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Effective ecosystem management requires a robust methodology to analyse, remedy and avoid ecosystem damage. Here we propose that the overall conceptual framework and approaches developed over millennia in medical science and practice to diagnose, cure and prevent disease can provide an excellent template. Key principles to adopt include combining well-established assessment methods with new analytical techniques and restricting both diagnosis and treatment to qualified personnel at various levels of specialization, in addition to striving for a better mechanistic understanding of ecosystem structure and functioning, as well as identifying the proximate and ultimate causes of ecosystem impairment. In addition to applying these principles, ecosystem management would much benefit from systematically embracing how medical doctors approach and interview patients, diagnose health condition, select treatments, take follow-up measures, and prevent illness. Here we translate the overall conceptual framework from medicine into environmental terms and illustrate with examples from rivers how the systematic adoption of the individual steps proven and tested in medical practice can improve ecosystem management.
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River doctors: Learning from medicine to improve
ecosystem management
Arturo Elosegi
a,
,MarkO.Gessner
b,c
, Roger G. Young
d
a
Faculty of Science and Technology, University of the Basque Country (UPV/EHU), PO Box 644, 48080 Bilbao, Spain
b
Department of Experimental Limnology, Leibniz Institute of Freshwater Ecology and Inland Fisheries (IGB), Alte Fischerhütte 2, 16775 Stechlin, Germany
c
Department of Ecology, Berlin Institute of Technology (TU Berlin), Ernst-Reuter-Platz 1, 10587 Berlin, Germany
d
Cawthron Institute, Private Bag 2, Nelson, New Zealand
abstractarticle info
Article history:
Received 9 J anuary 2017
Received in revised form 19 March 2017
Accepted 20 March 2017
Available online xxxx
Editor: D. Barcelo
Effective ecosystem management requires a robust methodology to analyse, remedy and avoid ecosystem dam-
age. Here we propose that the overallconceptualframework and approaches developed over millennia in med-
ical scienceand practice to diagnose, cure and prevent disease can provide anexcellent template. Key principles
to adopt include combiningwell-establishedassessment methods with new analyticaltechniques and restricting
both diagnosis and treatment to qualied personnel at various levels of specialization, in addition to striving for a
better mechanistic understanding of ecosystem structure and functioning, as well as identifying the proximate
and ultimate causes of ecosystem impairment. In addition to applying these principles, ecosystem management
would much benet from systematically embracing how medical doctors approach and interview patients, diag-
nose health condition, select treatments, take follow-up measures, and prevent illness. Here we translate the
overall conceptual framework from medicineinto environmental terms and illustrate with examples from rivers
how the systematic adoption of the individual steps proven and tested in medical practice can improve ecosys-
tem management.
© 2017 Elsevier B.V. All rights reserved.
1. Introduction
Human activities are now shaping the earth surface (Vitousek et al.,
1997; Foley et al., 2005) to an extent that many contend a new geological
epoch has begun, the Anthropocene (Zalasiewicz et al., 2010; Ruddiman
et al., 2015). The accelerated transformation of earth is beginning, in
turn, to threaten human society itself (Gleick and Palaniappan, 2010;
Steffen et al., 2015), prompting calls for adopting sustainability principles
and ecosystem stewardship (Chapin et al., 2010). These goals require an
effective methodology to manage ecosystems to maintain biodiversity
and ensure the continued provision of ecosystem services valued by soci-
ety (Zhenga et al., 2013; Costanza et al., 2014).
Rapport (1995) pointed out that the similarities between ecosystem
integrity and human health and its assessment go beyond an analogy,
although this recognition has not gained strong traction. Indeed, apart
from controversial discussions about whether ecosystem health is a
valid scienticconcept(Jax, 2010), there have been few attempts to
scrutinize the degree to which principles and practices from medicine
can be useful in ecosystem management. The central tenet of this
paper is that much can be learned from how patients are diagnosed,
treated and subsequent illness prevented, to improve the ways in
which ecosystems are assessed and restored, and undesirable condi-
tions avoided in the rst place, since the fundamental methodological
issues are strikingly similar. Therefore, the conceptual framework of
medical health protocols holds tremendous potential to benetecosys-
tem management by appropriately translating concepts and practices
(e.g. Barton et al., 2015). This tenet is independent of whether one sub-
scribes or objects to the concept of ecosystem health (Rapport et al.,
1998; Simberloff, 1998; Karr, 1999; Boulton, 1999; Meyer et al., 2005;
Jax, 2005). An important advantage of adopting the medical analogy is
that it provides common intuitive ground of concepts and terms,
which facilitates interactions among different people and disciplines
participating in ecosystem management (scientists, policy makers,
stakeholders etc.). Although is clear that one cannot ignore the funda-
mental difference between humans and ecosystems, which, for in-
stance, neither reproduce nor die, this recognition does not invalidate
the usefulness of the parallel.
Conventional medicine is the result of knowledge accumulated at
least since the Greek physician Hippocrates over 2500 years ago. Never-
theless, it has only been during the last 150 years that great leaps for-
ward have been made, with medical innovation and improvements
Science of the Total Environment 595 (2017) 294302
Authorship all authors conceived and wrote the paper.
Corresponding author.
E-mail addresses:arturo.elosegi@ehu.eus (A. Elosegi), gessner@igb-berlin.de
(M.O. Gessner), roger.young@cawthron.org.nz (R.G. Young).
http://dx.doi.org/10.1016/j.scitotenv.2017.03.188
0048-9697/© 2017 Elsevier B.V. All rights reserved.
Contents lists available at ScienceDirect
Science of the Total Environment
journal homepage: www.elsevier.com/locate/scitotenv
rapidly accelerating at present. The success of conventional medicine
lies in its systematic approach, its capacity to adopt scientic and tech-
nological innovations, its use of controlled trials and detailed case-stud-
ies as sources of evidence, and also its adherence to a suite of basic
principles, along with substantial resourcing for research and patient-
centered care. As we illustrate below, these points can be adapted to
ecosystem management. Many have already been applied in various
contexts, but we argue that substantial further benets can be gained
from systematically embracing the principles of medical practice as a
whole.
Here we rst identify a series of key medical principles to highlight
their potential for ecosystem management. Then we illustrate how spe-
cic steps of the medical methodology (i.e. how physicians approach
and interview patients, diagnose their condition, select treatments,
take follow-up measures, and prevent illness) can be translated into
ecosystem management. Finally, we highlight a set of treatment rules
that have proven powerful in medical practice. The specic examples
relating to ecosystem management that we provide are drawn from riv-
ers to ensure a tangible and coherent account (Table 1), but we expect
that the general lessons we derive are similarly applicable to other
types of ecosystems.
2. Embracing medical principles
Despite the diversity of medical elds, all physicians follow a series
of core principles. Six among these appear to be especially relevant for
ecosystem management.
2.1. Understanding structure and function
The rst principle is to base practice on a detailed understanding of
the anatomy, physiology and functioning of the healthy human body.
Similarly, ecosystem management is best based on mechanistic insights
into the structure of ecosystems unaffected by anthropogenic pressures
(i.e. their constituent elements, including organisms and abiotic factors,
their spatial conguration and temporal dynamics) and into the pro-
cesses that connect the individual elements. The functional dimension
of ecosystems has long been ignored in river assessments, although an
emerging awareness of its importance (Bunn et al., 1999; Gessner and
Chauvet, 2002) increasingly leads to including functional indicators in
assessment protocols (Young et al., 2008; Yates et al., 2014). The
consequence of adopting these principles is that continuous investment
is required to improve understanding of the structure and functioning
of unaffected ecosystems that serve as benchmarks toevaluate impacts.
