Background: Mental illness in children and youths has become an increasing problem. School-based mental health services (SBMHS) are an attempt to increase accessibility to mental health services. The effects of these services seem positive, with some mixed results. To date, little is known about the implementation process of SBMHS. Therefore, this scoping review synthesizes the literature on factors that affect the implementation of SBMHS. Methods: A scoping review based on four stages: (a) identifying relevant studies; (b) study selection; (c) charting the data; and (d) collating, summarizing, and reporting the results was performed. From the searches (4414 citations), 360 were include in the full-text screen and 38 in the review. Results: Implementation-related factors were found in all five domains of the Consolidated Framework for Implementation Research. However, certain subfactors were mentioned more often . Conclusions: Even though SBMHS differed in their goals and way they were conducted, certain common implementation factors were highlighted more frequently. To minimize the challenges associated with these types of interventions, learning about the implementation of SBMHS and using this knowledge in practice when introducing SBMHS is essential to achieving the best possible effects with SMBHSs. Mental illness in children and youths has become a public health concern. Symptoms can range from mild and short-term problems, such as mild anxiety or depressive symptoms, to more severe and long-term forms of diagnosed anxiety disorders or major depression . An estiTremendous social costs result from the consequences of leaving mental ill-health in children and youths untreated. These consequences may range from poor educational attainment, compromised physical health, substance abuse, juvenile delinquency, and unemployment to even premature mortality . InDespite this, mental ill-health of children and youths is often not identified and treated in a timely way. Estimations show that up to 75% of students suffering from mental ill-health receive inadequate treatment or are not treated at all ,12. ConsEducation and health are closely interlinked; school is important for one’s social and emotional development, and, therefore, school has an effect on health . MoreoveWhile school-based mental health services (SBMHS) may vary widely in focus, format, provider, and approach , they arEven though services related to mental ill-health can be found outside the school setting, these community mental health services are often underutilized. For example, Kauffman, , Langer The effectiveness of SBMHS has been studied in several reviews and meta-analyses. In general, mental health programs through SBMHS were found to have a positive effect on emotional and behavior problems . HoagwooBesides the different definitions, the variety of programs included under the SBHMS umbrella, and the different designs for evaluation, these programs are complex, which also makes the implementation process potentially challenging. For example, Rones and Hoagwood  identifiThis scoping review aimed at synthesizing the literature on the implementation of SBHMS. By doing so, we aim to increase the understanding of the systemic conditions and factors that affect the implementation of SBHMs.The following research question will be addressed: Which factors are important for the implementation of school-based mental health services (SBMHS)? To systematize the findings, the factors relevant for implementing SBMHS will be structured according to Consolidated Framework for Implementation Research (CFIR) that differentiates between characteristics of the intervention and individuals using the intervention, the inner and outer context as well as the process of implementing.To address the study aim, we performed a scoping review to identify barriers and enablers of the implementation of SBHMs. This method was chosen to provide a broad overview of implementation-related factors for SBHMs . We follThe search was conducted on 7 May 2019. The search strategy was developed in collaboration with a team of informatics experts from the university library at Karolinska Institutet. Based on several example papers focusing on SBHMs, and in discussion with representatives from the Swedish Public Health Agency and the Swedish Association of Local Authorities and Regions, potential keywords were identified. The search strategy included conducting searches in four databases: Medline, Eric, PsycINFO, and Web of Science see . ArticleSimultaneous with developing the search strategy, eligibility criteria for relevant studies were defined . To be iAll studies were screened to eliminate those that were not in line with the research question . Rayyan,In the next step, the full texts of the included studies from the title and abstract evaluation were accessed for final inclusion. Three authors  and two research assistants reviewed articles in full text. As in the first step, the studies were assessed by two independent reviewers, and conflicting decisions were discussed to reach a consensus about the inclusion or exclusion of the study. The full-text evaluation was finished in November 2020.In the next stage, key information from the included studies where charted . The folhttps://cfirguide.org, accessed on 10 February 2022) was used as a conceptual framework to structure the extracted information. CFIR clusters factors related to the implementation into five