Corrigendum: Reductions in global biodiversity loss predicted from conservation spending.

This corrects the article DOI: 10.1038/nature24295.

Clinical Education: Psychosocial Assessment and Treatment Planning for Patients with Inflammatory Bowel Disease.

Psychosocial factors play an important role in the disease course and illness experience of patients with inflammatory bowel disease (IBD). Consultation with a health psychologist is an important component of care for many IBD patients and provides an opportunity to identify areas of psychosocial concern, recognize coping deficits and strengths, and facilitate treatment recommendations. Psychosocial assessment in IBD requires a nuanced approach that goes beyond general mental health screening and considers the disease-specific concerns that impact patients. In this paper, we outline strategies for an IBD-focused psychological evaluation, including specific guidance for assessing disease-specific concerns of anxiety, depression, post-traumatic stress, sleep, pain, body image disturbance, food-related quality of life, and psychological resilience.

Reductions in global biodiversity loss predicted from conservation spending.

Halting global biodiversity loss is central to the Convention on Biological Diversity and United Nations Sustainable Development Goals, but success to date has been very limited. A critical determinant of success in achieving these goals is the financing that is committed to maintaining biodiversity; however, financing decisions are hindered by considerable uncertainty over the likely impact of any conservation investment. For greater effectiveness, we need an evidence-based model that shows how conservation spending quantitatively reduces the rate of biodiversity loss. Here we demonstrate such a model, and empirically quantify how conservation investment reduced biodiversity loss in 109 countries (signatories to the Convention on Biological Diversity and Sustainable Development Goals), by a median average of 29% per country between 1996 and 2008. We also show that biodiversity changes in signatory countries can be predicted with high accuracy, using a dual model that balances the effects of conservation investment against those of economic, agricultural and population growth (human development pressures). Decision-makers can use this model to forecast the improvement that any proposed biodiversity budget would achieve under various scenarios of human development pressure, and then compare these forecasts to any chosen policy target. We find that the impact of spending decreases as human development pressures grow, which implies that funding may need to increase over time. The model offers a flexible tool for balancing the Sustainable Development Goals of human development and maintaining biodiversity, by predicting the dynamic changes in conservation finance that will be needed as human development proceeds.

Sleep quality and mental health during COVID-19: the role of distress tolerance.

The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted psychological health for many. This study aimed to investigate if distress tolerance, an individual's perceived or actual 'capacity to withstand negative psychological states', helps to explain the relationship between sleep and mental health problems during the COVID-19 pandemic. College students (N = 187) completed questionnaires using an online survey platform between 6 April 2020, and 6 June 2020, during the COVID-19 pandemic. Hierarchical multiple regression analyses were used to examine the indirect effect of distress tolerance on the relationship between sleep quality and mental health. Distress tolerance partially accounted for the relationship between sleep quality and perceived stress but did not help to explain the association between sleep quality and depression or anxiety. Two components of distress tolerance, absorption and appraisal, helped to explain the relationship between sleep quality and all mental health outcomes. These findings help explain how distress tolerance relates to mental health when sleep is negatively impacted. Prospective designs replicating these findings are needed and future research may inform how psychological interventions could target distress tolerance in the context of poor sleep, especially during major stressors.

Distress and Prevention Behaviors During the COVID-19 Pandemic Among College Students: the Moderating Role of Resilience.

BACKGROUND: Pandemics can generate considerable distress, which can affect prevention behaviors. Resilience may buffer the negative effects of distress on engagement in relevant prevention behaviors, which may also hold true for COVID-19 prevention behaviors. The objective of the current study was to evaluate whether resilience moderated the relationship between distress and COVID-19 prevention behaviors early in the pandemic. METHODS: Data were collected via surveys in which all students at a large midwestern university were emailed invitations beginning March 18, 2020. Surveys were completed by 5,530 individuals. In addition to demographic questions and items about COVID-19 prevention behaviors, distress was assessed using the K6 Distress Scale and resilience using the Brief Resilience Scale. Data were analyzed using moderator regression analysis. RESULTS: Resilience moderates the effects from distress to prevention behaviors, such that the relationship was stronger for individuals with higher resilience than for individuals with lower resilience. When resilience was one standard deviation below the mean, at the mean value of resilience, and when resilience was one standard deviation above the mean, there was a significant positive relationship between distress and COVID-19 prevention behaviors. However, the relationship was strongest for those with high resilience, and lowest for those with low resilience. CONCLUSIONS: In the current sample, resilience appeared to influence the strength of the relationship between distress and COVID-19 prevention behaviors. Having higher resilience may promote positive adaptation to distress, leading individuals to engage in a greater number of disease-related prevention behaviors. Future research should examine this relationship longitudinally and in relation to differing constructs of resilience.