2.2. Identifying causes and mechanisms
A second medical principle rests on the premise that the causes and
mechanisms of an illness should be understood before prescribing a
cure, so the odds are high that the treatment is effective and does no
harm. During much of human history, disorder and disease were erro-
neously interpreted as a result of agents such as evil spirits and disequi-
librium in vital force (Maher, 1999; Ismail et al., 2005). Finding an
effective cure on this basis was a matter of luck combined with past ex-
perience, and medical advances were slow. Today, the causes of a vast
number of illnesses have been identied, including external agents
such as infectious diseases or poisons, internal physiological or genetic
disorders, dietary deciencies, or disorders with mixed causes. The un-
derlying mechanisms are often well understood at levels ranging from
biochemical reactions to global epidemic outbreaks.
Similarly, changes in ecosystems can be caused by external agents
(e.g. pollutants, invasive species), internal factors (e.g. natural changes
in species distribution or population genetic structure) or, commonly,
mixed causes (multiple stressors). Changes caused by internal factors
may not be perceived as impairment, thus limiting the analogy between
human bodies and ecosystems. However, since natural processes can
lead to undesirable states of ecosystems, for example from a conserva-
tion or productivity point of view, the fundamental problems posed to
ecosystem management and physicians in practice still remain very
similar.Irrespective of thenature of ecosystemchange, it is critically im-
portant for taking effective management measures to identify the prox-
imate (e.g. excessive nutrient supply) and ultimate (e.g. climate or land-
use change) factors causing a particular symptom (e.g. lack of sh or ex-
cessive algal growth).
2.3. Dening goals depending on context
Individual medical elds differ in their focus and specicgoals.Rou-
tine checks involve basic techniques to detect incipient health problems
and assess the general health status of a broad population. Sports med-
icine, in contrast, seeks to maximize physical performance in an elite
group of athletes. Plastic surgery focuses on aesthetics, which may or
Table 1
A selection of parallels between medicine and river ecosystem management.
Focus General purpose Medicine River management
Diagnosis Routine examination Body temperature, heart rate, physical examination, weight,
breathing (asthma, silicosis, pneumonia)
Water temperature, ow, river habitat survey, conductivity, oxygen
decit (ground water, organic matter)
Specic test Blood examination, electrocardiogram Detailed water chemistry, oxygen dynamics, hydrology
Microbiological
diagnostics
Microbiological analysis of pathogens Microbiological analysis of pathogens
Structural integrity Radiology, physical examination Community composition of biotic elements
Poisoning Toxicology Ecotoxicology
Risk assessment DNA analyses for tumor screening and tumor susceptibility Molecular community analyses to detect invasive species
Treatment Structure restoration Regenerative surgery Channel restoration
Physical elimination
of problem
Tumor removal Dam, levee or pipe removal
Aesthetics Plastic surgery Landscaping
Improvement of
nutrient balance
Diet restriction Nutrient control
Remediative
medication
Insulin injection Liming
Palliative treatment Dialysis Flushing ow releases
Prevention Guidelines Healthy life-style Best management practices, sound resource management planning
Regulation Health and safety regulation Environmental regulations
Protection Condom, sunscreen Bio-security measures to prevent spread of invasives, waste water
treatment plants
Enhance resilience Wound-healing drugs Enhance river connectivity
Enhance resistance Vaccination Maintenance of genetic diversity
Education Health education Environmental education
295A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
may not be related to physical or psychological health issues. Regenera-
tive medicine focuses on restoring essential body functioning in patients
suffering severe damage. Finally, palliative medicine seeks to alleviate
the suffering of patients with terminal illness, not to recover their
health. Thus, to deal with different goals, medicinehas developed differ-
ent approaches and methods, all subject to equally stringent training
and monitoring programs.
Ecosystem management faces strikingly parallel situations (Table 1).
For instance, agencies in many parts of the world routinely monitor riv-
ers by measuring basic chemical variables (e.g. pH, oxygen, nutrients)
and determining biological community composition. Specically
adapted protocols are used in some rivers vulnerable to a particular
type of chemical pollution (e.g. pesticide analyses) or receiving special
protection to conserve biodiversity (e.g. assessment of pearl mussel re-
cruitment). Similarly, restoration works reintroducing large wood and
boulders in river channels with heavy machinery (Nilsson et al., 2005)
are analogous to regenerative medicine, while channel reconguration
to enhance visual appeal has parallels with aesthetic surgery. Despite
these different goals, ecosystem managers tend to apply standard sets
of tools, borrowed from one domain for another. For example, metrics
developed for the EU Water Framework Directive (WFD), whose objec-
tive is to achieve good ecological statusin all water bodies, are applied
to rivers protected under the EU Natura 2000 network, whose goal is to
preserve biodiversity in a subset of ecosystems. Clearly, maladapted
methods are generally unsuccessful, suggesting that much can be
gained by developing and critically evaluating specic approaches for
contrasting management goals.
2.4. Developing and applying the best possible technology
A fourth principle of conventional medicine is to constantly enhance
established methodology with new technology. Medical laboratories in-
vest large amounts of money to develop and improve techniques, some
of many recentexamples being positron emission tomography, metabo-
lomics or robotic surgery. Ecosystem management has also beneted
from technological advances. Notable examples are large-scale analyses
by remote sensing (Stumpf et al., 2012) or water quality monitoring
with permanently deployed sensors, which enables ne-scale analysis
of temporal trends in water quality and whole-ecosystem metabolism
(e.g., Clapcott et al., 2016; Val et al., 2016).
Such technological progress notwithstanding, the tools routinely
used in ecosystem management are still crude by comparison. This is
partly due to incomparably smaller budgets that society is willing to in-
vest in environmental counterparts of human health. However, the
much more limited funds mobilized for environmental issues, do notin-
validate the principle that constantly seeking improvement is essential
to progress in the long run. Further, budgets and opportunities are likely
to grow as environmental technologies improve (e.g. through radically
new approaches to species surveys such as eDNA analyses; Rees et al.,
2014, Goldberg et al., 2016) and environmental awareness grows, not
least in the context of the burgeoning One Health approach
(Uchtmann et al., 2015) that recognizes the impact of environmental
conditions on human health.
2.5. Employing reliable designs
Related to the principle of developing and applying the best possible
technology are the constant efforts in medicine to improve study de-
signs. Of particular concern is the fact that medical assessments are eas-
ily misled by false positives, so that success tends to be overestimated
(Dresselhaus et al., 2002). Historically, this is exemplied by the prepos-
terous practice of blood-letting, which, although ineffective, if not detri-
mental, used to be extremely popular (Wootton, 2006). Approaches
such as double-blind tests have been devised to preclude bias in judge-
ment, and allowed establishment of what is known as evidence-based
medicine (Sackett et al., 1997; Grol and Grimshaw, 2003).
Ecosystem management would benet from similarly stringent pro-
cedures to evaluate remediative action (Sutherland et al., 2004, 2015),
particularly by fully embracing the weight-of-evidence approach also
used in risk assessment (Weed, 2005; Chapman, 2007). Regrettably, it
is still not uncommon in present practice that agencies continue to in-
vest money into ecosystem management measures that lack a sound
theoretical basis or empirical supportive evidence. This needs to change.
For instance, as argued by Ollero (2011), the so-called river parkscre-
ated for conservation purposes in Spain have resulted in more environ-
mental harm than benet,which prompted him to callfor a moratorium
on action until the basics of river restoration are well understood by the
authorities. A rst step towards adopting the stringent medical proce-
dures to assessments of restoration effectiveness would beto require in-
dependent accredited experts to conduct these assessments.
2.6. Relying on specically trained personnel
A sixth principle is that medicine is practiced exclusively by speci-
cally trained and qualied staff. Even apparently simple procedures,
such as taking blood samples, are restricted to trained personnel, either
medical doctors or nurses. Furthermore, there is a clear-cut distinction
among the tasks that each person is allowed to perform, from the
nurse to the general practitioner and specialist, and from the anesthesi-
ologist to the surgeon. Additionally, most modern health systems have
established procedures to ensure specic professional education, recog-
nizing that continued learning is mandatory to keep up with medical
advances (Schrock and Cydulka, 2006). Importantly, training must be
sufcient to enable recognition not only of common but also of rare
health problems. This is the reason why it is compulsory to have exten-
sive clinical training in hospitals, where a much larger range of disorders
is encountered than in a general practitioner's ofce.