categories .To organize and categorize the information related to implementation, the Consolidated Framework for Implementation Research  , the evidence strength and quality that the intervention will have desired outcomes, the perceived advantage of implementing this intervention compared to other interventions , how complex and adaptable the intervention is as well as if the intervention can be tested small-scale first. The costs associated with the intervention as well as the perception about how the intervention is design, packaged, and presented also describe important intervention characteristics. The outer setting of the organization where the intervention is implemented is described by the prioritization of patient needs and the resources allocated to patient needs by the organization, in how fare the organization is part of a larger network , if other organizations have implemented the intervention hence, there is peer pressure to also implement the intervention and if there are external policies and incentives that may affect the implementation of the intervention. The organization’s inner setting is described by structural characteristics , the nature and quality of networks as well as (in)formal communication within the organization as well as the culture . Moreover, implementation climate  is an important characteristic that is further differentiated in the tension for change , the compatibility of the intervention with existing workflows and norms, the relative priority the intervention is perceived to have, existing incentives and rewards that exist in the organization that affect the implementation process as well as the existence of a learning climate and clear goals and feedback related to the intervention. Another important factor of the inner context is the organization’s readiness for implementation . Here the involvement and commitment of leaders , the amount of dedicated resources for the intervention, as well as access to knowledge and information about the intervention and its implementation are important. Characteristics of individuals is another important factor according to CFIR. It is defined by individuals’ knowledge and beliefs about the intervention , individuals’ belief in their own capacity to execute the intervention , the phase of change individuals are in, but also individuals’ identification with the organization as well as personal characteristics such as motivation, value, or learning style . The implementation process according to CFIR is categorized in a planning phase , engaging, executing, and reflecting and evaluating phase. Engaging, that is the involvement of appropriate individuals is further differentiated in the engagement of opinion leaders, (in)formally appointed implementation leaders, champions as well as external change agents.Information from included studies that related to the implementation of SBMHS was extracted, and, in the next step, categorized based on the CFIR domains and their more specific subtopics.The data search resulted in 4414 studies that were potentially relevant to the research question of this scoping review. After 1006 duplicates were removed, 3408 studies remained and were included in the screening of titles and abstracts, resulting in 360 potentially eligible studies. Of these, 38 studies were included in the review after full-text screening. The PRISMA flowchart  summarizn = 22), followed by Great Britain (n = 7), Australia (n = 5), and Canada (n = 2). One study was conducted in Finland and one in Sweden. The SBMHS included universal (n = 16), selective (n = 7), and indicated interventions (n = 14). For two SBMHS, the interventions seemed a mixture of selective and indicated interventions. Examples of universal interventions included providing mental health support services to all students or promoting school readiness by creating emotionally supportive classrooms. Examples of selective interventions were introducing a stress-reducing early intervention team to student cases with a risk of mental ill health or establishing collaborations between schools and mental health services to improve psychosocial functioning of students with learning disabilities at risk of mental ill health. Examples of indicated interventions were improving communications between caretakers of children with ADHD or implementing a social skills program to promote children’s cooperative skills and anger management. The majority of SBMHS (n = 12) focused on improving mental health in general, whereas others focused on more specific issues . Most studies described programs where schools collaborated with mental health services (n = 19), whereas seven programs included collaboration between schools and health-care services. Social services were involved in six programs.The 38 studies were published between 1996 and 2018 see . The majA summary of factors related to the implementation of an SBMHS is presented in Generally, implementation-related information could be found for all five CFIR domains, but some of the subfactors in CFIR seemed to be particularly relevant to implementing SBMHS. Frequently named intervention characteristics were the adaptability of the intervention, the design quality and packaging of the intervention, and the costs associated with the intervention. For example, programs were often adapted to the content of the staff training, the way the treatment within the program was conducted, and the evaluation of the treatment