Stakeholder-driven transformative adaptation is needed for climate-smart nutrition security in sub-Saharan Africa.

Improving nutrition security in sub-Saharan Africa under increasing climate risks and population growth requires a strong and contextualized evidence base. Yet, to date, few studies have assessed climate-smart agriculture and nutrition security simultaneously. Here we use an integrated assessment framework (iFEED) to explore stakeholder-driven scenarios of food system transformation towards climate-smart nutrition security in Malawi, South Africa, Tanzania and Zambia. iFEED translates climate-food-emissions modelling into policy-relevant information using model output implication statements. Results show that diversifying agricultural production towards more micronutrient-rich foods is necessary to achieve an adequate population-level nutrient supply by mid-century. Agricultural areas must expand unless unprecedented rapid yield improvements are achieved. While these transformations are challenging to accomplish and often associated with increased greenhouse gas emissions, the alternative for a nutrition-secure future is to rely increasingly on imports, which would outsource emissions and be economically and politically challenging given the large import increases required.

Recommendations to guide sampling effort for polygon-based participatory mapping used to identify perceived ecosystem services hotspots.

Participatory mapping is increasingly used to map spatial variation in people's perceptions about ecosystem services. It has growing use in the identification of locations where places perceived to be important converge. Few recommendations have been published to navigate decisions about sampling effort in participatory mapping research when polygon data is collected, although one recommendation is for ≥ 25 participants assuming each participant maps c. 4-5 polygons per ecosystem service. Underlying data informing this recommendation reflects a particular context: collected using postal questionnaires to map a vast spatial area in southern Australia. Although not intended as definitive or suited to all contexts, the 25 participant (or 100-125 polygon) minimum sometimes informs participatory mapping research. Our empirical work, undertaken using face-to-face questionnaires in a small Vietnamese coastal study area, suggests the recommendation may not be appropriate in all contexts. We propose a modified stepwise approach which:•Prioritises spatial agreement (polygon overlap) rather than polygon count and participant numbers to assess data sufficiency•Uses narratives to triangulate outputs generated from participatory mapping data to reduce uncertainty related to low polygon counts.

Stereotactic radiotherapy (10 Gy X 3) for canine nonlymphomatous intranasal tumors is associated with prolonged survival and minimal risk of severe radiotoxicity.

OBJECTIVE: To describe oncologic outcomes following administration of a uniform stereotactic radiotherapy protocol (SRT; 10 Gy X 3) for canine intranasal tumors and to identify whether any clinical or dosimetric factors were predictive of event-free or overall survival time (EFST or OST). ANIMALS: 129 dogs. PROCEDURES: In this single-institution retrospective study, the medical records database was searched for canine nonlymphomatous intranasal tumors treated with 10 Gy X 3 SRT between August 2013 and November 2020. Findings regarding adverse effects and outcomes were analyzed overall, for dogs grouped on the basis of life stage (mature adult, senior, or end of life), and for treatment-related or tumor-related variables to identify potential predictors of outcome. RESULTS: After SRT, most dogs clinically improved with minimal acute radiotoxicity. The median EFST was 237 days; median OST was 542 days. Receipt of other tumor-directed therapies before or after SRT was associated with improved EFST in senior dogs (hazard ratio [HR], 0.416) and improved OST in mature adult (HR, 0.241) and senior dogs (HR, 0.348). In senior dogs, administration of higher near-minimum radiation doses was associated with improved EFST (HR, 0.686) and OST (HR, 0.743). In senior dogs, chondrosarcoma was associated with shorter OST (HR, 7.232), and in dogs at end of life, having a squamous cell or transitional carcinoma was associated with worse EFST (HR, 6.462). CLINICAL RELEVANCE: This SRT protocol results in improved quality of life and prolonged OST for dogs of all life stages. Radiation protocol optimization or use of multimodal therapy may further improve outcomes.

Coherence of marine alien species biosecurity legislation: A study of England and Wales.

