Urbanization is a global trend, and consequently the quality of urban environments is increasingly important for human health and wellbeing. Urban life-style is typically associated with low physical activity and sometimes with high mental stress, both contributing to an increasing burden of diseases. Nature-based solutions that make effective use of ecosystem services, particularly of cultural ecosystem services (CES), can provide vital building blocks to address these challenges. This paper argues that, the salutogenic, i.e. health-promoting effects of CES have so far not been adequately recognised and deserve more explicit attention in order to enhance decision making around health and wellbeing in urban areas. However, a number of research challenges will need to be addressed to reveal the mechanisms, which underpin delivery of urban CES. These include: causal chains of supply and demand, equity, and equality of public health benefits promoted. Methodological challenges in quantifying these are discussed. The paper is highly relevant for policy makers within and beyond Europe, and also serves as a review for current researchers and as a roadmap to future short- and long-term research opportunities.

Nature-based solutions (NbS) have been positioned and implemented in urban areas as solutions for enhancing urban resilience in the face of a wide range of urban challenges. However, there is a lack of recommendations of optimal NbS and appropriate typologies fitting to different contexts and urban design. The analytical frameworks for NbS implementation and impact evaluation, that integrate NbS into local policy frameworks, socio-economic transition pathways, and spatial planning, remain fragmented. In this article, the NbS concept and its related terminologies are first discussed. Second, the types of NbS implemented in Europe are reviewed and their benefits over time are explored, prior to categorizing them and highlighting the key methods, criteria, and indicators to identify and assess the NbS’s impacts, co-benefits, and trade-offs. The latter involved a review of the websites of 52 projects and some relevant publications funded by EU Research and Innovation programs and other relevant publications. The results show that there is a shared understanding that the NbS concept encompasses benefits of restoration and rehabilitation of ecosystems, carbon neutrality, improved environmental quality, health and well-being, and evidence for such benefits. This study also shows that most NbS-related projects and activities in Europe use hybrid approaches, with NbS typically developed, tested, or implemented to target specific types of environmental–social–economic challenges. The results of this study indicate that NbS as a holistic concept would be beneficial in the context of climate action and sustainable solutions to enhance ecosystem resilience and adaptive capacity within cities. As such, this article provides a snapshot of the role of NbS in urban sustainability development, a guide to the state-of-the-art, and key messages and recommendations of this rapidly emerging and evolving field.

Background: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease that may progress into, in the absence of proper treatment, severe liver damage. While the optimal pharmacotherapy for NAFLD remains uncertain and the adherence to lifestyle interventions is challenging, the use of herbal medicines such as traditional Chinese medicines (TCMs) to manage the condition is common. The evidence about TCMs in the management of NAFLD is continuously developing through randomized controlled trials (RCTs). This study aims to identify and evaluate the emerging evidence about the efficacy and safety of TCMs for NAFLD. Methods: A systematic literature search was conducted to identify RCTs which investigated TCMs in the management of NAFLD published in 6 electronic databases including PubMed, the Cochrane Library, EMBASE, Web of Science, Scopus and China National Knowledge Infrastructure since inception to September 2020. RCTs comparing TCMs with no treatment, placebo, non-pharmacological and/or pharmacological interventions were included irrespective of language or blinding. The quality of reporting was evaluated using the Consolidated Standards of Reporting Trials Statement extensions for Chinese herbal medicine Formulas (CONSORT-CHM). Risk-of-bias for each study was assessed using the Cochrane risk of bias tool. Results: A total of 53 RCTs involving 5997 participants with NAFLD were included in this review. Each included RCT tested a different TCMs giving a total of 53 TCMs identified in this study. Based on the evaluation of the RCT results, TCMs might have various beneficial effects such as improving TCM syndrome score, liver function, and body lipid profile. A range of non-serious, reversible adverse effects associated with the use of TCMs were also reported. However, no conclusion about the efficacy and safety of TCMs in NAFLD can be made. The quality of reporting was generally poor and the risks of bias was mostly uncertain in all trials. Conclusions: There is some evidence from RCTs that supported the effectiveness and safety of TCMs for NAFLD. However, no conclusive recommendations can be made due to the questionable quality of the RCTs. Improvement in the RCT protocol, the use of a larger sample size, a setting of multicenter, and a more focused approach in selecting TCMs are recommended for developing high quality evidence about the use of TCMs in managing NAFLD.

This article confirms that China’s economic sanction in the form of restricting salmon imports from Norway was in retaliation for the 2010 Nobel Peace Prize awarded to a Chinese dissident. By combining personal accounts of stakeholders interviewed in the Norway–China salmon trade with an examination of trade data, there is strong evidence that links changes in trade patterns of fresh/chilled whole Norwegian salmon to border measures applied in response to the peace prize. While disproportionate border measures targeting Norwegian salmon have distorted China’s market since 2011, private actors appear to have busted the sanction by circumventing these measures, including rerouting, falsifying country-of-origin certification, and smuggling. This could have long-term consequences for trade patterns and quality. Official statistics record a reduced Norwegian market share and decreased Norway–China salmon trade despite an expansion of the volume of Chinese imports. However, official data do not record Norwegian salmon entering illegally, which some stakeholders estimate at between 50 and 70 per cent of the market. Norway’s official refusal to meet the Dalai Lama in May 2014 suggests that China’s sanction has affected foreign policy. The salmon sanction demonstrates that China has become more assertive in its international relations.