The lesson for ecosystem management is that procedures need to be
devised, implemented and enforced to train and certify professionals, as
human error jeopardizes reliable assessments and treatment success
(Haase et al., 2010). This includes clear denition of the functions and
aptitudes of particular categories of staff, ranging from sampling and
sorting to identifying organisms, and from straightforward chemical or
hydrological analyses to sophisticated chemical analytics or the design
of large-scale restoration projects. Dening the learning trajectory in
the education of practitioners is equally important, preferably at an in-
ternational level. First steps have been taken by learned societies (e.g.
Ecological Society of America, Society for Freshwater Science) to estab-
lish accreditation systems based on training and certication of special-
ized ecologists. However, the systems in place (e.g. the Society for
Freshwater Science Taxonomic Certication Program; http://www.
sfstcp.com) are neither comprehensive nor legally binding. Renement,
wide application and legal establishment are needed to ensure that spe-
cialized staff perform specialized tasks. Similar to clinical training in
hospitals, training would be particularly effective if it included extensive
visits of case studies where specic stressors play a role and have been
addressed.
3. A medicine-inspired approach to ecosystem management
Medical doctors follow a stepwise procedure to diagnose impair-
ment, prescribe treatments and follow up the evolution of patients.
This strict sequence of action can serve as a rule for ecosystem manage-
ment, too.
3.1. Anamnesis
The rst step in curing a disease is an accurate and precise diagnosis.
Medical diagnosis starts with anamnesis, where physicians examine the
medical history of patients and inquire about personal matters such as
general constitution, profession and life-style before asking questions
about the particular health problem. Anamnesis is a key step, as a
296 A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
patient's medical history can be critical to understand current symp-
toms, assess health risks or prevent particular therapeutic approaches
(Coulehan and Block, 2005). Likewise, historical information on im-
paired ecosystems, such as past toxic spills, chronic pollution, species in-
troductions, or geomorphological modications, should be gathered to
identify legacies not immediately evident. Notably, legacies can include
incidences remote from the siteof enquiry, because of long-distance at-
mospheric or river transport, thus necessitating expansion of anamnesis
to whole drainage basins or potentially even larger areas. Historical en-
vironmental data tend to be limited and unreliable, which puts ecosys-
tem managers in a position akin to that of medical doctors working in
situations where a functioning medical system is lacking (e.g. in some
rural areas of developing countries or regions affected by conict). It
is, nonetheless, important to gather all available information, and to
be able to discern the parts that can be most relevant and reliable.
Medical interviews follow prescribed protocols with questions that
go beyond the stated problems (Stoeckle and Billings, 1987). Informa-
tion such as age, job and habits (smoking, alcohol consumption, partic-
ipation in high-risk sports) is routinely considered to evaluate the
diagnostic ndings in context and to pinpoint the most likely issues. Im-
portantly, physicians are aware that patients often provide incomplete
or incorrect information, and exaggerate or play down symptoms
(Nardone et al., 1992). Therefore, seemingly irrelevant questions are de-
vised to gain contextual information, including delicate issues such as
family abuse, without the patient suspecting the intention. When eco-
system managers interview stakeholders to gather information on the
history and state of impaired ecosystems, the same precautions apply
but are rarely recognized: stakeholders can give incomplete, partial,
narrow, exaggerated, or plainly inaccurate information (Box 1). There-
fore, questions must be carefully designed and responses cautiously an-
alyzed to serve ecosystem management as well as anamnesis helps
physicians in diagnosis.
3.2. Differential diagnosis
Anamnesis is followed by medical examination combining the
collection of both general and specic evidence to identify likely
health problems (Stoeckle and Billings, 1987). Since most symptoms
can have multiple causes, the goal is to narrow down the possible or-
igins of a problem by applying a set of criteria to distinguish between
alternative diseases. This is the purpose and approach of differential
diagnosis. Examinations routinely start by monitoring general vari-
ables such as body weight, heart rate and blood pressure before
applying specic diagnostics. Sometimes general practitioners di-
rectly make measurements, sometimessamples(blood,urine,etc.)
or the patients are sent for analyses or examinations requiring spe-
cic expertise or equipment (e.g., analytical laboratory, radiologist,
cardiologist). Physicians can employ a huge diagnostic toolbox, and
selecting the most meaningful tests can be challenging. Although ex-
perience and intuition play a role, accurate diagnosis is primarily a
result of logical reasoning. This includes identifying the most rele-
vant indicators, taking into account the prevalence of diseases in dif-
ferent sectors of society (Fig. 1AD).
Box 1
Diagnosis and treatment of an impaired river ecosystem: Hypothetical
Stream is a mountain stream with an abnormally low abundance of
trout.
Step 1. Anamnesis
Gather information about the stream, including geology and
catchment land use, and question water managers and local resi-
dents. The local angling association reports huge fish catches in
the past. The Wildlife Service states that trout densities in thepast
were not extraordinarily high. Rangers assert that trout abundance
has declined, but cannotsay whether the declinehad been gradual
or sudden. Similar declines are not evident in other streams in the
region. A dairy farm present in the catchment for over 100 years
changed farming practices about 15 years ago. Other potential
stressors include extensive landfills originating from mines aban-
doned decades ago, which have not changed over the last
20 years. There is also no evidence of a region-wide stressor,such
as acid rain or pesticide use.
Step 2. Differential diagnosis
Start gathering existing information and measuring general indica-
tor variables. Instream habitat is appropriate for trout. Local water
authorities providedata on water quality and invertebrate commu-
nities, which do not indicate a problem. No change has been de-
tected in flow regime. The riparian vegetation is intact. Based on
this information, initial hypotheses are formulated about causes
of the trout decline.
Analyze specific indicators with special attention given to effects
of the farm (growth of filamentous algae, anoxia, etc.) and mine
waste (pH, metal concentrations). Litter decomposition is slower
than in similar streams nearby. Diatom communities suggest inci-
dences of acidification and metal pollution, supporting the initial
hypothesis of mining impact. The trout population is dominated
by old fish. Other indicators, such as growth of benthic algae
protected from grazing, are within a normal range.
Obtain information on acidification. Bioassays confirm that adult
trout survive in the stream for at least 20 days. However, trout
and stream sediments show elevated metal concentrations. Mon-
itoring during rainfall events revealsepisodes of low pH (b4.5) and
high metal concentrations, suggesting leachate of mine waste
from the landfills into the stream.
Broaden the spatial scope. Incorporate tools for differential diag-
nosis. The catchment upstream appears to have experienced little
influence from human activity. Few changes have occurred in the
last decades, except for the dairy farm. A low dam effective as a
fish barrier was built 13 km downstream 16 years ago.
A diagnosis is finally reached. The periodic leaching of acidic mine
waste during occasional heavy rainfall affects the trout popula-
tion, although it does not cause adult fish mortality. The problem
has probably been chronic for a long time, but fish re-colonizing
from downstream disguised the lack of recruitment. The dam con-
struction prevented re-colonization, and thus,the population grad-
ually declined.
Step 3. Treatment
Address both factors supposed to have caused the trout decline.
First, divert rainwater to prevent seepage of mine waste from
the landfill. Secondly, re-establish longitudinal connectivity by
installing a fish ladder in the dam, ensuring that juvenile trout
can pass but invasive black bass in the lower reaches cannot.
Step 4. Monitoring
Monitor trout density and age structure on an annual basis for five
years following the remediation measures. Establish a stream-wa-
ter monitoring programme to determine whether heavy rainfall
leads to acid pulses. Monitor the stream reach upstream of the
dam by bimonthly environmental DNA analyses and annual elec-
trofishing to track whether black bass have invaded. Stock the up-
stream reach with young-of-the-year trout caught downstream,
and set aside funds to address any upstream incursions of black
bass.
Step 5. Dissemination
The diagnosis, treatment and results of the monitoring are shared
worldwide ina scientific journal article and on a dedicated website
(e.g. Sutherland et al., 2004).
