Background: Cancer is a growing public health concern in Africa and Asia, where access to effective healthcare and resources is often limited. There is an urgent need for evidence-based cancer control policies in Africa and Asia, along with systems for prevention, early detection, diagnosis and treatment, and palliative care. This emerging issue has garnered growing interest from international institutions but there has been little visible action, and the existing knowledge remains scattered and fragmented. This scoping review aims to explore the breadth and scope of evidence regarding knowledge transfer interventions to enhance cancer care in Africa and Asia. Methods: We conducted a systematic search of Embase, Emcare, ERIC, APA PsycInfo, Medline, and Google Scholar, supplemented by expert bibliographies and references. Peer-reviewed empirical studies in English or French from January 1978 to September 2024 were included. Data were organised using the AIMD (Aims, Ingredients, Mechanism & Delivery) framework. Study quality was presented using the Mixed Methods Appraisal Tool. Results: The scoping review examined seven articles providing evidence on five unique interventions. The interventions included target both decision-makers and health professionals and aim to strengthen evidence-based cancer control policies and implementation strategies. The interventions documented have all been initiated by external actors, mainly international institutions or researchers from high-income countries, in collaboration with African and Asian stakeholders. In addition, some researchers have been involved in participatory research projects designed to enable decision-makers to implement evidence-based cancer control policies and programmes. Conclusions: This scoping review highlights a critical lack of evidence on knowledge transfer interventions in cancer care across Africa and Asia, partly due to limited funding for non-communicable diseases. It calls for the integration of knowledge transfer components into all cancer research and interventions, supported by robust evaluation strategies, to develop evidence-based, economically feasible, and culturally appropriate policies, guidelines and interventions that can be used in nations with limited healthcare resources to improve cancer outcomes.

In the context of ever-increasing humanitarian needs worldwide, anticipatory action is being recognised as one of main the ways in which predictable shocks can be prevented from turning into crises, reducing both the impacts and the costs. Anticipatory action is a critical approach, bridging the work of disaster risk reduction and humanitarian response, and showing great promise as a modality for nexus programming (for example, linking humanitarian to development). While a scale-up of anticipatory action is much needed, it also requires a truly decolonial and feminist approach that supports communities to uphold their rights. To meet this vision, Oxfam has laid out four interconnected fundamental principles for all partners and stakeholders involved in scaling up anticipatory action to use: Adopting these principles in the scale-up of anticipatory action will unlock some of the key challenges of the approach. The principles acknowledge the sectoral trends that call for sector-wide transformation in line with key principles, but overall, they are designed to ensure that anticipatory action is effective and fit for purpose. This paper calls for governments, communities, humanitarian, climate, peace and development practitioners, and the private sector to adopt the proposed four interconnected fundamentals in the scale-up of anticipatory action and support at-risk communities to uphold their rights. This principled approach to embedding anticipatory action into policy, practice, and legal frameworks is required to maximise the potential of anticipatory action and prevent predictable shocks from becoming crises.

COVID-19 is not only associated with substantial acute liver and kidney injuries, but also with an elevated risk of post-acute sequelae involving the kidney and liver system. We aimed to investigate whether COVID-19 exposure increases the long-term risk of kidney and liver disease, and what are the magnitudes of these associations. We searched PubMed, Embase, Web of Science, , and the Living Overview of the Evidence COVID-19 Repository for cohort studies estimating the association between COVID-19 and kidney and liver outcomes. Random-effects meta-analyses were performed to combine the results of the included studies. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Fifteen cohort studies with more than 32 million participants were included in the systematic review COVID-19 was associated with a 35% greater risk of kidney diseases (10 more per 1000 persons; low certainty evidence) and 54% greater risk of liver disease (3 more per 1000 persons; low certainty evidence). The absolute increases due to COVID-19 for acute kidney injury, chronic kidney disease, and liver test abnormality were 3, 8, and 3 per 1000 persons, respectively. Subgroup analyses found no differences between different type of kidney and liver diseases. The findings provide further evidence for the association between COVID-19 and incident kidney and liver conditions. The absolute magnitude of the effect of COVID-19 on kidney and liver outcomes was, however, relatively small.