compliance to fit to the local context . MoreoveInformation related to the outer setting was mainly captured by the subfactors of cosmopolitanism and external policies and incentives. One reoccurring example related to external policies was the different compensation systems among cooperating actors ,46. SimiInner-setting factors that primarily were mentioned were the networks and communication, goals, and feedback, as well as the available resources that contributed to a readiness for the implementation. In particular, the need for an open dialogue between actors within the SBHMS was perceived as a cornerstone for developing trust and respect between actors . A suppoRegarding individuals’ characteristics is important for the implementation of SBHMs; in particular, actors’ knowledge of and belief in the program were mentioned. For example, when the actors involved strongly believed that the program would improve children’s mental health, staff’s motivation to work with the program increased .When it comes to the process related to the program, engagement of key stakeholders and the participants in the interventions was frequently mentioned. For example, in Panayiotopoulos and Kerfoot , creatinDue to the increasing number of children and youths who are at risk of, and have experienced, mental ill-health, the efficient implementation of countermeasures such as SBMHS is essential. Therefore, this scoping review synthesized the available research on factors that influence the implementation of SBMHS. From 38 studies, information related to the implementation of SBMHS was gathered and structured. SBMHS have incorporated a variety of programs spanning from universal programs that target all students and aim at improving children and youths’ general mental well-being to programs that target specific individuals, either who were at risk for mental ill-health or who experienced mental ill-health. In addition, the SBMHS also varied in their focuses . Whereas the universal programs focused on increasing general mental health or more specific facets of it , the selective and particularly the indicated programs often addressed narrower topics . Most studies were conducted in English-speaking countries. Implementation-related factors of SBMHS for all five CFIR domains  were identified. However, information was primarily found around three of the five domains , and certain subfactors were mentioned more frequently than others were .The design and packaging of the intervention was an often-mentioned factor and was often related to the adaptability of the intervention to the local context. Hence, for SBMHS implementation, being able to tailor a specific intervention to the needs and circumstances of the school and other actors involved was perceived important. Generally, adaptations have been discussed in relation to the fidelity of interventions, which presents the degree to which an intervention is carried out based on how it was described and originally tested when developed ,83. FideSBMHS are essentially the collaboration of various actors who are relevant to children and youths’ mental health; that is, health-care providers, social-care providers, and schools. These three actors ultimately represent different organizations, which also means different primary goals, different ways of working, different cultures, and, potentially, different laws to which they relate. These organization-specific factors may represent challenges to smooth communication between actors when it comes to SBMHS, and they ultimately might make it harder to implement SBMHS successful. Organizational factors have been found to be critical for the successful implementation of evidence-based practices ,98. HoweStakeholder engagement is central to successful implementation in general ,102, andTaken together, this scoping review can be used as a resource and starting point for schools and their collaboration partners that aim at implementing SBMHS in the future. Relevant factors for implementation are highlighted here that can be incorporated and covered when planning the implementation process. One suggestion for successful implementation is the use of multifaceted implementation strategies . SchoolsThe limitations of this scoping review should be acknowledged. This scoping review includes studies that were published until May 2019. Later studies were not included as the pandemic most likely affected the educational system differently in different countries due to the measures and contract restriction that were introduced. Hence, implementation factors that can be found in studies conducted during the pandemic might therefore primary be a representation of the pandemic measure each country has introduced and might therefore not be comparable to a non-pandemic situation. Future studies should investigate SBMHS and mental health of children and youth in future studies further. In addition, most studies included did not have an explicit focus on studying the implementation of SBMHS. Therefore, we might only have captured the most relevant factors that affected SBMHS implementation that therefore often were mentioned in the This scoping review demonstrated that specific implementation factors seem to be more important in the implementation of SBMHS. Besides the need to study the implementation process explicitly, valuable practical guidance can extracted from this scoping review when new SBMHS are planned or existing services optimized.