Box1(continued)
297A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
Differential diagnosis is equally applicable to ecosystems (Fig. 2),
where it could be dened as a systematic approach to distinguish,
based on unique sets of characteristics, between two or more potential
causes of ecosystem impairment that share symptoms. Differential di-
agnosis starts with broad indicators and progresses using increasingly
specic criteria to screen out potential causes of a problem (Box 1). A
wide range of indicators has been developed.Examples for river ecosys-
tems (Bonada et al., 2006; Woolsey et al., 2007; Friberg et al., 2011)in-
clude some with specic targets, such as diatom indices to reveal
impacts of acidication (Van Dam,1988). However, a general diagnostic
framework for selecting indicators to differentiate among multiple
causes of ecosystem impairment is lacking. Many indicators (e.g.
macroinvertebrate community structure) have been developed to
provide an integrated assessment of general ecological state, and
therefore offer little diagnostic power. First steps have recently
been made towards establishing a differential diagnosis approach
to river assessment (Elosegi and Sabater, 2013), but clearly more de-
velopment is required in theory and practice. This includes integra-
tion of both the structural and functional dimensions of ecosystem
condition (Bunn and Davies, 2000; Gessner and Chauvet, 2002)ina
systemic perspective.
Although most patients suffer from one of a relatively short list of
diseases, such as u or intestinal disorders, physicians are aware of the
possible incidence of other and sometimes rare afictions. Similarly, en-
vironmental stressors such as excessive nutrient loading, toxic pollution
or channel modication are frequent in rivers, and hence the target of
most management efforts. However, a solid understanding of a much
broader range of stressors (e.g. pharmaceuticals, endocrine disruptors,
various factors relating to climate change), including their prevalence
and effects, is needed for accurate diagnosis in rare or complex cases.
Patients and ecosystems alike often show multiple symptoms at the
same time, as reected by the term syndrome to describe a suite of eco-
system responses to particular stressors (e.g., the urban stream syn-
drome; Paul and Meyer, 2001; Walsh et al., 2005). It is important to
recognize these, as well as multiple-stressor situations (Townsend et
al., 2008;Ormerodet al., 2010), where one stressor mightreduce the ef-
fect of a remedial action to reduce damage caused by another stressor,
or preclude the use of particular treatments. For instance, increasing
longitudinal connectivity might be the measure of choice to alleviate
the common problem of fragmented populations in river networks;
however, the associated high risk of invasion by exotic species might
preclude implementation of this measure. An important precaution in
this context is to consider that impacts can be due to indirect effects
Fig. 1. Four contrasting people subject to varying medical risk factors, illustrating the
parallels between prospective medical patients and potenti ally impaired river
ecosystems. Medical doctors use the same general approach, but different sets of
indicators in the diagnosis of each patient. For example, a pregnancy test wo uld be
relevant only for individual A. Similarly, although all four people could have lung cancer,
the probability is much higher for individual D. All four individuals could be subject to a
physical performance test, but expectations on healthy performance and future health
goals would differ widely. The medical goals would also differ: top physicalperformance
(A), relatively autonomous and painless life (B), early detection of emerging problems
(C), and changing risky habits (D).
Fig. 2. Four rivers affe cted by different s tressors. Ecosystem managers can adopt the
approaches established in medicine to diagnose and tr eat disease, based on a set of
general and specic indicators while recognizing that objectives vary among rivers. A
key goal for a pristine forest stream (A) may be biodiversity conservation involving
expensive measures to protect a single critically endan gered species. A ma nagement
priority for a river affected by deforestation and livesto ck grazing (B) would be to
restore riparian vegetation. Wate r temperature, the presence of leaf-shredding
invertebrates and litter decomposition rate could serve as indicators to assess success.
Identifying the sources of gross river pol lution indicated by a thick foam cover (C) is
straightforwa rd, but any remediative measures need to be followed by mo nitoring
water chemistr y and benthic inve rtebrate communities. In strongly modied urban
rivers (D) options for improvement are severely restricted, and may be limited to
simply meeting minimumwater quality standards.
298 A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
caused by altered species interactions, which can lead to counterintui-
tive outcomes (Gessner and Tlili, 2016).
3.3. Treatment approaches
After reaching an accurate diagnosis, medical doctors must select
among alternative treatment approaches. Some types of treatment are
curative in the sense that they solve a given problem, others are pallia-
tive, meaning that damage or symptoms are only alleviated. This dis-
tinction also has evident parallels with actions taken in ecosystem
management. For example, a heavily modied ecosystem could receive
a treatment equivalent to palliative care (e.g. the construction of arti-
cial pool-rife sequences to improve habitat diversity in rivers), without
restoring the ecosystem, whereas remediation of an ecosystem affected
by toxic contaminants could aim for full recovery. Some treatments
need to be applied just once to be effective, others are prescribed forev-
er. Dam removal from rivers is a one-time operation, whereas stocking
of juvenile sh may have to be perpetual, if conditions cannot be suf-
ciently improved to establish self-sustaining populations. Ecosystem
management involves recognition that restoration to meet one environ-
mental goal may limit the ability of other social, economic or environ-
mental objectives to be met. Therefore, trade-offs between different
goals and values are an inherent consideration when deciding on
treatments.
Treatments can follow one of two general strategies: the causative
agent such as a pathogen or environmental stressor is removed to en-
able recovery. This is passive restoration. Examples from rivers are the
removal of livestock to let riparian forests regenerate or sewage treat-
ment before discharge into a receiving stream. By virtue of their intrin-
sically dynamic and resilient nature, rivers often recover rapidly from
anthropogenic impacts, and may thus serve as models to implement
this approach, whereas the response of other ecosystems can be much
slower. Alternatively, recovery of impacted ecosystems can be actively
promoted. Examples for rivers include sh stocking, channel widening,
wood and boulder additions, dam demolition to re-establish longitudi-
nal connectivity or articial oods to partially restore natural ow re-
gimes (e.g. Bernhardt et al., 2005; Marks et al., 2010; Poff et al., 2010;
Cross et al., 2011; Olden et al., 2014).
One important rule to select treatment approaches is to minimize
unwanted side-effects. This rule encapsulates the 2500-year old Hippo-
cratic oath as a foundation of western conventional medicine (Palmer et
al., 2005). It is equally relevant in the context of ecosystem manage-
ment. One example of undesirable side-effects is the detrimental com-
paction and disturbance of riparian soil by using heavy machinery to
improve habitat structure and diversity of river oodplains. Similarly,
attempts to restore longitudinal connectivity of river channels also re-
move barriers for invasive species, which can have detrimental effects
on upstream populations of indigenous species.
Minimizing intrusion is another important point to consider when
selecting treatments, and has led to great progress in medicine. Open sur-
gery is increasingly replaced by endoscopy, broad-spectrum antibiotics
by specic ones, and advances in chemotherapy have improved specic
targeting of carcinogenic cells. Similarly, ecosystem management should
favour methods that minimize intervention. For instance, although river
bends can be dug with heavy machinery to revitalize straightened chan-
nels of formerly meandering or braided rivers, an attractive alternative is
to trigger natural lateral movement of riverbeds by breaching levees, re-
moving rip-rap and introducing large wood to initiate bank erosion
(Tockner et al., 1998; Kail et al., 2007). The second, minimally intrusive
option reects natural dynamics and thus is clearly preferable in most cir-
cumstances. In addition, it is less expensive, which enables application at
thesamecostatlargerscales,albeitoverlongertimeperiods.
Treatment selection must also consider risks and uncertainties. An
incorrect diagnosis leads to an incorrect prescription and can cause
harm. Therefore, medical doctors carefully weigh the risks and benets
of taking action. Even simple medical interventions like blood
withdrawal involve risks. This is similarly true for most actions taken
in ecosystems. For example, re-connecting river channels to their ood-
plain could entail property damage and even deaths during oods, or
mobilize toxic chemicals stored in the oodplain. Therefore, it is essen-
tial to identify all signicant risks with potential to damage humans or
the environment. The ubiquity of risks has led to warnings against the
overreliance on medicine to address the public health challenges of
modern western society (Gigerenzer, 2013). This point clearly has par-
allels in ecosystem management, where large investments are some-
times made in traditional hard engineering when passive measures
would be cheaper, more effective and less risky (Feld et al., 2011).