The marine environment is particularly at risk from the intentional and unintentional introduction and spread of invasive alien species (IAS); preventing their introduction and spread from occurring is therefore, a key component in the on-going management of marine IAS. Ensuring legislation is coherent and consistent is essential to the success of managing the existing and future impacts of marine IAS. We explore the coherence (determined as consistency and interaction) of marine biosecurity legislation for IAS at different geopolitical scales. There was consistency between both the Bern Convention and Convention on Biological Diversity and European and national legislation that had been created in response. There was a lack of interaction evidenced by the Ballast Water Management Convention, which had not yet been transposed into regional (mainly European) or national legislation. Implementation measures such as legislation should be coherent as any failure in the chain could potentially weaken the overall effort to establish and maintain biosecurity and achieve behaviour change.

Perceived Climate Variability and Compounding Stressors: Implications for Risks to Livelihoods of Smallholder Indian Farmers.

Micro-scale perspectives are seldom included in planned climate change adaptations, yet farmers' perceptions can provide useful insights into livelihood impacts from interactions between climatic and other stressors. This research aims to understand how climate variability and other stressors are impacting the livelihoods of smallholder farmers in Azamgarh district, eastern Uttar Pradesh, India. Data from 84 smallholder farmers were collected using mixed qualitative and quantitative approaches, including interview and participatory methods, informed by multiple stressor and sustainable livelihood frameworks. Results revealed that farmers are increasingly facing problems caused by the reduced duration and number of rainy days, and erratic rainfall. Anomalies in seasonal cycles (longer summers, shorter winters) seem to have altered the local climate. Farmers reported that repeated drought impacts, even in years of moderate rainfall, are adversely affecting the rice crop, challenging the formal definition of drought. Climate variability, identified as the foremost stressor, often acts as a risk multiplier for ecological (e.g., soil sodicity), socio-economic (e.g., rising costs of cultivation) and political (e.g., mismatching policies and poor extension systems) stressors. In addition to climate stresses, resource-poor marginal groups in particular experienced higher risks resulting from changes in resource management regimes. This study provides an important cue to revisit the formal definitions of normal rainfall and drought, accommodating farmers' perceptions that evenly distributed rainfall, and not total rainfall is a key determinant of crop yields. Though India has developed adaptive measures for climate change and variability, integration of farmers' perceptions of climate and other stressors into such policies can improve the resilience of smallholder farmers, who have hitherto depended largely on autonomous adaptation strategies.

The effectiveness of disinfectant and steam exposure treatments to prevent the spread of the highly invasive killer shrimp, Dikerogammarus villosus.

Biosecurity protocols designed to prevent the spread of invasive alien species (IAS) are now an essential aspect of IAS management. However, the effectiveness of various biosecurity treatments requires further exploration. Killer shrimp, Dikerogammarus villosus, a notoriously high impact and ecosystem destabilising invader, has rapidly spread across Europe, and is of concern to invade Northern America. In this study, we examine the effectiveness of three commonly used, broad-spectrum disinfectants to cause mortality of D. villosus: Virasure Aquatic, Virkon Aquatic, and Virkon S. Immersion and spray treatments of 1%, 2% and 4% disinfectant solutions were examined for applications of up to 300 secs immersion and for up to ten consecutive sprays. Furthermore, we assessed the effectiveness of steam (≥100 °C) treatments for up to 120 secs. For all disinfectants, immersion in 1% solutions caused 100% mortality at ≥120 secs. At higher concentrations, shorter immersion times caused complete mortality: 60 and 15 secs for 2% and 4% solutions, respectively. Five sprays of 2% and 4% solutions resulted in 100% mortality, for all disinfectants. Direct steam exposure was highly effective, with complete D. villosus mortality occurring at ≥10 secs. Overall, brief exposure to broad-spectrum disinfectants and direct steam could be used to limit D. villosus spread.

Helping stakeholders select and apply appraisal tools to mitigate soil threats: Researchers' experiences from across Europe.