Postoperative gastrointestinal disorder (POGD) was a common complication after surgery under anesthesia. Strategies in combination with Traditional Chinese Medicine and Western medicine showed some distinct effects but standardized clinical practice guidelines were not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center/Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University, was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients' preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations included disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.

The authors identify tasks that the People's Liberation Army (PLA) would likely be assigned by Chinese leaders to achieve strategic goals both in peacetime competition with the United States and in a hypothetical low-intensity conflict. The authors then analyze potential vulnerabilities in the PLA's execution of those tasks and how the United States could leverage those vulnerabilities to disrupt China's strategic goals, focusing on the potential for peacetime competition to erupt into a broader low-intensity conflict featuring smaller, indirect, or hybrid confrontations that span the world. The authors expand on a comprehensive list of potential PLA missions developed in prior research and explore vulnerabilities in the PLA's execution of the specific tasks required to achieve Beijing's strategic objectives. Across these missions and tasks, they identify five sets of vulnerabilities that, if disrupted, could affect Beijing's ability to achieve its goals: fears of domestic instability after PLA actions, risk of escalating conflict, harm to China's reputation, the PLA's limited ability to support partner states, and the PLA's limited ability to project power. These vulnerabilities provide a sense of the potential pressure points that the PLA could face in accomplishing its objectives. Options for the United States to leverage these pressure points include deterring harmful PLA actions by shaping perceptions of how those actions might affect China's interests, exploiting the consequences of PLA actions to deter Beijing from repeating similar actions, and exploiting PLA weaknesses in power projection and partner support to weaken confidence in the PLA and discourage similar operations.

Over the past decade, China has upended the world of development assistance, rapidly becoming the world's largest bilateral lender by channeling large sums of money into the developing world. As China's economic engagement in the developing world has grown, so too have U.S. and allied concerns that China is leveraging development assistance to assert Chinese influence, weaken the United States' relative position, and achieve Beijing's broader national security interests. In this report, the authors conduct a net assessment of U.S. and Chinese development assistance and cooperation. The authors describe each country's differing approaches to economic engagement with developing countries and conduct a data-driven comparison to identify strategic asymmetries that might present opportunities for the United States to better compete with China for relationships and influence in the developing world. The assessment reveals that Chinese economic engagement in the developing world should not be conceptualized as aid or assistance; this mischaracterization has potentially led to an overreliance on U.S. development tools as a primary response. Moreover, despite evidence of the short-term benefits that China might gain from its development financing, it is not clear whether these benefits are sustainable or effective over the long term when compared with the U.S. approach. Nevertheless, China's efforts — its heavy emphasis on energy and infrastructure projects, its approach to working through elite actors in developing countries, and its willing embrace of greater risk and reduced transparency — create challenges and opportunities for the United States as it looks to compete with China in the developing world.

Background The health effects of dietary fats are a controversial issue on which experts and authoritative organizations have often disagreed. Care providers, guideline developers, policy-makers, and researchers use systematic reviews to advise patients and members of the public on optimal dietary habits, and to formulate public health recommendations and policies. Existing reviews, however, have serious limitations that impede optimal dietary fat recommendations, such as a lack of focus on outcomes important to people, substantial risk of bias (RoB) issues, ignoring absolute estimates of effects together with comprehensive assessments of the certainty of the estimates for all outcomes.Objective We therefore propose a methodologically innovative systematic review using direct and indirect evidence on diet and food-based fats (i.e., reduction or replacement of saturated fat with monounsaturated or polyunsaturated fat, or carbohydrates or protein) and the risk of important health outcomes.Methods We will collaborate with an experienced research librarian to search MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews (CDSR) for randomized clinical trials (RCTs) addressing saturated fat and our health outcomes of interest. In duplicate, we will screen, extract results from primary studies, assess their RoB, conduct de novo meta-analyses and/or network meta-analysis, assess the impact of missing outcome data on meta-analyses, present absolute effect estimates, and assess the certainty of evidence for each outcome using the GRADE contextualized approach. Our work will inform recommendations on saturated fat based on international standards for reporting systematic reviews and guidelines.Conclusion Our systematic review and meta-analysis will provide the most comprehensive and rigorous summary of the evidence addressing the relationship between saturated fat modification for people-important health outcomes. The evidence from this review will be used to inform public health nutrition guidelines.

