This protocol is for an NIHR HSDR commissioned project that aims to map systematic reviews on the use of remote monitoring interventions for adults living with long term physical health conditions. Remote monitoring allows a health care professional to assess and manage the health of a patient, without the need for the patient to be seen face-to-face. This may involve the use of technologies such as wearable or assistive home devices, offering opportunities for innovation in the health care system, and could contribute to effective self-management and the delivery of personalised care. Remote monitoring also has the potential to increase efficiency and reduce health care costs. Having access to current evidence on the most effective forms of remote monitoring, and factors affecting the acceptability and implementation of these interventions, will support their commissioning and delivery by health care providers.

We aim to systematically map the volume, diversity and nature of systematic reviews on remote monitoring for people living with long term physical health conditions. We will search several databases, including the Cochrane Database of Systematic Reviews, Epistemonikos, CINAHL, Embase, and MEDLINE, as well as conducting supplementary web searches. Studies will be included if they are systematic reviews focusing on adults with a long term physical health condition(s), using any form of remote monitoring as long as data from monitoring is being passed to a health care professional. Any comparator will be eligible for inclusion. We are interested in all outcomes relating to effectiveness, acceptability and implementation; for reviews of effectiveness, we will include only those containing comparative outcome evaluations, whilst for acceptability and implementation we will include reviews focusing on any study design. Included studies will be limited to those published in English and conducted in high-income countries. EPPI Reviewer 4 will be used for data extraction and the quality of included studies will be assessed using the AMSTAR 2 quality appraisal tool.

We will produce an interactive evidence and gap map to visually represent the results of data extraction and quality appraisal. The map will show key outcome domains as columns and key intervention domains as rows, with multiple layers to allow access to more detailed information on the studies containing information on particular combinations of outcomes and interventions. It will also be possible to filter the map e.g. to focus on specific populations. This evidence and gap map will form a resource for practitioners, allowing the identification of existing evidence to support the design and delivery of interventions. It will also allow researchers and funders to find gaps where there is a need for systematic reviews or further research.

Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways-both beneficial as well as harmful-link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions.

The degradation of urban natural spaces reduces their ability to benefit human populations. Restoration can support urban sustainability by improving both the ecological health of these spaces and the public benefits they provide, but studies rarely combine both perspectives. We assessed the ecological and social benefits of an urban river restoration project relative to an unrestored river on the basis of the following four principles: Increasing ecological integrity; benefitting and engaging society; taking account of the past and future; and sustainability. Ecological health at each site was assessed by analyzing macroinvertebrate samples. The social benefits were measured by conducting focus groups with local users of green spaces surrounding the two rivers and comparing their responses. Restoration increased the ecological health of the river and was viewed positively by users, enhancing the river as a space to visit for psychological benefits. However, there were concerns over the erasure of the cultural heritage of the area. Our findings indicate that the long-term sustainability of restoration projects, particularly in urban areas, can be enhanced by integrating ecological and social dimensions. Although short-term ecological improvements may be small, they have the potential to provide a range of benefits for human populations.

OBJECTIVES: Without urgent action, climate change will put the health of future populations at risk. Policies to reduce these risks require support from today's populations; however, there are few studies assessing public support for such policies. Willingness to pay (WtP), a measure of the maximum a person is prepared to pay for a defined benefit, is widely used to assess public support for policies. We used WtP to investigate whether there is public support to reduce future health risks from climate change and if individual and contextual factors affect WtP, including perceptions of the seriousness of the impacts of climate change. STUDY DESIGN: a cross-sectional British survey. METHODS: Questions about people's WtP for policies to reduce future climate change-related deaths and their perceptions of the seriousness of climate change impacts were included in a British survey of adults aged 16 years and over (n=1859). We used contingent valuation, a survey-based method for eliciting WtP for outcomes like health which do not have a direct market value. RESULTS: the majority (61%) were willing to pay to reduce future increases in climate change-related deaths in Britain. Those regarding climate change impacts as not at all serious were less willing to pay than those regarding the impacts as extremely serious (OR 0.04, 95% CI 0.02-0.09). Income was also related to WtP; the highest-income group were twice as likely to be willing to pay as the lowest-income group (OR 2.14, 95% CI 1.40-3.29). CONCLUSIONS: There was public support for policies to address future health impacts of climate change; the level of support varied with people's perceptions of the seriousness of these impacts and their financial circumstances. Our study adds to evidence that health, including the health of future populations, is an outcome that people value and suggests that framing climate change around such values may help to accelerate action.

AbstractCompared to younger age groups, older people spend more time in their locality and rely more heavily on its pedestrian and public transport infrastructure. Qualitative studies provide unique insight into people's experiences. We conducted a qualitative evidence synthesis of United Kingdom-based studies of older people's experiences of travelling in the urban environment. We searched health, social science, age-related and transport-related databases from 1998 to 2017. Fourteen papers (from 12 studies) were included in a thematic synthesis, a three-staged process that moves iteratively between codes, descriptive themes and cross-cutting analytical themes. Emerging themes were discussed with policy advisers. Four overarching themes were identified. The first and second theme pointed to the importance of ‘getting out’ and of being independent travellers. The third and fourth themes highlighted how local environments and travel systems enabled (or prevented) older people from realising these valued dimensions of travel. The loss of local amenities and micro-environmental features, such as pavement quality, personal safety and aesthetic appearance, were recurrent concerns. Free modes of travel like walking and bus travel were highly valued, including the social engagement they facilitated. Our review suggests that, while its extrinsic value (reaching destinations) matters, the intrinsic value of travel matters too. The process of travel is experienced and enjoyed for its own sake, with older people describing its contribution to their wellbeing.