Soil improvement measures need to be ecologically credible, socially acceptable and economically affordable if they are to enter widespread use. However, in real world decision contexts not all measures can sufficiently meet these criteria. As such, developing, selecting and using appropriate tools to support more systematic appraisal of soil improvement measures in different decision-making contexts represents an important challenge. Tools differ in their aims, ranging from those focused on appraising issues of cost-effectiveness, wider ecosystem services impacts and adoption barriers/opportunities, to those seeking to foster participatory engagement and social learning. Despite the growing complexity of the decision-support tool landscape, comprehensive guidance for selecting tools that are best suited to appraise soil improvement measures, as well as those well-adapted to enable participatory deployment, has generally been lacking. We address this gap using the experience and survey data from an EU-funded project (RECARE: Preventing and REmediating degradation of soils in Europe through land CARE). RECARE applied different socio-cultural, biophysical and monetary appraisal tools to assess the costs, benefits and adoption of soil improvement measures across Europe. We focused on these appraisal tools and evaluated their performance against three broad attributes that gauge their differences and suitability for widespread deployment to aid stakeholder decision making in soil management. Data were collected using an online questionnaire administered to RECARE researchers. Although some tools worked better than others across case studies, the information collated was used to provide guiding strategies for choosing appropriate tools, considering resources and data availability, characterisation of uncertainty, and the purpose for which a specific soil improvement measure is being developed or promoted. This paper provides insights to others working in practical soil improvement contexts as to why getting the tools right matters. It demonstrates how use of the right tools can add value to decision-making in ameliorating soil threats, supporting the sustainable management of the services that our soil ecosystems provide.

Levels of satisfaction with children's respite services, parental coping and family functioning.

Little is known about how parents' experiences of respite services or 'short breaks' for a child with complex medical needs relate to family functioning and the manner in which parents cope. The aim of this study was to examine the relationship between parents' satisfaction with short breaks, family functioning and parental coping and to determine whether these variables change over time. The sample included 32 families receiving short breaks. A repeated measures quantitative design was used, with data collected at baseline and 12 months. The main outcome variables were satisfaction with short breaks, family functioning and parental coping. At baseline, descriptive statistics showed positive levels of satisfaction with services and coping, while family functioning scores suggested more negative profiles. Also at baseline, significant negative correlations were identified between the age of the child receiving short breaks and certain approaches to parental coping. At Time 2 (n = 17, 73% of possible responses), satisfaction with services was significantly positively correlated with aspects of family functioning and coping. Using dependent t tests, no evidence was found of significant change overtime in satisfaction or family functioning for the sample who completed data collection at both time points. However, a significant decrease in use of certain coping approaches was found over time. While parents' satisfaction levels with short breaks were high across test occasions, there is need for service development aimed at providing interventions that are tailored to ameliorate tension within the family and promote active parental coping over time.

Corruption and conflicts as barriers to adaptive governance: Water governance in dryland systems in the Rio del Carmen watershed.

Water governance in the Rio del Carmen watershed has failed to achieve sustainable water use, generating social conflicts, water overexploitation, and grassland loss. This leaves it unable to adapt and learn, to reconcile different stakeholder perspectives and to adequately respond to uncertainty. Adaptive water governance regulates water access through flexible, inclusive and innovative institutions, increasing system adaptive capacity in the face of uncertainty. This is necessary for water-scarce systems since they suffer context-specific exposure to land degradation and climate change. This research focuses on how water governance regulates water access in the Rio del Carmen watershed, Mexico, identifying key legal and institutional features that could increase adaptation and secure water resources in the long-term. 27 semi-structured interviews were conducted with key stakeholders in the watershed, in order to understand the water governance structure and its system dynamics. It was found that water mismanagement, overexploitation, and conflicts over access to water are due to the lack of application and neglect of formal rules. Results indicate that breaches of the legal framework are commonplace, permitted by corruption of both former and current government officials. Many farmers have institutionalized this corruption in order to access water; increasing social conflicts and hindering any type of planning or water management, which, in turn, continues to affect the ecological conditions of the watershed. By understanding the governance system, its structure and the interactions that weaken and bypass formal institutions to the detriment of water resources, stakeholder engagement has emerged as an entry point for enabling collaboration and acceptance of formal institutions. This process has the potential to create a formal network, as a Watershed Committee, that could be honoured in practice through the efficacy of this engagement.