.Purpose of review: This article aims to review and synthesize the current research evidence regarding the efficacy of telepsychiatry-delivered substance use disorder treatment using a narrative review with a focus on the effects of remote healthcare delivery within the substance abuse treatment space. Recent findings: The COVID-19 pandemic exerted substantial pressures on all levels of society. Social isolation, loss of employment, stress, physical illness, overburdened health services, unmet medical needs, and rapidly changing pandemic restrictions had particularly severe consequences for people with mental health issues and substance use disorders. Since the start of the pandemic, addiction treatment (and medical treatment overall) using remote health platforms has significantly expanded to different platforms and delivery systems. The USA, in particular, reported transformational policy developments to enable the delivery of telehealth during the COVID-19 pandemic. However, systemic barriers such as a widespread lack of internet access and insufficient patient and provider digital skills remain. Summary: Overall, telepsychiatry is a promising approach for the treatment of substance use disorders, but more randomized controlled trials are needed in the future to assess the evidence base of available interventions.

OBJECTIVE: The objective was to review literature related to the dedicated education unit practice education model for undergraduate nursing students, and identify common characteristics and processes for implementing and sustaining this model. INTRODUCTION: Although practice education is central to undergraduate nursing education, evidence-informed practices for learning in the clinical setting remain elusive. Changes to health care over the past decades related to the role and scope of practice for nurses, gradual shifts to community- and population-based care delivery, and expectations for interprofessional practice require forward-looking education models. The dedicated education unit model was developed in 1997 as a potential solution to globally recognized challenges in nursing education amidst discourses of nursing resource scarcity. Despite more than two decades of innovation and expansion, there is still limited understanding of the effectiveness of the dedicated education unit as a solution to those challenges, or for the anticipated benefits for students and patients, through enhanced evidence-informed health care. This analysis of the characteristics and processes of the model is timely for evaluating and sustaining implementation of the dedicated education unit across nursing practice and education settings. INCLUSION CRITERIA: English-only publications related to the dedicated education unit practice education model for undergraduate nursing students in baccalaureate and associate degree programs using qualitative, quantitative, or mixed methods research, and quality improvement, program evaluation, and opinion publications were included. METHODS: Using selected keywords including "dedicated education unit," we searched CINAHL, Google Scholar, MEDLINE, Academic Premier Search, ERIC, Cochrane Database of Systematic Reviews, JBI EBP Database, and ProQuest Dissertations and Theses. Two independent reviewers screened titles and abstracts against inclusion criteria. We reviewed reference lists for gray literature and additional references. Data were extracted from the included articles and categorized for characteristics and processes. Eighty-two publications from January 1997 to May 2020 were included. The findings were presented descriptively with tables and figures to support the data. RESULTS: DEU models were based on five characteristics and four processes. Characteristics of the DEU model included effective academic-practice partnership, adaptability to diverse contexts, unit culture of educational excellence, responsive and supportive unit leadership, and clarity of roles and responsibilities. Processes included building nurse and faculty capacity, facilitating student learning, communicating regularly at systems and unit levels, and evaluating and sustaining the model. CONCLUSIONS: Evidence demonstrated that the dedicated education unit practice education model is well-established. However, there were existing gaps in this evidence, specifically evaluation and economic analyses. There was also limited attention to long-term sustainability of the model. The common characteristics and processes identified in this review may be used to support planning, implementation, and evaluation, including development and validation of evaluation tools. Although administrative infrastructure was noted as central to the dedicated education unit strategy, it was rarely acknowledged as part of management and thus also requires further study.