Feasibility of Predicting In-Season Mental Health Problems in College Student-Athletes From Pre-season Assessment.

OBJECTIVE: To examine whether pre-season assessment using a validated assessment tool, the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), could predict college student-athletes identified as experiencing in-season mental health (MH) problems. DESIGN: A prospective study of athletes who completed a pre-season evaluation in August 2018. SETTING AND PARTICIPANTS: A total of 195 National Collegiate Athletic Association Division 1 student-athletes from a large midwestern university in northeast Ohio. INDEPENDENT VARIABLE: The MMPI-2-RF, a 338-item self-report measure of constructs relevant to the assessment of psychopathology and personality. MAIN OUTCOME MEASURE: Mental health problems of student-athletes tracked throughout the competitive season (August 2018-May 2019) by a team of athletic department personnel who met weekly with a licensed clinical psychologist. RESULTS: In pre-season assessment, 71.8% of athletes clinically elevated at least one MMPI-2-RF scale and underreporting was higher in student-athletes than normative controls. Pre-season levels of internalizing psychopathology, diffuse physical symptoms, and unusual thoughts predicted increased likelihood of experiencing MH problems during the competitive season. CONCLUSIONS: The current findings suggest that the MMPI-2-RF may be a promising tool for identifying student-athletes at risk for MH concerns.

Health Literacy, Cognitive Function, and Mortality in Patients With Heart Failure.

BACKGROUND: Health literacy has predicted mortality in heart failure. However, the role of cognitive functioning in this relationship has not been evaluated. We hypothesized that health literacy would predict all-cause mortality but that cognitive functioning would modify the relationship between health literacy and mortality in heart failure. OBJECTIVE: The aim of this study was to examine the association between health literacy, cognitive functioning, and mortality in patients with heart failure. METHODS: This secondary analysis of a larger study included 298 patients with heart failure with reduced ejection fraction (trial identifier: NCT01461629). Health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine (REALM) and Medical Term Recognition Test (METER), and cognitive functioning was evaluated using the Modified Mini-Mental Status Examination (3MS). Cox proportional hazards regression was used with time-until-death as the dependent variable. RESULTS: After controlling for age, sex, and race, neither METER nor REALM scores predicted mortality in heart failure (Ps ≥ .37). However, 3MS predicted mortality in models using the METER (Δχ2 = 9.20, P < .01; B = -.07; hazard ratio, 0.94 [95% confidence interval, 0.89-0.98]; P < .01) and REALM (Δχ2 = 9.77, P < .01; B = -0.07; hazard ratio, 0.94 [95% confidence interval, 0.90-0.97]; P < .01). Furthermore, adding the 3MS improved model fit. CONCLUSIONS: Cognitive functioning predicted mortality in heart failure better than health literacy. Results suggest the need to further evaluate the contribution of cognitive functioning to increased risk of mortality in those with heart failure.

Targeting global conservation funding to limit immediate biodiversity declines.

Inadequate funding levels are a major impediment to effective global biodiversity conservation and are likely associated with recent failures to meet United Nations biodiversity targets. Some countries are more severely underfunded than others and therefore represent urgent financial priorities. However, attempts to identify these highly underfunded countries have been hampered for decades by poor and incomplete data on actual spending, coupled with uncertainty and lack of consensus over the relative size of spending gaps. Here, we assemble a global database of annual conservation spending. We then develop a statistical model that explains 86% of variation in conservation expenditures, and use this to identify countries where funding is robustly below expected levels. The 40 most severely underfunded countries contain 32% of all threatened mammalian diversity and include neighbors in some of the world's most biodiversity-rich areas (Sundaland, Wallacea, and Near Oceania). However, very modest increases in international assistance would achieve a large improvement in the relative adequacy of global conservation finance. Our results could therefore be quickly applied to limit immediate biodiversity losses at relatively little cost.

Dietary innovations spurred the diversification of ruminants during the Caenozoic.

Global climate shifts and ecological flexibility are two major factors that may affect rates of speciation and extinction across clades. Here, we connect past climate to changes in diet and diversification dynamics of ruminant mammals. Using novel versions of Multi-State Speciation and Extinction models, we explore the most likely scenarios for evolutionary transitions among diets in this clade and ask whether ruminant lineages with different feeding styles (browsing, grazing and mixed feeding) underwent differential rates of diversification concomitant with global temperature change. The best model of trait change had transitions from browsers to grazers via mixed feeding, with appreciable rates of transition to and from grazing and mixed feeding. Diversification rates in mixed-feeder and grazer lineages tracked the palaeotemperature curve, exhibiting higher rates during the Miocene thermal maxima. The origination of facultative mixed diet and grazing states may have triggered two adaptive radiations--one during the Oligocene-Miocene transition and the other during Middle-to-Late Miocene. Our estimate of mixed diets for basal lineages of both bovids and cervids is congruent with fossil evidence, while the reconstruction of browser ancestors for some impoverished clades--Giraffidae and Tragulidae--is not. Our results offer model-based neontological support to previous palaeontological findings and fossil-based hypothesis highlighting the importance of dietary innovations--especially mixed feeding--in the success of ruminants during the Neogene.