Investigating Climate Compatible Development Outcomes and their Implications for Distributive Justice: Evidence from Malawi.

Governments and donors are investing in climate compatible development in order to reduce climate and development vulnerabilities. However, the rate at which climate compatible development is being operationalised has outpaced academic enquiry into the concept. Interventions aiming to achieve climate compatible development "wins" (for development, mitigation, adaptation) can also create negative side-effects. Moreover, benefits and negative side-effects may differ across time and space and have diverse consequences for individuals and groups. Assessments of the full range of outcomes created by climate compatible development projects and their implications for distributive justice are scarce. This article develops a framework using a systematic literature review that enables holistic climate compatible development outcome evaluation over seven parameters identified. Thereafter, we explore the outcomes of two donor-funded projects that pursue climate compatible development triple-wins in Malawi using this framework. Household surveys, semi-structured interviews and documentary material are analysed. Results reveal that uneven outcomes are experienced between stakeholder groups and change over time. Although climate compatible development triple-wins can be achieved through projects, they do not represent the full range of outcomes. Ecosystem-and community-based activities are becoming popularised as approaches for achieving climate compatible development goals. However, findings suggest that a strengthened evidence base is required to ensure that these approaches are able to meet climate compatible development goals and further distributive justice.

Prioritisation of future research topics in paediatric palliative care in Ireland: a Delphi study.

This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies. As a new specialty, there is a need to develop an evidence-based approach to providing children's palliative care. In order to do this in a systematic way, identification of the research priorities in children's palliative care within Ireland is required.

Family and healthcare professionals' perceptions of a pilot hospice at home programme for children: a qualitative study.

BACKGROUND: Parents commonly report a significant improvement in quality of life following the provision of hospice and supportive care and have identified a need for such a service in the home. The purpose of this study was to understand the experiences of families receiving a nurse led pilot hospice at home programme and the experiences of healthcare professionals delivering and engaging with the programme. METHODS: An exploratory, qualitative study was conducted, including telephone interviews with parents and focus groups and individual interviews with healthcare professionals. All parents of families who received the programme of care between June 2014 and September 2015 and healthcare professionals delivering and engaging with the programme were invited to participate. RESULTS: Seven parents participated in telephone interviews. Four focus groups took place, two with external stakeholders (18 participants in total), one with in-patient hospice staff (13 participants) and one with the hospice at home team (8 participants). Two additional interviews took place with individual stakeholders who were unable to attend a scheduled focus group. Themes from interviews with parents focused on the value of having consistent and expert care. The findings from healthcare professionals centred on communication within and across services, education and training and lone working. CONCLUSIONS: The pilot hospice at home programme was welcomed by all those who took part in the study. The programme may be improved by enhanced clarification of roles, enhanced access to multi-disciplinary services, greater communication across services and improved information provision to families.

Evaluating a pilot paediatric hospice-at-home service: a literature review.

Background: This literature review aims to offer practitioners an overview of the key components involved in designing the evaluation of a paediatric hospice-at-home pilot that will assess the effectiveness, efficiency and sustainability of the programme. The literature was reviewed in two stages: the first examined existing literature in the area of paediatric palliative care. The second looked at the wider field of adult palliative care to gain further insights into evaluation tool design. The findings are presented as a conceptual model to highlight each component of the pilot development stage as identified for evaluation purposes, emphasising their role and impact on the resultant delivery of integrated care. The clarity and transparency of this model offers a comprehensive overview of the evaluation process to all involved in the pilot.

Findings from a Clinical Learning Needs Survey at Ireland's first children's hospice.