OBJECTIVE To compare the effects of treatments for coronavirus disease 2019 (covid-19). DESIGN Living systematic review and network meta-analysis. DATA SOURCES US Centers for Disease Control and Prevention COVID-19 Research Articles Downloadable Database, which includes 25 electronic databases and six additional Chinese databases to 20 July 2020. STUDY SELECTION Randomised clinical trials in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. Pairs of reviewers independently screened potentially eligible articles. METHODS After duplicate data abstraction, a bayesian random effects network meta-analysis was conducted. Risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development and evaluation (GRADE) approach. For each outcome, interventions were classified in groups from the most to the least beneficial or harmful following GRADE guidance. RESULTS 23 randomised controlled trials were included in the analysis performed on 26 June 2020. The certainty of the evidence for most comparisons was very low because of risk of bias (lack of blinding) and serious imprecision. Glucocorticoids were the only intervention with evidence for a reduction in death compared with standard care (risk difference 37 fewer per 1000 patients, 95% credible interval 63 fewer to 11 fewer, moderate certainty) and mechanical ventilation (31 fewer per 1000 patients, 47 fewer to 9 fewer, moderate certainty). These estimates are based on direct evidence; network estimates for glucocorticoids compared with standard care were less precise because of network heterogeneity. Three drugs might reduce symptom duration compared with standard care: hydroxychloroquine (mean difference -4.5 days, low certainty), remdesivir (-2.6 days, moderate certainty), and lopinavir-ritonavir (-1.2 days, low certainty). Hydroxychloroquine might increase the risk of adverse events compared with the other interventions, and remdesivir probably does not substantially increase the risk of adverse effects leading to drug discontinuation. No other interventions included enough patients to meaningfully interpret adverse effects leading to drug discontinuation. CONCLUSION Glucocorticoids probably reduce mortality and mechanical ventilation in patients with covid-19 compared with standard care. The effectiveness of most interventions is uncertain because most of the randomised controlled trials so far have been small and have important study limitations.

Introduction The adaptation of guidelines is an increasingly used methodology for the efficient development of contextualised recommendations. Nevertheless, there is no specific reporting guidance. The essential Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement could be useful for reporting adapted guidelines, but it does not address all the important aspects of the adaptation process. The objective of our project is to develop an extension of the RIGHT statement for the reporting of adapted guidelines (RIGHT-Ad@pt Checklist). Methods and analysis To develop the RIGHT-Ad@pt Checklist, we will use a multistep process that includes: (1) establishment of a Working Group; (2) generation of an initial checklist based on the RIGHT statement; (3) optimisation of the checklist (an initial assessment of adapted guidelines, semistructured interviews, a Delphi consensus survey, an external review by guideline developers and users and a final assessment of adapted guidelines); and (4) approval of the final checklist. At each step of the process, we will calculate absolute frequencies and proportions, use content analysis to summarise and draw conclusions, discuss the results, draft a report and refine the checklist. Ethics and dissemination We have obtained a waiver of approval from the Clinical Research Ethics Committee at the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain). We will disseminate the RIGHT-Ad@pt Checklist by publishing into a peer-reviewed journal, presenting to relevant stakeholders and translating into different languages. We will continuously seek feedback from stakeholders, surveil new relevant evidence and, if necessary, update the checklist. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