The interaction between organs is a crucial part of modern medicine. As a very prerequisite to manage a disease, practitioners should have a full awareness of the related organs. Kidney and heart are two vital organs that are closely interconnected in various fields. These two organs have a lot of common risk factors for making a person unhealthy; therefore, if you prevent the disease in one of them, the other’s morbidity might be alleviated as well. Among them, nephrolithiasis and myocardial infarction (MI) have more risk factors in common, and both could be fatal. Also, these two diseases are important regarding the prevalence, incidence, and burden of disease. Some studies confirm the relationship between MI and nephrolithiasis; however, further researches are needed to discover the exact direction of their relationship. The present review aims to explain the mechanism of MI and nephrolithiasis; clarify the relationship between these two disease based on physiological, pathological, and clinical studies; and propose some solutions for the prevention and treatment of such diseases. Nowadays, the prevalence of nephrolithiasis is rising in all countries because of the global warming phenomenon . NoticeaAlthough renal stone formation is one of the oldest human diseases, its mechanism is still unclear and there are many ambiguities in this regard , 26. NepThe intra- and extra-cellular formation events of calcium oxalate stones include initiation of the urinary super-saturation with oxalate or calcium in the setting of hyperoxaluria and hypercalciuria. Subsequently, oxidative stress brings about cellular apoptosis or necrosis, causing cellular damage and membrane ruptures. Initially, expression of crystalline-binding molecules  increases, and consequently, these molecules are exposed and the crystals are attached to the cellular membrane. The crystals are then transferred to the interstitial tissue causing inflammation and chemoattractant protein I. Alternatively, cellular damage facilitates the nucleation and grows on the crystal nucleus, followed by the juxtaposition of crystals. Meanwhile, the crystal and the cell interact with each other, the crystals are connected, and eventually, the stone is formed. Thus far, various mechanisms have been proposed for the nephrolithiasis, of which four mechanisms are discussed below , 51. TheThe mechanism of forming calcium oxalate stones on the plaques in hyperparathyroidism and patients with an ileostomy and those with a resected small intestine is different from that of idiopathic people. The second mechanism is the formation of calculi in the creation of a plaque in Bellini ducts. First, diluted Bellini ducts are filled with crystals, which sometimes grow into the urinary lumen, and then hyaluronic acid and brushite (CaHPO4 2H2O) grow on this plaque . In factThe activity of myocytes and their normal function are highly dependent on the oxidative metabolism. In addition to this dependence, myocytes are very sensitive to O2 variations. Any factor that reduces cellular O2 levels can lead to the apoptosis and necrosis of myocytes. Coronary obstruction as the most common cause of O2 reduction brings about energy starvation and ultimately myocardium necrosis . The detReduced glomerular filtration rate (GFR) and albuminuria are associated with coronary disease. In addition, nephrolithiasis is known as a risk factor for MI. As a result, an increased risk of MI following a nephrolithiasis-induced chronic kidney disease has continuously been a matter of concern . CoronarGiven the strong associations between various bodily organs and vital organs, including the heart and kidneys, as well as the considerable sharing of risk factors among the two organs, it is apparently possible to prevent other ailments by preventing diseases related to these two organs. For example, high water intake can lead to better circulation, reduce coronary spasm and MI, and prevent nephrolithiasis according to the mechanisms described above. Less salt intake results in a decreased salt sedimentation in the kidneys and can provide cardiovascular health by lowering blood pressure. Adequate dairy consumption through adequate calcium supply can also prevent hypertension and the need for cardiac revascularization along with the lower rate of nephrolithiasis. Regular exercise can contribute to improved GFR and increased pre-renal volume by better oxygenation of myocardia and enhanced circulation leading to prevention of nephrolithiasis. The role of nephrolithiasis treatment on the possibility of reducing cardiovascular disorders is a fascinating subject that needs further studies in the future. Due to ever increasing advances in science and detailing of various sciences, especially in the medical field, one should not overlook the fact that the wide interrelations of organs as the probable treatment of many diseases today entails a strong group work. Furthermore, when it becomes feasible to discover the common main cause of diseases, considerable steps can be taken in the prevention and treatment of common organ diseases, which also lowers the costs for the society.What follows from this study implies that there are many relationships between the heart and kidneys in terms of both diseases and risk factors. Among the diseases, what discussed more in this study was the relationship between nephrolithiasis and MI. However, the issues like ‘which organ has a more dominant influence on the other’ or ‘diseases of which organ are the leading cause of the other one’ are debatable issues and require more extensive studies in this field.The authors declare no conflict of interests.