Psychosocial management in cardiac rehabilitation: Current practices, recommendations, and opportunities.

Psychosocial management is a core component of outpatient Phase-II cardiac rehabilitation (CR) and includes psychosocial assessment, providing interventions, measuring outcomes, and care coordination. Psychosocial management contributes to the effectiveness of comprehensive CR, but the implementation is not always consistent or clearly described in the literature, in part due to the availability of behavioral health specialists. Patients in CR have many psychosocial needs including anxiety, depression, substance use disorders, sleep problems, psychosocial stress, and cognitive impairment. Behavioral considerations are inherent in many other aspects of CR,such as participation in CR, health behaviors, adherence, and tobacco cessation. Evaluation, or psychosocial assessment, should identify significant issues, record related medications, and incorporate findings in the individual treatment plan. Some patients require further evaluation and treatment by a qualified behavioral health specialist. Psychosocial interventions provided to all patients include patient education, counseling, stress-management, a supportive environment, and exercise. Measuring outcomes entails repeating the psychosocial assessment when patients finish CR and documenting changes. Coordinating care requires understanding available local mental health infrastructure and procedures for making referrals, and may entail identifying additional resources. Interventions provided concurrently with CR to a subset of patients with more extensive needs are typically pharmacotherapy, psychotherapy, or addictions counseling, which are beyond the scope of practice for most CR professionals. The way psychosocial management is implemented suggests clinical and research opportunities. For example, the combined effects of antidepressants and CR on depression and anxiety are not known. A prominent clinical opportunity is to fully implement psychosocial assessment, as required by statute and the core components. This could involve referring patients for whom clinically significant psychosocial concerns are identified during the evaluation for a more thorough assessment by a behavioral health specialist using an appropriate billing model. A research priority is a contemporary description of behavioral health services available to CR programs, including how psychosocial management is implemented. As delivery of CR comes to include more alternative models (e.g., home-based), research is needed on how that affects the delivery of psychosocial management. Increased use of telehealth may broaden clinical opportunities for psychosocial management.

Meta-Analysis of Antidepressant Pharmacotherapy in Patients Eligible for Cardiac Rehabilitation: ANTIDEPRESSANT AMBIVALENCE.

PURPOSE: Many patients exhibit clinically significant depression upon enrollment in cardiac rehabilitation (CR). Antidepressants are a first-line treatment option for depression, but the effectiveness of antidepressants in patients with heart disease is mixed. The purpose of this meta-analysis was to evaluate the efficacy of antidepressants for depression in patients eligible for CR. METHODS: A meta-analysis was conducted including randomized controlled trials of antidepressants from January 1990 to September 2021 that compared antidepressants with placebo. Random-effects models were used between group effect sizes (Hedges' g ). RESULTS: A total of 13 trials with predominately White (68% ± 12; n =7) male (70% ± 11) samples averaging 61 ± 5 yr compared antidepressants (1128 participants) with placebo (1079 participants). Antidepressants reduced depressive symptoms ( g = 0.17: 95% CI, 0.08-0.27), but the effect was small. Heterogeneity among study effects was low ( I2 = 6.42) and nonsignificant ( Q = 10.75, P = .46), although patients with heart failure ( gHF = 0.05: 95% CI, -0.09 to 0.18) demonstrated smaller effects compared with patients with other cardiovascular disease conditions (g non-HF = 0.22: 95% CI, 0.11-0.32) ( QB [1] = 3.97; P < .05). No study reported safety concerns associated with antidepressants. SUMMARY: The effect size of antidepressant pharmacotherapy in this population is small. No trials reported on the combined effects of exercise and pharmacotherapy. If the patient is not suicidal, CR staff may consider patient preference and refer patients for additional treatment as necessary.

Missing saiga on the taiga.

Conservation biologists understand that linking demographic histories of species at risk with causal biotic and abiotic events should help us predict the effects of ongoing biotic and abiotic change. In parallel, researchers have started to use ancient genetic information (aDNA) to explore the demographic histories of a number of species present in the Pleistocene fossil record (see, e.g. Shapiro et al. 2004). However, aDNA studies have primarily focused on identifying long-term population trends, linked to climate variability and the role of early human activity. Population trends over more recent time, e.g. during the Holocene, have been poorly explored, partly owing to analytical limitations. In this issue, Campos et al. (2010a) highlight the potential of aDNA to investigate demographic patterns over such recent time periods for the compelling and endangered saiga antelope Saiga tatarica (Fig. 1). The time may come when past and current demography can be combined to produce a seamless record. [Figure: see text].