How doctors weigh risk is strongly dependent on context. When the
potential benets are large and alternatives are lacking, even measures
involving high risk may be acceptable. Physicians are legally obliged to
inform their patients about both the benets and risks of a proposed
treatmentand any alternatives. Similarly, in the case of ecosystems, res-
idents, agencies, industries and others possibly affected by management
actions should be informed about the benets and risks associated with
a proposed intervention. This requires suitable participatory processes
to ensure that the stakeholders can play a role in decisions to be taken.
Choices about medical therapy can involve triage, a contentious
issue referring to the diversion of scarce resources away from patients
with low recovery prospects to others with a better chance of recovery.
Though ethically lessdelicate, deningpriorities for ecosystem manage-
ment efforts is often similarly controversial. Clearly, however, it can be
appropriate to avoid devoting resources to situations where positive
ecological outcomes will be limited (Statzner and Sperling, 1993;
Statzner et al., 1997). This insight has gained recognition in several en-
vironmental policies. For example, the EU WFD denes so-called heavi-
ly modied water bodies, for which lower standards are accepted if
some specied uses such as elementary human needs and drinking
water supply are compromised by measures to improve ecosystem
conditions.
One important factor that causes risks is uncertainty, which
hence needs to be carefully considered as well. This situation is par-
ticularly familiar to hospital emergency departments, where, to pre-
vent serious damage, immediate action may be needed before all
relevant information can be gathered. Similarly, ecosystem manage-
ment measures must sometimes be taken with incomplete informa-
tion at hand because action cannot be delayed (Cullen, 1990; Singh,
2002). Toxic spills in rivers are an analogue of accident patients in
emergency hospital departments, requiring prompt decisions. Im-
portantly, however, uncertainties are by no means restricted to
emergency situations but are commonly due to ambiguous diagnos-
tic outcomes or even failure to diagnose any particular problem. To
minimize risks, it is crucial in all of these situations involving uncer-
tainties that sound protocols are established to guide decisions as
much for impacted ecosystems (Schindler and Hilborn, 2015)asfor
medical patients.
3.4. Monitor response to therapy and adapt treatment accordingly
Medical advances only started speeding up when the scientic
method was fully embraced. This includes patient surveillance fol-
lowing treatment. One alarmingly weak feature of ecosystem man-
agement practices in general, and river restoration in particular, is
the lack of adequate monitoring (Jähnig et al., 2011; Bernhardt et
al., 2005; Palmer et al., 2005). Clearly, monitoring is an indispensable
component of ecosystem management, particularly after restoration
measures have been taken, and investing the necessary funds to
implement a monitoring scheme is thus imperative. Given that
nancial resources are nearly always limiting, this may involve
accepting a reduction in the desired scope of a particular restoration
measureforthesakeofproperlyfollowingupontheresultsandre-
serving contingency funds for adaptive measures if unanticipated
negative consequences arise.
299A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
Adaptiveecosystem management has arisen as an approach to make
decisions in the face of uncertainty and recognizes the need for robust
monitoring to determine the success of alternativemanagement actions
and support future decision making (Holling, 1978). While showing
much promise, attempts to implement adaptive management often suf-
fer, however, from problems with the associated monitoring programs,
as well as from a lack of connection with stakeholders (Greig et al.,
2013).
3.5. Widely publicize treatment outcomes
Clinical research has achieved a high level of internationalization.
Large-scale studies are conducted in multiple nations to boost sam-
plesizeswhendiseaseprevalenceislow,andthereisconsiderable
pressure and incentives to disseminate results to the broad medical
community. This includes reporting both positive and negative out-
comes to limit publication bias. Importantly, the international di-
mension of major clinical trials often goes beyond communicating
results in the technical literature and also includes targeted dissem-
ination of information to practitioners.
Given limited communication, most ecosystem restoration projects
go unnoticed beyond a small geographic range. This prevents knowl-
edge transfer and thus obliges othersto learn from their own experience
and mistakes. Consequently, embracing the duty to inform others about
the outcomes of management measures as a principle is likely to propel
progress in ecosystem management. A critical point is to avoid bias to-
wards successful projects (hnig et al., 2011). Failures are often equally
instructive, as they can point to important misconceptions (Bernhardt
and Palmer, 2011). Although an effective communication system
could be put in place in various ways, a system that involves both incen-
tives and pressure is likely to be needed to promote wide commitment
of the community.
3.6. Further prevention
With the causes and mechanisms of action identied for many dis-
eases, methods have been devised to prevent the risk of suffering
from specic diseases. The same is true for ecosystems, as knowledge
grows about the causes of stressors and poor ecosystem conditions.
The importance of preventing excessive nutrient supply and the spread
of invasive species is widely recognized in ecosystem management.
Nevertheless, policy makers and ecosystem managers often repeat mis-
takes in different places and contexts, as a consequence of a lack of ei-
ther knowledge or political will. For instance, the introduction of
exotic species for various reasons, such as landscape restoration or
sport angling, has caused not only ecological harm but also huge eco-
nomic loss (Pimentel et al., 2005).
Despite the value of the precautionary principle, complete risk
prevention is not only impossible, but sometimes unwise. Opportu-
nity costs must be taken into account to avoid spending resources
in situations where marginal benets are the best possible outcome
(Statzner et al., 1997). Preventive measures are often taken by the
medical community at a very broad spatial scale, such as when a
risk of pandemics has triggered measures to limit the movement of
goods or people (Stein, 2015). Clearly, prevention does not necessar-
ily work at the individual level alone. This lesson can be transferred
to ecosystem management where preventive measures should con-
sider the broader landscape. For rivers, this includes the oodplain,
river network, catchment and even larger geographical units, includ-
ing earth as a whole.
Information alone cannot prevent all issues. People aware of the
habits and attitudes that promote health (e.g. healthy food, exercise,
no smoking) may ignore them for many reasons. Similarly, people
aware of environmentally friendly habits and attitudes often ignore
or struggle to apply them, although well-informed individuals tend
to adopt healthier and more environmentally friendly behaviours
(Silles, 2009; Coertjens et al., 2010). This suggests that, apart from
legal measures, education can be effective at overcoming tendencies
to ignore disease and environmental risks and thus enhance both
public health and ecosystem stewardship. Examples of this include
the steady decline in cigarette smoking and the more widespread
adoption of safe driving behaviour by road users over the last de-
cades. Striking examples for river ecosystems are the growing
awareness and political drive to remove dams (Marks et al., 2010),
re-establish natural ow regimes (Poff et al., 2010; Olden et al.,
2014)andrestoreoodplain connectivity instead of relying on
hard channel engineering for ood protection (Tockner et al.,
1998). Similarly, environmental education campaigns have been
effective in helping constrain the spread of invasive species (e.g.
Didymosphenia geminata;Root and O'Reilly, 2012). Clearly, however,
there is still much to improve in terms of risk prevention in ecosys-
tem management.
4. Limitations of the medical template
As we have illustratedby numerous examples, there is a wide range
of parallels between medicine and ecosystem management and there
are many medical principles and practices that could benet ecosystem
management. However, like any analogy, the similarities can only be
taken so far. In particular, the challenge of ecosystem management is
often described as a so-called wicked problem(Brown et al., 2010)re-
quiring collective action from different sectors of the community to de-
ne the problem and seek solutions that are often case-specic.
Appropriate therapies are easily identied in some cases, but social, eco-
nomic or nancial constraints complicate the implementation, especial-
ly when action is required at large scale. Different sectors of the
community often have differing values and their goals are often com-
peting and may change over time. Therefore, it is often not a simple
matter of treating one issue in the absence of any consideration about
other requirements of the system. This contrasts with medical practice
where maintenance and improvement of human health is a common
goal that is widely held, although it can also be constrained by nances,
competing views among different medical specialty areas, or complica-
tions caused by changing levels of health care expectations.