The purpose of this review was to identify and evaluate psychoeducational intervention studies addressing the psychological adjustment needs of family members, spouses, and friends (supporters) providing support to women with early-stage breast cancer with the goal of guiding future research and practice. This is an integrative review initiated by a systematic search conducted within the PubMed, CINAHL, and PsycINFO databases among literature published from 2003 to 2014. Articles were retained for evaluation if the sample was from a western culture, and outcomes were reported separately for supporters of women with early-stage breast cancer after receipt of a psychosocial/educational intervention. Studies using qualitative, pilot, and pre-experimental designs were included for review. Six studies meeting the inclusion criteria were identified. Of these, three were randomized controlled trials (one pilot) and three used a pre-experimental, single-group design. All of the interventions demonstrated some efficacy; however, limitations in design, sample, and reporting of outcomes were identified. The pre-experimental and pilot design of the majority of the research identified in this review limits the ability to make firm recommendations for translation to clinical practice although the psychoeducational interventions appear clinically useful. Future research should define samples of supporters consistently across studies, report behavioral and psychological outcomes separately for individuals with differing relationships with the affected woman, increase racial diversity among samples, consider time and cost when designing psychoeducational interventions, and focus interventions on specific characteristics and needs of the diverse groups of individuals who provide support for women with early-stage breast cancer

Purpose: By conducting a systematic review, we describe strategies to actively disseminate knowledge or facilitate practice change among healthcare providers caring for children with cancer and we evaluate the effectiveness of these strategies. Data sources: We searched Ovid Medline, EMBASE and PsychINFO. Study selection: Fully published primary studies were included if they evaluated one or more professional intervention strategies to actively disseminate knowledge or facilitate practice change in pediatric cancer or hematopoietic stem cell transplantation. Data extraction: Data extracted included study characteristics and strategies evaluated. In studies with a quantitative analysis of patient outcomes, the relationship between study-level characteristics and statistically significant primary analyses was evaluated. Results of data synthesis: Of 20 644 titles and abstracts screened, 146 studies were retrieved in full and 60 were included. In 20 studies, quantitative evaluation of patient outcomes was examined and a primary outcome was stated. Eighteen studies were 'before and after' design; there were no randomized studies. All studies were at risk for bias. Interrupted time series was never the primary analytic approach. No specific strategy type was successful at improving patient outcomes. Conclusions: Literature describing strategies to facilitate practice change in pediatric cancer is emerging. However, major methodological limitations exist. Studies with robust designs are required to identify effective strategies to effect practice change.

Objective: Risk of suicide attempt, suicidal ideation and deliberate self-harm is high among young people, yet limited evidence exists regarding effective interventions, particularly from randomized controlled trials. The aim of this study was to conduct a systematic review and meta-analysis of all randomized controlled trials testing interventions for adolescents and young adults who have presented to a clinical setting with any of these behaviours. Methods: The Cochrane Central Register of Controlled Trials, Medline, EMBASE and PsycINFO were searched for articles published from 1980 to June 2010. The following keywords formed the basis of the search strategy: 'self-injurious behaviour', 'attempted suicide', 'suicide', 'suicidal behaviour', 'self-inflicted wounds', 'self-mutilation', 'self-harm'. We also hand searched conference abstracts from two major suicide prevention conferences and the reference lists of all retrieved articles and previous reviews. Results: There were 15 trials included in the review, with six ongoing trials also identified. In general, the reporting of the conduct of trials was poor, making it difficult to assess the risk of bias. The reporting of outcome data was inconsistent. No differences were found between treatment and control groups except in one study that found a difference between individual cognitive behavioural therapy and treatment as usual. Conclusion: The evidence regarding effective interventions for adolescents and young adults with suicide attempt, deliberate self-harm or suicidal ideation is extremely limited. Many more methodologically rigorous trials are required. However, in the meantime CBT shows some promise, but further investigation is required in order to determine its ability to reduce suicide risk among young people presenting to clinical services.