Modern and ancient DNA reveal recent partial replacement of caribou in the southwest Yukon.

The long-term persistence of forest-dwelling caribou (Rangifer tarandus caribou) will probably be determined by management and conservation decisions. Understanding the evolutionary relationships between modern caribou herds, and how these relationships have changed through time will provide key information for the design of appropriate management strategies. To explore these relationships, we amplified microsatellite and mitochondrial markers from modern caribou from across the Southern Yukon, Canada, as well as mitochondrial DNA from Holocene specimens recovered from alpine ice patches in the same region. Our analyses identify a genetically distinct group of caribou composed of herds from the Southern Lakes region that may warrant special management consideration. We also identify a partial genetic replacement event occurring 1000 years before present, coincident with the deposition of the White River tephra and the Medieval Warm Period. These results suggest that, in the face of increasing anthropogenic pressures and climate variability, maintaining the ability of caribou herds to expand in numbers and range may be more important than protecting the survival of any individual, isolated sedentary forest-dwelling herd.

Global priorities for conserving the evolutionary history of sharks, rays and chimaeras.

In an era of accelerated biodiversity loss and limited conservation resources, systematic prioritization of species and places is essential. In terrestrial vertebrates, evolutionary distinctness has been used to identify species and locations that embody the greatest share of evolutionary history. We estimate evolutionary distinctness for a large marine vertebrate radiation on a dated taxon-complete tree for all 1,192 chondrichthyan fishes (sharks, rays and chimaeras) by augmenting a new 610-species molecular phylogeny using taxonomic constraints. Chondrichthyans are by far the most evolutionarily distinct of all major radiations of jawed vertebrates-the average species embodies 26 million years of unique evolutionary history. With this metric, we identify 21 countries with the highest richness, endemism and evolutionary distinctness of threatened species as targets for conservation prioritization. On average, threatened chondrichthyans are more evolutionarily distinct-further motivating improved conservation, fisheries management and trade regulation to avoid significant pruning of the chondrichthyan tree of life.

Computing evolutionary distinctiveness indices in large scale analysis.

We present optimal linear time algorithms for computing the Shapley values and 'heightened evolutionary distinctiveness' (HED) scores for the set of taxa in a phylogenetic tree. We demonstrate the efficiency of these new algorithms by applying them to a set of 10,000 reasonable 5139-species mammal trees. This is the first time these indices have been computed on such a large taxon and we contrast our finding with an ad-hoc index for mammals, fair proportion (FP), used by the Zoological Society of London's EDGE programme. Our empirical results follow expectations. In particular, the Shapley values are very strongly correlated with the FP scores, but provide a higher weight to the few monotremes that comprise the sister to all other mammals. We also find that the HED score, which measures a species' unique contribution to future subsets as function of the probability that close relatives will go extinct, is very sensitive to the estimated probabilities. When they are low, HED scores are less than FP scores, and approach the simple measure of a species' age. Deviations (like the Solendon genus of the West Indies) occur when sister species are both at high risk of extinction and their clade roots deep in the tree. Conversely, when endangered species have higher probabilities of being lost, HED scores can be greater than FP scores and species like the African elephant Loxondonta africana, the two solendons and the thumbless bat Furipterus horrens can move up the rankings. We suggest that conservation attention be applied to such species that carry genetic responsibility for imperiled close relatives. We also briefly discuss extensions of Shapley values and HED scores that are possible with the algorithms presented here.

Investing in evolutionary history: implementing a phylogenetic approach for mammal conservation.

Under the impact of human activity, global extinction rates have risen a thousand times higher than shown in the fossil record. The resources available for conservation are insufficient to prevent the loss of much of the world's threatened biodiversity during this crisis. Conservation planners have been forced to prioritize their protective activities, in the context of great uncertainty. This has become known as 'the agony of choice'. A range of methods have been proposed for prioritizing species for conservation attention; one of the most strongly supported is prioritizing those species that maximize phylogenetic distinctiveness (PD). We evaluate how a composite measure of extinction risk and phylogenetic isolation (EDGE) has been used to prioritize species according to their degree of unique evolutionary history (evolutionary distinctiveness, ED) weighted by conservation urgency (global endangerment, GE). We review PD-based approaches and provide an updated list of EDGE mammals using the 2010 IUCN Red List. We evaluate how robust this method is to changes in phylogenetic uncertainty, knowledge of taxonomy and extinction risk, and examine how mammalian species that rank highly in EDGE score are representative of the collective from which they are drawn.