5. Conclusion
To conclude, the immense successes of medical practiceindicate that
a sound mechanistic understanding of ecosystem structure, function,
and the consequences of human stressors is important for effective eco-
system management. This understanding must be combined with a sys-
tematic application of a comprehensive toolbox for environmental
assessment, including anamnesis and tools for differential diagnosis to
remediate environmental problems effectively. As this toolbox becomes
more complex, a broad array of specic professional skills is necessary
to maximize success and prevent unwanted side effects. Effective train-
ing and information exchange amongpractitioners andstakeholders are
hence important ingredients of success when applying principles of
medical practices to ecosystem management. While our illustrations
of parallels between medicine and ecosystem management is focused
on rivers, we expect that the conclusions drawn are applicable to eco-
system management in general. It is time that maintaining and improv-
ing ecosystem conditions is accepted as a moral goal for humanity, as
well as a necessity for achieving a sustainable future. Consequently, it
must be undertaken with similareffort and diligence as efforts to main-
tain and improve human health, notwithstanding the greater difculty
to raise the required funds for environmental purposes. Indeed,
thoughtful ecosystem stewardship can have ramications well beyond
the conservation and restoration of ecosystems, including positive feed-
backs to the health and well-being of present and future generations
(Messer et al., 2014; Uchtmann et al., 2015).
300 A. Elosegi et al. / Science of the Total Environment 595 (2017) 294302
Acknowledgements
This paper beneted from funding by the EU Commission (pro-
jects GLOBAQUA, grant agreement no. 603629-ENV-2013-6.2-1,
and MARS, grant agreement no. 603378-ENV-2013.6.2-1) and the
New Zealand government (MBIE Rehabilitation of Aquatic Ecosys-
tems programme C01X1002). We are grateful to Emily S. Bernhardt
(Nicholas School of the Environment, Duke University, USA), Pedro
R. Grandes (Faculty of Medicine, University of the Basque Country,
Spain), Linda Reinemer (Department of General Psychiatry, Clinic
Königshof, Germany), Laszlo Maté(Swiss Accident Insurance, SU-
VA, Switzerland), Sergi Sabater (Catalan Institute of Water Research,
ICRA, Spain) and Klement Tockner (IGB Berlin, Germany) for discus-
sion or comments on a previous draft.
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... To increase the success of river restoration actions, it is necessary to understand which aspects of a river system, physical-chemical or hydromorphological, contribute to the impairment of water quality. Elosegi et al. [5] argue that river managers should perform a differential diagnosis, as a doctor would diagnose a patient. This means not only that they should monitor individual quality elements and compare them to their legal targets, but they should also interpret these results using a systems perspective [6]. ...
... The ecological quality ratio consists of a set of biotic indices that show how far river water quality deviates from the so-called reference condition. Several authors argue that the ecological quality ratios, albeit being powerful quality assessment tools, do not provide the explanatory power to identify the causes of river impairment [5,[8][9][10]. Rather, they are qualitative indicators [6] that indicate how large the need is for restoring water quality. ...
... To reduce the number of scenarios that should be tested with water quality models, a crucial first step is something that can be referred to as solution scanning [52]. By first analyzing the system and making a diagnosis [5] of the impairment at hand, river managers can specify a limited set of management options [53] that could be tested in scenario calculations with perhaps more complex water quality models. Due to this, we argue to not only put the ecological models as the last model in an integrated modeling framework, but to use them also as a first step in these frameworks. ...
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... The continuous monitoring of diurnal DO concentrations provided rich information on DO conditions such as the mean and range of DO, especially low DO, which is a useful indicator of habitat suitability for aquatic organisms [106][107][108]. We found that the magnitude of diurnal DO in summer and autumn was higher than in spring and winter due to high rates of photosynthesis and organic matter respiration (Table 1). ...
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This study evaluated nutrient flux (nitrate (NO3−), ammonium (NH4+), phosphate (PO43−), and dissolved organic carbon (DOC) at the sediment-water interface and river ecosystem metabolism (REM) to investigate how these ecological functions vary in Beijing’s urban waterways. Three tributaries of the River Beiyun were selected. Water quality varied across the study sites as each receives a mixture of wastewater treatment plant (WWTP) effluents and tributary inflows. A chamber technique was applied where water-specific nutrient concentrations were measured at two exposure times (3 and 10 min). Under the actions of physical and biological processes, NO3− and NH4+ flux was primarily controlled by equilibrium concentration and the N-cycle. However, bioabsorption appeared to regulate DOC flux. Specifically, NO3− flux ranged from −0.31 to +0.30 mg/(m2·s), NH4+ was −0.01 to +0.05 mg/(m2·s), PO43− was −0.01 to +0.01 mg/(m2·s), DOC was −0.04 to +0.13 mg/(m2·s). We applied the nighttime slope regression to estimate gross primary production (GPP) and ecosystem respiration (ER). Except in summer, net ecosystem production (GPP+ER) less than 0 indicated heterotrophic study reaches. Structural equation modelling revealed that nutrient dynamics and water temperature were the primary factors driving REM. Our study provides the needed systems-based understanding of vital ecological processes to improve in-stream management.
... The continuous monitoring of DO concentrations provides information about anoxia and hypoxia, which are vital for evaluating habitat suitability for aquatic organisms (Pollock et al. 2007;Rode et al. 2016;Elosegi et al. 2017). The magnitude of diurnal DO swings at D3.0 was higher than at U0.2 resulting from high rates of photosynthesis and organic matter respiration (Fig. 5), which can cause physiological stress in aquatic organisms (Pollock et al. 2007). ...
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River ecosystem metabolism (REM) is a measure of ecological function which integrates gross primary production (GPP) and ecosystem respiration (ER). Urban rivers often receive effluents from wastewater treatment plants (WWTP) which frequently alter nutrient concentrations and modify temperature regimes of receiving water bodies. To investigate how variations in nutrients and water temperature affect REM, we applied the night-time slope modelling to estimate diurnal REM at sites above and below a wastewater outfall on the River Wandle, UK. Overall, estimated GPP (0–21.2 mgO 2 ·L − 1 ·d − 1 ) and ER (5.5–10.1 mgO 2 ·L − 1 ·d − 1 ) from our study sites were similar to those of urban impacted rivers in other countries. GPP values were similar between sites, but downstream ER values were significantly higher affected by the WWTP effluent. GPP/ER ratios were < 1 indicating heterotrophic conditions and the river as a carbon source during the study. We found that sites had similar activation energy associated with ER suggesting our work provides a useful reference for estimating temperature corrected metabolic processes for other urban rivers in the region. Furthermore, structural equation modelling revealed that nutrient supply, water temperature and light availability were the main factors driving REM. This research highlights the major environmental factors affecting REM, which helps to understand the response of river metabolism and river regulation of regional carbon cycle to future climate change and provide evidence to inform river restoration and future in-stream management.
... The Anthropocene, a new geological epoch, has been emerged where human is a dominant factor and modifying the natural environment of the Earth (Elosegi et al. 2017;Abhilash et al. 2021). During the Anthropocene, an extensive fraction of the natural land has been converted into human-influenced biomes, which now represent about 75% of land surface on the Earth (Ellis and Ramankutty 2008;Geisen et al. 2019). ...