Lack of knowledge and mistrust towards vaccines represent a challenge in achieving the vaccination coverage required for population immunity. The aim of this study is to examine the opinion that specific demographic groups have about COVID-19 vaccination, in order to detect potential fears and reasons for negative attitudes towards vaccination, and to gain knowledge on how to prepare strategies to eliminate possible misinformation that could affect vaccine hesitancy. The data collection approach was based on online questionnaire surveys, divided into three groups of questions that followed the main postulates of the health belief theory—a theory that helps understanding a behaviour of the public in some concrete surrounding in receiving preventive measures. Ordinary least squares regression analyses were used to examine the influence of individual factors on refusing the vaccine, and to provide information on the perception of participants on the danger of COVID-19 infection, and on potential barriers that could retard the vaccine utility. There was an equal proportion of participants  who planned on receiving the COVID-19 vaccine (37%), and of those who did not (36.3%). The rest (26.7%) of participants were still indecisive. Our results indicated that attitudes on whether to receive the vaccine, on how serious consequences might be if getting the infection, as well as a suspicious towards the vaccine efficacy and the fear of the vaccine potential side effects, may depend on participants’ age (<40 vs. >40 years) and on whether they are healthcare workers or not. The barriers that make participants‘ unsure about of receiving the vaccine, such as a distrust in the vaccine efficacy and safety, may vary in different socio-demographic groups and depending on which is the point of time in the course of the pandemic development, as well as on the vaccine availability and experience in using certain vaccine formulas. There is a pressing need for health services to continuously provide information to the general population, and to address the root causes of mistrust through improved communication, using a wide range of policies, interventions and technologies. The Coronavirus disease 19 (COVID-19) pandemic, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the defining global health crisis of our time which affected public health, social life, economic strategies and political efficacy [Regardless of COVID-19, disease prevention by vaccination is considered one of the greatest successes of public health medicine, which efficacy was confirmed in reducing the global morbidity and mortality of some serious diseases, such as polio, measles, rabies, typhus and some others . VaccineAmongst the barriers to universal vaccination, misinformation regarding the benefits, medicinal composition and adverse effects of vaccination limits patient understanding, and the increase in antivaccination movement was mainly caused by believes that vaccinations do more harm than good to children, especially in case of connecting vaccination with autism . FurtherNow in the age of modern technology, growing interest has emerged in the role of interactive social media in public health promotion. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. While this could be very useful as a way of quickly spreading correct information by medical authorities, this also challenge medical and public health authorities, giving patients a wealth of misinformation and anecdotal evidence, and encourages them to participate more actively in medical decision-making, which can have potentially dangerous consequences for the public ,14,15,16The health behaviour and decisions of everyone are influenced by demographically specific social, political and cultural factors, especially in terms of customs, beliefs and opinions of family members and colleagues, as well as personal experiences and current health status ,21. The This situation is different form everything we have faced before. There are a number of insufficiently known factors influencing the spread of COVID-19 infection such as unknown biology and mutagenic capacity of the causative agent, efficacy of new vaccines on current circulating strains, harmful vaccine side effects and vaccine efficacy in the event of altered virus properties. So decision to get vaccinated is more difficult than before.In the case of COVID-19, there is a dynamical environment because of many uncertainties that exist and change over time. In order to provide right information and communication strategies to particular socio-demographic groups, a similar survey, as it is one presented in this manuscript, has to be repeated several times during the course of the pandemic.The groups most at risk for developing serious complications of COVID-19 are similar to those at high risk for developing more severe consequences of seasonal flu—patients suffering from chronic diseases such as: diabetes mellitus, hypertension, heart and pulmonary diseases; and those over 65, as well as health professionals who are on the front line of defence against the virus . Therefon = 276), divided into three age groups: 20–40 years, 40–60 years and older than 60 years of age. Regarding their employment status, they were divided into groups: health professional, working in another profession, unemployed and retired.This study was conducted in facility in Osijek in December of 2020 and January 2021. Osijek is a city with 70,000 inhabitants and the administrative centre of eastern Croatia. The study was conducted on included 56 men and 220 women  and housing status .The second group of questions was constructed to gather information on the perception of the dangers of COVID-19 infection, with the answers offered: yes, no and I don’t know. Questions