had a total sample size of 20. We found that participants smoked for a median of 5 times in the past 30 days. The main determinants of hookah smoking included the limited knowledge of health effects and addiction, positive attitude, family and peer influence, use as a means to socially connect with others, culture, social acceptability, lack of education at school and work place, access to hookah bars and smoke shops, and lack of strict enforcement of laws to ban smoking of youth. Educational interventions should be implemented by public health authorities to target the youth, their social and communities to provide education on hookah harm and addictiveness and to restrict access to- and the production, distribution, marketing and sales of hookahs.

The diversity bonus in pooling local knowledge about complex problems.

Recently, theoreticians have hypothesized that diverse groups, as opposed to groups that are homogeneous, may have relative merits [S. E. Page, The Diversity Bonus (2019)]-all of which lead to more success in solving complex problems. As such, understanding complex, intertwined environmental and social issues may benefit from the integration of diverse types of local expertise. However, efforts to support this hypothesis have been frequently made through laboratory-based or computational experiments, and it is unclear whether these discoveries generalize to real-world complexities. To bridge this divide, we combine an Internet-based knowledge elicitation technique with theoretical principles of collective intelligence to design an experiment with local stakeholders. Using a case of striped bass fisheries in Massachusetts, we pool the local knowledge of resource stakeholders represented by graphical cognitive maps to produce a causal model of complex social-ecological interdependencies associated with fisheries ecosystems. Blinded reviews from a scientific expert panel revealed that the models of diverse groups outranked those from homogeneous groups. Evaluation via stochastic network analysis also indicated that a diverse group more adequately modeled complex feedbacks and interdependencies than homogeneous groups. We then used our data to run Monte Carlo experiments wherein the distributions of stakeholder-driven cognitive maps were randomly reproduced and virtual groups were generated. Random experiments also predicted that knowledge diversity improves group success, which was measured by benchmarking group models against an ecosystem-based fishery management model. We also highlight that diversity must be moderated through a proper aggregation process, leading to more complex yet parsimonious models.

Climate shock effects and mediation in fisheries.

Climate shocks can reorganize the social-ecological linkages in food-producing communities, leading to a sudden loss of key products in food systems. The extent and persistence of this reorganization are difficult to observe and summarize, but are critical aspects of predicting and rapidly assessing community vulnerability to extreme events. We apply network analysis to evaluate the impact of a climate shock-an unprecedented marine heatwave-on patterns of resource use in California fishing communities, which were severely affected through closures of the Dungeness crab fishery. The climate shock significantly modified flows of users between fishery resources during the closures. These modifications were predicted by pre-shock patterns of resource use and were associated with three strategies used by fishing community member vessels to respond to the closures: temporary exit from the food system, spillover of effort from the Dungeness crab fishery into other fisheries, and spatial shifts in where crab were landed. Regional differences in resource use patterns and vessel-level responses highlighted the Dungeness crab fishery as a seasonal "gilded trap" for northern California fishing communities. We also detected disparities in climate shock response based on vessel size, with larger vessels more likely to display spatial mobility. Our study demonstrates the importance of highly connected and decentralized networks of resource use in reducing the vulnerability of human communities to climate shocks.

Governing complexity: Integrating science, governance, and law to manage accelerating change in the globalized commons.

The speed and uncertainty of environmental change in the Anthropocene challenge the capacity of coevolving social-ecological-technological systems (SETs) to adapt or transform to these changes. Formal government and legal structures further constrain the adaptive capacity of our SETs. However, new, self-organized forms of adaptive governance are emerging at multiple scales in natural resource-based SETs. Adaptive governance involves the private and public sectors as well as formal and informal institutions, self-organized to fill governance gaps in the traditional roles of states. While new governance forms are emerging, they are not yet doing so rapidly enough to match the pace of environmental change. Furthermore, they do not yet possess the legitimacy or capacity needed to address disparities between the winners and losers from change. These emergent forms of adaptive governance appear to be particularly effective in managing complexity. We explore governance and SETs as coevolving complex systems, focusing on legal systems to understand the potential pathways and obstacles to equitable adaptation. We explore how governments may facilitate the emergence of adaptive governance and promote legitimacy in both the process of governance despite the involvement of nonstate actors, and its adherence to democratic values of equity and justice. To manage the contextual nature of the results of change in complex systems, we propose the establishment of long-term study initiatives for the coproduction of knowledge, to accelerate learning and synergize interactions between science and governance and to foster public science and epistemic communities dedicated to navigating transitions to more just, sustainable, and resilient futures.

Building public engagement and access to palliative care and advance care planning: a qualitative study.

BACKGROUND: Research evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required. METHODS: Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement. RESULTS: Three themes were generated from the data: "Visibility and relatability"; "Embedding opportunities for engagement into everyday life"; "Societal and cultural barriers to open discussion". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement. CONCLUSIONS: Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.

The socio-ecological determinants of help-seeking practices and healthcare access among young men: a systematic review.

Delayed engagement with health services is a key contributor to poorer health outcomes experienced by men. Patterns of health service usage which reduce the opportunity for disease prevention and health promotion appear to be especially prominent amongst young men. To identify the multiple and intersecting determinants of young men's help-seeking practices and health services usage, this review uses the social ecological model (SEM) to guide a critical synthesis of the literature on barriers and facilitators experienced by young men in accessing health services. A systematic review was conducted across five databases (MEDLINE, Embase, PsychINFO, CINAHL and Scopus). Included studies presented primary data regarding young men's (12-24 years) barriers and/or facilitators to seeking and accessing health care. Thirty-one studies (24 qualitative and 7 quantitative) underwent data extraction, quality appraisal and thematic analysis under the guiding framework of the SEM. Seven key themes were constructed, encapsulating the perceived barriers and facilitators to help-seeking and accessing health care experienced by young men, including masculine attitudes, health literacy, social pressure, service accessibility, economic factors, service characteristics and cultural attitudes. These findings highlight the complex interplay between the individual, interpersonal, organizational and societal factors impacting young men's healthcare engagement. They also illuminate avenues for multifaceted, context-specific interventions to enhance healthcare accessibility for this group, including addressing health literacy gaps, providing culturally sensitive care and reducing cost barriers.

Parental Travel Behaviors and Children's Independent Mobility: A MultiSite Study.

PURPOSE: Children who are allowed greater independent mobility (IM) are more physically active. This study investigated associations between parents' current travel mode to work, their own IM and school travel mode as a child, and their child's IM. METHODS: Children in grades 4 to 6 (n = 1699) were recruited from urban, suburban, and rural schools in Vancouver, Ottawa, and Trois-Rivières. Parents reported their current travel mode to work, IM, and school travel mode as a child. Children self-reported their IM using Hillman's 6 mobility licenses. Multiple imputation was performed to replace missing data. Gender-stratified generalized linear mixed models were adjusted for child age, parent gender, urbanization, and socioeconomic status. RESULTS: The older a parent was allowed to travel alone as a child, the less IM their child had (boys: ß = -0.09, 95% confidence interval [CI], -0.13 to -0.04; girls: ß = -0.09, 95% CI, -0.13 to -0.06). Girls whose parents biked to work (ß = 0.45, 95% CI, 0.06-0.83) or lived in Trois-Rivières versus other sites (ß = 0.82, 95% CI, -0.43 to 1.21) had higher IM. IM increased with each year of age (boys: ß = 0.46, CI, 0.34-0.58; girls: ß = 0.38, 95% CI, 0.28-0.48). CONCLUSION: Parents who experienced IM later may be more restrictive of their child's IM. This may help explain the intergenerational decline in children's IM.