BACKGROUND: Experts recommend opioid treatment agreements and urine drug testing to reduce opioid analgesia misuse, but evidence of their effectiveness has not been systematically reviewed. PURPOSE: To synthesize studies of the association of treatment agreements and urine drug testing with opioid misuse outcomes in outpatients with chronic noncancer pain. DATA SOURCES: MEDLINE, PsycINFO, EMBASE, Cochrane Central Register of Controlled Clinical Trials (January 1966 to June 2009), reference lists, and expert contacts. STUDY SELECTION: Original research addressing opioid medications, chronic pain, and treatment agreements or urine drug testing, with a sample size of 50 participants or more and published in English, Spanish, or French. DATA EXTRACTION: Two investigators independently identified eligible studies, extracted data, and assessed study quality. The outcome of opioid misuse was defined as drug abuse, drug misuse, aberrant drug-related behavior, diversion, or addiction. DATA SYNTHESIS: Of 102 eligible studies, 11 met inclusion criteria; 6 were in pain clinics and 5 were in primary care settings. Four primary care studies examined multicomponent strategies that included interdisciplinary support. All studies were observational and rated as poor to fair quality. In 4 studies with comparison groups, opioid misuse was modestly reduced (7% to 23%) after treatment agreements with or without urine drug testing. In the other 7 studies, the proportion of patients with opioid misuse after treatment agreements, urine drug testing, or both varied widely (3% to 43%). LIMITATIONS: Diversity of interventions and opioid misuse measures precluded meta-analysis. Most studies evaluated combinations of interventions. CONCLUSION: Relatively weak evidence supports the effectiveness of opioid treatment agreements and urine drug testing in reducing opioid misuse by patients with chronic pain. Further research on effective ways to monitor and reduce opioid misuse is needed, especially in primary care settings. PRIMARY FUNDING SOURCE: Substance Abuse and Mental Health Services Administration, National Institute on Drug Abuse, and Robert Wood Johnson Foundation.

Context: Intensive care unit (ICU) physician staffing varies widely, and its association with patient outcomes remains unclear. Objective: To evaluate the association between ICU physician staffing and patient outcomes. Data sources: We searched MEDLINE (January 1, 1965, through September 30, 2001) for the following medical subject heading (MeSH) terms: intensive care units, ICU, health resources/utilization, hospitalization, medical staff, hospital organization and administration, personnel staffing and scheduling, length of stay, and LOS. We also used the following text words: staffing, intensivist, critical, care, and specialist. To identify observational studies, we added the MeSH terms case-control study and retrospective study. Although we searched for non-English-language citations, we reviewed only English-language articles. We also searched EMBASE, HealthStar (Health Services, Technology, Administration, and Research), and HSRPROJ (Health Services Research Projects in Progress) via Internet Grateful Med and The Cochrane Library and hand searched abstract proceedings from intensive care national scientific meetings (January 1, 1994, through December 31, 2001). Study selection: We selected randomized and observational controlled trials of critically ill adults or children. Studies examined ICU attending physician staffing strategies and the outcomes of hospital and ICU mortality and length of stay (LOS). Studies were selected and critiqued by 2 reviewers. We reviewed 2590 abstracts and identified 26 relevant observational studies (of which 1 included 2 comparisons), resulting in 27 comparisons of alternative staffing strategies. Twenty studies focused on a single ICU. Data synthesis: We grouped ICU physician staffing into low-intensity (no intensivist or elective intensivist consultation) or high-intensity (mandatory intensivist consultation or closed ICU [all care directed by intensivist]) groups. High-intensity staffing was associated with lower hospital mortality in 16 of 17 studies (94%) and with a pooled estimate of the relative risk for hospital mortality of 0.71 (95% confidence interval [CI], 0.62-0.82). High-intensity staffing was associated with a lower ICU mortality in 14 of 15 studies (93%) and with a pooled estimate of the relative risk for ICU mortality of 0.61 (95% CI, 0.50-0.75). High-intensity staffing reduced hospital LOS in 10 of 13 studies and reduced ICU LOS in 14 of 18 studies without case-mix adjustment. High-intensity staffing was associated with reduced hospital LOS in 2 of 4 studies and ICU LOS in both studies that adjusted for case mix. No study found increased LOS with high-intensity staffing after case-mix adjustment. Conclusions: High-intensity vs low-intensity ICU physician staffing is associated with reduced hospital and ICU mortality and hospital and ICU LOS.