PURPOSE: Caring for children with life-limiting conditions places exceptional demands on health professionals. Staff require the optimal skills and expertise necessary to provide the highest quality of care and to achieve this it is essential to understand their learning requirements. AIM: The aim is to share the main findings from a Clinical Learning Needs Survey conducted at LauraLynn, currently Ireland's only children's hospice. To date no other Irish service has conducted a formal identification of professional learning and development needs specific to the Irish context. The findings from the study assist workforce planning by providing a glimpse into the immediate study needs of staff working in a children's palliative care setting. The study had two main aims: a) Assist clinical staff within one organisation to identify their own professional learning priorities in children's palliative care and b) Inform the design and delivery of a responsive suite of workshops, programmes and study sessions for children's palliative care. RESULTS: The study identified the key learning needs as end-of-life care, palliative emergencies, communication skill development and bereavement support. CONCLUSION: These findings are similar to those found internationally and demonstrate the commitment of a new organisation to ensure that specific employee learning requirements are met if the organisation and wider specialty of Irish children's palliative care is to continue its evolution.

Implementing REDD+ at the local level: Assessing the key enablers for credible mitigation and sustainable livelihood outcomes.

Achieving cost-effective mitigation and sustainable livelihoods through reducing emissions from deforestation and forest degradation (REDD+) depends heavily on the local context within which REDD+ projects are implemented. Studies have focused on how REDD+ can benefit or harm local people, with little attention paid to how people, their assets and institutions can promote or impede REDD+. This paper examines the key local assets necessary for REDD+ to protect forests and support local livelihoods based on evidence from a globally-linked REDD+ project in Kenya. Household interviews (n = 100), focus group discussions (n = 6) and in-depth interviews with government (n = 8) and project stakeholders (n = 14) were undertaken to rank and explain how local assets interact with the project's efforts to protect forests, and the role of State institutions in shaping project-asset interactions. Locally, pro-poor assets such as land tenure and water access had most influence on the project's ability to protect forests. Inclusion of communal forests as part of the REDD+ project entitled local poor peasant farmers to participate in and benefit from the project and so dissuaded them from using protected forests for charcoal production. Water access determined agricultural productivity and intensity of forest use for livelihoods and coping. Even though carbon revenues were distributed equally between social groups and support directed to pro-poor livelihood initiatives, efforts were impeded by State decisions on land that interfered with communal approaches to forest conservation, by strict carbon standards that limited trade-offs between livelihoods and forest protection and by fluctuating carbon prices and buyers that limited funds needed for project operations and local livelihoods. Equitable and pro-poor benefit sharing are necessary but not sufficient for effective REDD+ implementation unless national institutions are reformed and global carbon pricing harmonized with local livelihood needs.

Reflections on the provision of community palliative care for terminally ill children in Ireland.

In many areas of Ireland, children dying at home still have inadequate access to specialist palliative care. This causes unnecessary emotional and physical distress to the child, family, caregivers and healthcare professionals. Irish health policies aimed at improving the situation need to be fully resourced, structured, implemented, supported and evaluated. Timely referral of the child, advance care planning, patient advocacy and, finally, management of symptoms at the end of life by palliative care children's nurse specialists can transform the experience of all involved. The author reflects on caring for a child with a life-limiting condition using the McNeilly (2006) reflection model.

Caring for children and families in the community: experiences of Irish palliative care clinical nurse specialists.

An increasing number of children require care at home owing to life-limiting illness. In addition, there is growing recognition of the specific care needs of such children and their families, and it is anticipated that recent developments in children's palliative care will result in more people accessing these services. In the Republic of Ireland (ROI), community palliative care clinical nurse specialists (CNSs), who are not registered children's nurses, contribute significantly to the support of these children and families. This study aimed to obtain a picture of the current nursing service that would help to determine whether the needs of these patients are being met. Seven community palliative care CNSs from across one health region in the ROI participated in a focus group. Four key themes emerged: gaining access to the child and family, role complexities, pressures of caring, and support strategies. Provision of community children's palliative care by the CNS is complex. The participants demonstrated their commitment to consult, coordinate, negotiate, and ultimately deliver the care required by children and families, but against a background of issues relating to accessing the patient and family, the complexity of the CNS role, and the pressures that such work incurs.