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Sacred natural sites (SNS) are multi-functional in nature and provide a variety of ecosystem services that contribute to human well-being and environmental sustainability. Interest in the SNS and their role in biodiversity conservation and ecosystem services have grown in the Anthropocene. Researchers suggested that, besides having spiritual and religious values for local community, SNS provide provisioning, regulating, cultural and supporting services. In this study, we identifed and valued the importance of ecosystem services provided by SNS in the Varanasi district of Uttar Pradesh, India. The methods used included feld work, in-depth literature review, observations, focus-group discussions (FGD) and interviews. This study identifed 35 ecosystem services of SNS spanning across four categories including provisioning, regulating, cultural and supporting services. According to the informants, SNS provide a wide range of ecosystem services, with supporting services being most valued followed by cultural, regulating, and provisioning services. We recommend that a sustainable management of SNS should be based on the local people’s participation in policy, planning and decision-making and utilization of hybrid knowledge system combining modern science and traditional ecological knowledge. Findings of the research contribute to a growing literature on ecosystem services and provide a basis for future studies to unearth how ecosystem services of SNS can support the achievement of sustainable development goals (SDGs).
... Applying lessons learned from public health and medicine, measures of biological condition are first calibrated against a gradient of human influence, then chosen and validated as metrics that indicate changes in key biological attributes, the way a fever indicates illness in people. Validated metrics are then assessed against regional reference benchmarks (see Rossano, 2001 andElosegi et al., 2017 for more discussion of medical and public health templates). The idealized reference condition-ecological integrity-is defined as an ecological system able to support and maintain an adaptive biological system comprising the full range of parts and processes expected for that region, a system whose evolutionary legacy remains intact (Karr, 2009;Karr & Chu, 1999). ...
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Ecological integrity has been criticized as a “bad fit as a value” for conservation biology and restoration ecology. But work over the past four decades centered on ecological integrity—especially biological integrity—has given rise to effective methods for biological monitoring and assessment to better understand the disintegration of living systems, including under scenarios of rapid climate change. Revealing when and where living systems have been altered by human activity, such methods have been adapted and applied most comprehensively in streams and rivers, but also in other ecosystems, ranging from tropical forests to marine coral reefs and on all continents except Antarctica. Equally important, restoration and maintenance of biological integrity is already a fundamental goal in law and offers an inspiring framework for communication and engagement—among scientists, resource managers, law‐ and policymakers, and the public. This essay builds the case that ecological integrity has proved both real and valuable as a conservation paradigm. Biological monitoring and assessment founded on the concept of ecological integrity, especially biological integrity, has led to real‐world achievements under the US Clean Water Act. Between 1979 and 2017, for example, the health of Ohio’s Scioto River improved so much that as many as 70 fish species, including some that had been absent for more than a century, could again be found in the mainstem river near Columbus. This example is only one of the many demonstrating that ecological integrity is both real and valuable in conservation.
... Boulton (1999) discussed the lack of a 'holy grail' tool for the assessment of ecosystem health (see Karr, 1999), and suggested that a combination of abiotic, structural, and functional measurements, including litter decomposition, should be used depending on the problem being addressed. Elosegi et al. (2017) further argued that ecologists should learn from millennia of development in medicine and use a combination of tools, including litter decomposition when suitable, to assess ecosystem health. ...
Chapter
The decomposition of plant litter in freshwaters is an integrative process involving multiple organism groups and connecting terrestrial and freshwater ecosystems. The quantification of leaf litter decomposition has been advocated as an effective indicator of ecosystem functional integrity in the bioassessment of freshwaters. Indeed, variation in litter decomposition rates has been used to detect the impacts of a wide range of anthropogenic disturbances on the functioning of detritus-based food webs in freshwater ecosystems, particularly in streams. However, these assessments have almost exclusively been undertaken as part of research projects, and the application of litter decomposition as a tool in routine biomonitoring remains limited. We evaluate the potential for litter decomposition as a tool for ecosystem assessment by environmental agencies and managers, drawing on insights and experiences from three lines of evidence: (i) a broad selection of published research projects, (ii) an existing national-scale monitoring program and (iii) a meta-analysis comparing litter decomposition rates between nutrient-enriched and reference sites. We use this as a basis for discussing inter alia common substrates used in decomposition assays, alternatives for field protocols and sampling designs, and the use of different indices and reference conditions when arriving at an assessment of functional status.
... Key lessons learned are that water bodies respond differently to nutrient enrichment depending on category, type and geographical location and that the influence of confounding factors on the underlying nutrient-biology relationship can also vary considerably [6][7][8][9][10]. This may lead to a "weak" or even to a wrong diagnosis of the cause(s) of failure to meet the ecological goals which in turn affects the suggested Program of Measures (PoMs) [11][12][13]. ...
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Eutrophication caused by nutrient enrichment is a predominant stressor leading to lake degradation and, thus, the set-up of boundaries that support good ecological status, the Water Framework Directive’s main target, is a necessity. Greece is one of the Member States that have recorded delays in complying with the coherent management goals of European legislation. A wide range of different statistical approaches has been proposed in the Best Practice Guide for determining appropriate nutrient thresholds. To determine the nutrient thresholds supporting the good status of natural Greek lakes, the phytoplankton dataset gathered from the national monitoring programme (2015–2020) was used for shallow and deep natural lakes. The regression analyses were sufficient and robust in order to derive total phosphorus thresholds that ranged from 20 to 41 μg/L in shallow and 15–32 μg/L in deep natural lake types. Nutrient boundaries that encompass the stressors these lakes are subject to, are essential in proper lake management design.
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River ecosystem metabolism (REM) is a measure of ecological function which integrates gross primary production (GPP) and ecosystem respiration (ER). Urban rivers often receive effluents from wastewater treatment plants (WWTP) which frequently alter nutrient concentrations and modify temperature regimes of receiving water bodies. In this study, we applied the nighttime slope method (NSM) to estimate diurnal REM at sites above and below a wastewater outfall on the River Wandle, a tributary to the River Thames, and structural equation modelling (SEM) revealed that nutrient supply, water temperature and light availability were the main factors driving REM. Overall estimated GPP and ER from our study sites were like those of urban impacted rivers in other countries. Upstream to downstream, GPP values (0 ~ 21.2 mgO 2 ·L − 1 ·d − 1 ) were similar, but ER values (5.5 ~ 10.1 mgO 2 ·L − 1 ·d − 1 ) were significantly higher at the downstream site receiving WWTP effluents. GPP/ER ratios were > 1 indicating heterotrophic conditions during the study. We found that sites had similar activation energy associated with ER suggesting our work provides a useful reference for estimating temperature corrected metabolic processes for other urban rivers in the region. Structural equation modelling (SEM) revealed that nutrient supply, water temperature and light availability were the main factors driving REM. This research highlights the major environmental factors affecting REM providing needed evidence to inform river restoration and future in-stream management.
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Gregory’s pioneering work on progressive river channel change, driven in England by both natural and anthropogenic forces, helped to guide major concepts and roles for fluvial geomorphology. It opened the door to a steep rise of applied fluvial geomorphology and a bigger role in public policy and river basin management. The channel change paradigm spans the millennia; by the late 20th Century, the extent of Anthropocene harm to rivers justified both a radical label as ‘damage’ and a professional focus to prescribe remedies. Imitating engineering, then dominant in river management, Gregory favoured the term ‘design’. The damage principally impacted river habitat and increasing collaboration with freshwater ecologists in the restitution of damage became part of the international move to ‘river science’. European legislation strengthened the legal status of physical habitat in overall river quality. In the 21st Century fluvial geomorphology has both strengthened and diversified further within ‘river science’, but also gaining social, behavioural, even political, insights through ‘citizen science’ and the ‘co-design’ of river corridor projects with communities. The professional challenges of the climate and biodiversity emergencies return us to Gregory’s question, ‘how applied should we become?’ The increasingly public profiles of, for example, flood risk policy require river scientists to participate in recommending and co-designing options such as rehabilitation, restoration and rewilding. The separate and joint contributions of these options are discussed through the geomorphological prism. Progressive and episodic channel changes will increase as the drivers and remedies interact; we must play a role in scenario setting and adaptive management, promoting workable collaboration between natural and social sciences, especially in the contested field of design.