were whether participants were considered susceptible to the disease or getting a more severe form of the disease, whether they were vaccinated regularly against seasonal flu and whether they received last year’s flu vaccine, and whether they planned to receive the COVID-19 vaccine.The third group of questions provided information on the perception of the utility of the vaccine in relation to barriers, with answers offered: true, neither true nor false and false. This group was divided into three subgroups: organisational barriers , perception of disease risk  and perception of vaccine protective effect .Responses were analysed multivariate according to age groups and categories of health and non-health workers.p = 0.05. The statistical software Past ver. 2.17c  was used to analyse and evaluate statistical outcomes [Multiple regression analysis was applied to demonstrate the trend of the influence of individual factors on the decision to vaccinate against COVID-19. We used a multiple linear regression model and other statistical methods for statistical analysis: analysis of variance (two-way ANOVA) and calculation of the odds ratio to analyse the influence of different factors on vaccination decision in individual groups of subjects. The main purpose of statistical analysis in this paper is to show the relationship between variables represented by multiple linear regression . The significance level for all statistical analyses was set at outcomes .Sociodemographic data of participants.Most participants were under 60 years of age (75%). The reason for the predominance of the younger population could be that the surveys were conducted electronically and through social networks, which are mostly used by young people. More women (79.7%) than men (20.3%) participated which could also be explained with method of survey distribution because woman are more likely to participate in online research and social media activities ,33. Rega2.Intention to get vaccinatedWoman make a significantly different decision depending on whether they are younger or older age group. More younger women decide not to get vaccinated, and older woman are more determined to get vaccinated . For menFurthermore, employment status has a very important role in decision making. Non-healthcare workers are more prone to decide, compared to healthcare workers, not to get vaccinated, or they are in a greater part unsure of what to decide .3.Perception of one’s susceptibility for infectionMost participants, 52.6% of them, do not find themselves prone to getting diseases, while a slightly smaller number of them, 42.1%, are convinced they will not get a more severe form of disease.Since the participants are mostly young, 65.2% of them do not suffer from any chronic illnesses, and those who do mostly have only one or two chronic illnesses.Most of the participants, 74.4% of them, do not get seasonal influenza vaccine regularly, and did not get vaccinated this season. Characteristics are presented in Most participants are aware of the serious risk of contracting the disease, and the importance of vaccination. However, their opinion on the health risks is that they are not so susceptible to the disease and will get over it without more serious consequences, which probably affects their indecision regarding receiving the vaccine .Characteristic are presented in There is a substantial level of uncertainty around the COVID-19 vaccine with the greatest distrust related to the potential side effects. Furthermore, there is no enough trust in vaccine efficacy.Many participants are still undecided, they still form their opinion and think that they are not sufficiently informed to form strong views on the vaccine, which affects their decision.The task for public health services is to provide information about safety of vaccine but problem in this unique situation is that knowledge regarding vaccine safety will change during the vaccination champaign and it is unlikely to be influenced by this factor before the vaccination campaign begins .Regarding perception of vaccine utility in relation to organisational barriers, even though there is a substantial public concern about vaccine availability , this doAs there is an urgent need for a more updated and comprehensive understanding of attitudes towards vaccines, factors determining vaccine intent in the context of the COVID-19 pandemic should tailor public health messages accordingly. This study demonstrates difference in attitude toward vaccine in different socio-demographic groups .This study was conducted in time before vaccine was available in general population. A wide range of age groups was included, from 20 to over 60 years old. Even though most of the participants are from the younger age group, there is still a significant portion of risk groups among them, 34.8% of participants have one or more chronic diseases and 34.4% are a healthcare professional, for whom vaccination against COVID-19 is highly recommended .The decision not to vaccinate is influenced by age and employment status . YoungerThe problem revealed by this research is that most of all participants still do not have a strong opinion about COVID-19 vaccination, mainly because they find that there is not enough information about the vaccine. Another problem is an otherwise poor propensity to vaccinate against seasonal flu, which is an optional vaccine that it is also recommended for at-risk groups .Poor response to vaccination against seasonal flu among health care professionals has been a subject of much research due to increased risk of interpersonal transmission among staff and patients, which found that the main reasons for not getting the vaccine were fear of vaccine-related complications, lack of information and personal interest, not