The aim of this study is to improve understanding of how biological resource conservation concerns can be better incorporated into projects and programs that primarily address the objective of rural development rather than environmental conservation. A multi-disciplinary study team was assembled and six background papers produced, along with the main overview paper. The six papers were on: 1) measuring biodiversity, predicting impacts, and monitoring change; 2) integrated pest management and biodiversity conservation; 3) biodiversity conservation in agricultural landscapes in Britain: relevant issues for developing countries; 4) reconciling biodiversity and development issues in practice; the search for a win-win situation in Ghana's coastal wetlands; 5) strategies for biodiversity conservation: examples from Tanzania; and 6) participatory initiatives in biodiversity conservation: lessons from experience. A study was also made of World Bank policies and procedures relating to biodiversity management and rural development together with three portfolio reviews. These findings were incorporated into this paper. This paper argues that bioresources and people's livelihood systems are intricately interrelated, and opportunities for intervention for development purposes must start from good understanding of different people's access to and use and management of these resources, and also the incentives, constraints, and institutional factors governing the process.

This paper disaggregates the term "biodiversity" into components (landscapes, ecosystems, communities, species/populations, and genes) and attributes (structure, composition, and function). It then disaggrgates "logging" by detailing the vast range of activities subsumed under the term including variation of logging intensities, logging methods, collateral damage, and silvicultural approaches. Using the richness present in both terms, a framework for considering the impacts of logging and other forest management activities on the various components and attributes of biodiversity is presented. This framework is, in turn, used to evaluate the extensive literature covering different studies of logging in tropical forests. This paper does not conclude with uncritical support for sustainable forest managmement of timber as a conservation strategy. Such an endorsement is unwarranted given widespread illegal logging in the tropics, widespread frontier logging and logging of areas of high priority for biodiversity protection, the persistence of poor logging practices despite substantial efforts in research and training, and the generally slow rate at which most loggers are transforming themselves from timber exploiters into forest managers. Rather the authors assert, from a biodiversity maintenance perspective, that natural forest management is preferable to virtually all land-use practices other than complete protection.

The study addresses the importance of wildlife to people, and as a resource of nutritional, economic, and socio-cultural values, and examines the complexities of hunting in tropical forests. It also expresses that today, such hunting is rarely sustainable, because of declining forest areas, which decreases wildlife populations; because of changes among human populations in the tropical forests, who have increasingly become more sedentary; because of cultural changes, where social taboos against hunting certain species are breaking down, and systems of traditional hunting territories are disappearing; and, because environmental economic changes, prod the commercialization of wildlife hunting in these areas. The study explores the multifaceted, and complex problem of hunting, suggesting solutions must be area specific, based on detailed knowledge of hunting patterns, ecology, and local socio-cultural conditions. Recommendations include: establishment of national networks to manage protected, and extractive reserves areas, to supply subsistence needs to local hunting communities; establish land uses to support protected/extractive reserves areas in partnership with local communities; enact, comply, and enforce regulations to prevent exploitation by timber companies' workers; and, encourage participatory approaches among non-governmental organizations, academic institutions, and the international community at large.

As the world is urbanizing, many cities are grappling with a population that is growing rapidly, thereby increasing demand for land and housing. This pressure on land and housing markets often is exacerbated by inappropriate or inadequate policies. The result is a supply of well-located land and housing that falls well short of demand and the proliferation of poorly serviced informal settlements, many of which are located far from jobs, city services and amenities. This paper discusses the major policy levers local leaders may have at their disposal to improve access to land and housing and thereby change the landscape of cities for the better. It discusses common obstacles administrative, political, and financial and options for overcoming them. In particular, the report: (1) takes a fresh look at some traditional mechanisms such as land regulation, property taxation, and public-private partnerships; (2) reintroduces some innovative land tools community land trusts, guided development, transfer of development rights, land pooling/readjustment, and land sharing that may have a place in cities' arsenal of responses; and (3) suggests ways to garner the political support that will be needed to move forward with programs of reform.