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Great temporal and spatial variability of inputs make comprehensive monitoring in small and middle sized rivers difficult. In this study, relevant inputs in a small river were recorded with suitable online monitoring equipment coupled in mobile water quality monitoring stations, the study area being a transborder catchment with French and German (Saarland federal state) subcatchments. In addition to a pronounced spatial variability necessitating a denser net of measuring points this catchment has also to be assessed in the light of different national regulations. To identify individual pollution sources and weigh their relative importance, relevant parameters were recorded over a representative monitoring period of several months: phosphorus (P) as total phosphorus (TP) and total reactive P phosphorus (TRP), nitrate (NO3–N), ammonium (NH4–N), total organic carbon (TOC), temperature, oxygen (O2), pH, turbidity, and electrical conductivity (EC). The recorded data were subjected to adapted interpretation together with other catchment-related factors. In order to retrieve maximum information from the online data sets the relationships among certain parameter pairs were also analysed for both storm events and low flow periods. Comparison of loads at the different monitoring sites could reliably verify the majority of nutrient inputs originating in the French subcatchment. Additional sampling of output channels from sewage treatment works (STWs) in the Saarland subcatchment revealed that inputs from several decentralised STWs do not result in significant loads, as opposed to inputs from one STW in France. Our holistic approach provides a basis for adopting cost-effective measures to reduce loads in small river catchments as well as cross-border harmonisation of environmental policies.
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Stream metabolism (gross primary production and ecosystem respiration) is increasingly used to assess waterway health because mean values are responsive to spatial variation in land use, but little is known about how human land use influences the temporal variability of stream metabolism. We investigated daily variation in dissolved O2 (DO) concentrations and calculated mean and within-season variation in gross primary production (GPP) and ecosystem respiration (ER) rates at 13 stream sites across a landuse intensity gradient in the Auckland region, New Zealand, over 9 y. Based on generalized linear mixed models, mean daily GPP (0.1–12.6 g O2 m⁻² d⁻¹) and ER (1.8–29.6 g O2 m⁻² d⁻¹) and seasonal variation in stream metabolism were significantly related to landuse intensity with higher variability associated with higher values of a landuse stress score. Overall, mean daily rates and day-to-day variation in GPP and ER were greatest in summer and least in winter. We recommend summer monitoring over a minimum 5-d period to assess stream health. Our results show that human land use affects the mean and the temporal variability of DO and stream metabolism. This finding has important consequences for characterizing in-stream processes and the resilience of stream ecosystems. Only long-term temporal monitoring provides the data needed to assess fully how streams function.
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Is planting grass margins around fields beneficial for wildlife? Which management interventions increase bee numbers in farmland? Does helping migrating toads across roads increase populations? How do you reduce predation on bird populations? What Works in Conservation has been created to provide practitioners with answers to these and many other questions about practical conservation. This book provides an assessment of the effectiveness of 648 conservation interventions based on summarized scientific evidence relevant to the practical global conservation of amphibians, reducing the risk of predation for birds, conservation of European farmland biodiversity and some aspects of enhancing natural pest control and soil fertility. It contains key results from the summarized evidence for each conservation intervention and an assessment of the effectiveness of each by international expert panels. The volume is published in partnership with the Conservation Evidence project and is fully linked to the project's website where more detailed evidence and references can be freely accessed.
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Ecology and ecotoxicology have different historical roots, despite their similar names, but are slowly converging to meet the challenge of addressing the massive global proliferation and release of chemicals in the environment. The conceptual, methodological, review and standard research papers in this special issue reflect this emerging trend of blending ecological and ecotoxicological perspectives to assess impacts in freshwater ecosystems. Assessing community and ecosystem impacts of chemical contaminants is complex, however, and will require approaches that explicitly consider biological and chemical diversity as well as the natural variability of environmental factors at multiple spatial and temporal scales. Central themes of the papers in this issue are (i) the importance of indirect effects of chemical contaminants on species interactions and food webs; (ii) effects of multiple stressors, especially interactions between contaminants and environmental factors; (iii) consequences of chemical exposure on ecosystem processes such as primary production and litter decomposition; (iv) the need to account for context dependency and (v) potentially harmful community and ecosystem effects of emerging contaminants, among which nanoparticles are prominently represented. Collectively, these papers show that integrating ecological principles into the design and implementation of ecotoxicological research is essential for assessing and predicting contaminant impacts on biological communities and ecosystems. Conversely, applied ecology and bioassessment would benefit from concepts and approaches developed in ecotoxicology and from fully embracing chemical contaminants as key drivers of community structure and ecosystem processes.
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Global change is transforming freshwater ecosystems, mainly through changes in basin flow dynamics. This study assessed how the combination of climate change and human management of river flow impacts metabolism of the Ebro River (the largest river basin in Spain, 86,100 km2), assessed as gross primary production—GPP—and ecosystem respiration—ER. In order to investigate the influence of global change on freshwater ecosystems, an analysis of trends and frequencies from 25 sampling sites of the Ebro river basin was conducted. For this purpose, we examined the effect of anthropogenic flow control on river metabolism with a Granger causality study; simultaneously, took into account the effects of climate change, a period of extraordinary drought (largest in past 140 years). We identified periods of sudden flow changes resulting from both human management and global climate effects. From 1998 to 2012, the Ebro River basin was trending toward a more autotrophic condition indicated by P/R ratio. Particularly, the results show that floods that occurred after long periods of low flows had a dramatic impact on the respiration (i.e., mineralization) capacity of the river. This approach allowed for a detailed characterization of the relationships between river metabolism and drought impacts at the watershed level. These findings may allow for a better understanding of the ecological impacts provoked by flow management, thus contributing to maintain the health of freshwater communities and ecosystem services that rely on their integrity.
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Objective: To determine if the medical record might overestimate the quality of care through false, and potentially unethical, documentation by physicians. Design: Prospective trial comparing two methods for measuring the quality of care for four common outpatient conditions: (1) structured reports by standardised patients (SPs) who presented unannounced to the physicians’ clinics, and (2) abstraction of the medical records generated during these visits. Setting: The general medicine clinics of two veterans affairs medical centres. Participants: Twenty randomly selected physicians (10 at each site) from among eligible second and third year internal medicine residents and attending physicians. Main measurements: Explicit criteria were used to score the medical records of physicians and the reports of SPs generated during 160 visits (8 cases × 20 physicians). Individual scoring items were categorised into four domains of clinical performance: history, physical examination, treatment, and diagnosis. To determine the false positive rate, physician entries were classified as false positive (documented in the record but not reported by the SP), false negative, true positive, and true negative. Results: False positives were identified in the medical record for 6.4% of measured items. The false positive rate was higher for physical examination (0.330) and diagnosis (0.304) than for history (0.166) and treatment (0.082). For individual physician subjects, the false positive rate ranged from 0.098 to 0.397. Conclusions: These data indicate that the medical record falsely overestimates the quality of important dimensions of care such as the physical examination. Though it is doubtful that most subjects in our study participated in regular, intentional falsification, we cannot exclude the possibility that false positives were in some instances intentional, and therefore fraudulent, misrepresentations. Further research is needed to explore the questions raised but incompletely answered by this research.
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Insufficient data from existing surveillance systems underlie societal tolerance of acute and slow-onset health disasters that threaten, harm, and kill vast numbers of humans, animals, and plants. Here we describe barriers to integrated "One Health" surveillance, including those related to a lack of medical services, professional divisions, incompatible vocabularies, isolated data sets, and territorial borders. We draw from publications of experts who justify broader and more integrated surveillance, education, and stewardship focused on preventing and mitigating disease emergence and re-emergence. In addition, we highlight efforts from Illinois, the United States and the broader world, pointing to examples of relevant education; ways to acquire, compile, and analyze diagnostic and syndromic data; mapping of diseases of humans and animals; and rapid communication of findings and recommendations. For the future, we propose using needed outcomes for health and sustainability to set priorities for One Health programs of education, surveillance, and stewardship. Professionals and paraprofessionals should gather, interpret, and widely communicate the implications of data, not only on infectious diseases, but also on toxic agents, malnutrition, ecological damage, the grave impacts of warfare, societal drivers underlying these problems, and the effectiveness of specific countermeasures.