believing in vaccine efficacy or accessibility of the vaccine. On the contrary, employers willing to take influenza vaccine were motivated by a desire to protect themselves and patients or get vaccinated because employers require them to ,35.Zimmerman and coll. in their research found that the inconvenience of getting an influenza vaccine was one of the main reasons for not receiving the vaccine among healthcare professionals, especially if they cannot reconcile work commitments, and that offering benefits increases the vaccination coverage of this population . Some stSome of these reasons could be expected as potential reasons for non-vaccination against COVID-19 and can be prevented while some others, like vaccine related complications, and information regarding vaccine efficacy are unpredictable and are likely to change during pandemic.Dror et al. in their study showed that vaccine acceptance among medical teams in COVID-19 departments is around 94%, which is higher compared to 75–91% in other medical departments. Furthermore, medical staff who think they have a higher risk of getting the disease are more susceptible to accepting the vaccine, and the most common fear is related to the question of vaccine safety . This suSince this research was done before the vaccination started, in all subgroups (divided by age and by employment status) there are a lot of undecided respondents whose decision will likely to be formed based on internal and external factors, such as personal experiences or pieces of information received through public media or social networks.In the context of Croatian culturological circumstances, as our experience teaches us, the source of information for elderly is mainly through national television and for the young also through social media.The socio-economic situation in Croatia was not perfect before COVID-19 pandemic and it has even gotten worse since pandemic has started, mainly due to severe lock-down and preventive measures which resulted in increased unemployment and endangered existence of many people. Due to long-term epidemiological measures, also the quality of life has decreased . Some puAccording to the crisis committee reports on TV, the main causes of minor epidemic outbreaks, in Croatia, is a gathering of young people in cafes and clubs, which could also be a consequence of increased unemployment, as well as a gathering of people for religious and traditional customs. On the contrary, due to differences in the population density of individual counties in Croatia, there is a difference in the number of infected and epidemiological measures for individual counties, which leaves people with unanswered questions and with an impression of inconsistency.Another problem, that is less likely to be influenced by the communication campaigns, is that, compared to well established vaccination protocols against infectious diseases found in the regular vaccination calendar, like measles, mumps, rubella and diphtheria or infectious diseases with well-established vaccination campaigns, like seasonal flu, specificity in COVID-19 pandemic and vaccination as a protective measure is that now there is still a lot of unknown about effectiveness and side effects of vaccine, and also there is a question whether pandemic could be stopped with vaccination . FurtherFurthermore, the first clinical trials for testing the efficacy of the novel COVID-19 vaccines were of a short-term, and the current on-going vaccination campaign is one large clinical test, where it is uncertain whether this vaccine will protect from new, mutated strain of virus ,46.It is important to follow recommendations of healthcare professionals and to adapt guidelines to the dynamic of the pandemic, by following the principle “watch and waiting”, and according to the characteristics of the specific socio-demographic groups. It is primarily necessary to protect the elderly and other most vulnerable groups, and when this is accomplished, the middle aged and younger become susceptible to infection.When pandemic started, younger people were considered a less at-risk population for severe form of disease but lately, there are reported severe form of disease in young people without other comorbidities, as well ,48,49,50According to all that, it is to expect that there is a hesitate of the public and also oscillations in the motivation for vaccination between the fear of vaccination and the fear of spreading the epidemic.Strong argument of well-established vaccination campaigns, experience that vaccination has been a good protect against many dangerous infectious diseases cannot be used now when viral mutations and vaccine itself are still insufficiently known. It is necessary to monitor the course of the pandemic and results and effectiveness of the vaccination, with constant adaptation to the situation, which makes communication with the public very complex.Research about COVID-19 vaccine acceptance in the general population and among healthcare professionals were conducted in many countries around the world with very variable results .In the general public, by December 2020, the greatest acceptance of COVID-19 vaccine had Ecuador, Malaysia, Indonesia and China, with acceptance rates between 91% and 97%, and the lowest rates were found in Kuwait, where only 23.6% of the general population were intending to take COVID-19 vaccine ,54,55,56Italy and France were not much better, with acceptance rates of 53.7% and 58.9%, respectively ,58. FurtA recent study in the UK and USA demonstrated that as a consequence of disinformation, interest in vaccine has declined since September 2020 .Research regarding healthcare professionals demonstrated the highest acceptance rates, of 78.1%, in Israel, and the lowest rates in the Democratic Republic of the Congo 27.7% ,61.Sallam M. in his research concluded that there is a need for more studies regarding the COVID-19 vaccine acceptance in Eastern Europe and this research is reporting the situation on this issue in Croatia .A recent study about acceptance of the COVID-19 vaccine among healthcare professionals showed that the high risk of getting an infection at work is the main reason for willingness to get vaccinated, contrary to the general population where vaccine safety was the main factor .In the preparation of strategies for vaccination campaigns, as our results also indicate, more knowledge about cognitive decision-making processes is needed and a greater application of knowledge from behavioural science. There are two basic strategies for influencing people to accept certain preventive measures: boosting (empowerment) and nudging (pushing them gentle) . One strIt is important to evaluate vaccine acceptance in specific socio-demographic groups in every country in order to better plan actions and campaigns to increase acceptance rates.As we examined the perception of vaccine protective effect and risk associated with the vaccine, we need to conclude that, in Croatia, in the time this survey was done, there was still a substantial level of uncertainty about the COVID-19 vaccine, with the greatest distrust related to the potential side effects. Many participants were undecided, and their opinion was still forming . This unThe limitation of our study is that most of the correspondents were from the younger age group, the main reason being that the surveys were conducted electronically and through social networks, which are mostly used by young people. Despite this limitation, there was a significant proportion of high-risk correspondents, healthcare professionals and chronic patients. Furthermore, it is important to emphasise that our study was conducted when there was still not enough information on the COVID-19 vaccine and vaccination has not yet started fully, so it is possible that now when vaccination takes place all over the world with media reports, public opinion might have changed. We also highly support the Australian model of organisation of COVID-19 vaccination, which promotes a major roll of general practitioners and primary care physicians in educating and administration of the COVID-19 vaccine in the general population, as they have been confirmed as the most trusted source of information . There iDifferent demographic groups have different external and personal influences that are reflected in their cognitive processes. That is why it is necessary to adjust the way of informing each individual group about the vaccine. Vaccination of health professionals is especially important because of the devastating impact of staff shortages on the health system during the COVID-19 pandemic. Furthermore, this would reduce nosocomial transmission of the virus among the staff and patients. The goal of the campaign for the COVID-19 vaccine should be to raise awareness of the importance of the vaccine, including information on potential personal risks. Therefore, it is extremely important to provide an adequate level of education to health professionals and to provide the general public with access to accurate information related to the safety and efficacy of vaccines.During a pandemic, depending on how effective the vaccine proves to be and on the dynamic of the spread of the infection, the attitudes of individual subgroups of the population may change, which is why similar surveys should be repeated several times during a pandemic. There is a need for carefully listening to the rumours of the public and critically analysing new evidence related to the COVID-19 outbreak, and according to it, for a fine-tunning the vaccination communication and motivation strategies.


With the rise and popularization of the concept of green sustainable development, green income growth of agricultural insurance policies has attracted wide attention. Whether green income growth can be achieved has become an important criterion for measuring an agricultural insurance policy. In this context, this paper attempts to test whether the agricultural insurance policy achieves green income growth. Based on the panel data of 31 provinces  in China, including 22 provinces, 5 autonomous regions and 4 municipalities directly under the central government. Hong Kong Special Administrative Region, Macau Special Administrative Region and Taiwan Province are not included in the research sample) from 2009 to 2020 in China, this paper empirically evaluates the triple-effect of total cost insurance pilot program (TCI) on farmers’ income, environment and public health by employing a difference-in-difference model (DID). The results show that TCI increases farmers’ income, but deteriorates the environment and residents’ health without achieving green income growth. In the analysis of heterogeneity, compared with central and western regions, farmers’ income is more likely to increase in the eastern regions. However, environmental pollution is more severe, and residents’ health deteriorates more, in eastern regions. In addition, the positive effect of TCI on farmers’ income and the deterioration of residents’ health is more obvious in areas with a higher degree of damage, while the negative effect of TCI on the environment is more obvious in areas with a lower degree of damage. Furthermore, the mechanism analysis shows that TCI not only promotes the increase in farmers’ income through insurance density, but also affects the environment and residents’ health through straw burning. Therefore, the government should raise the subsidy standard for farmers to use straw-processing equipment and also to implement differentiated subsidies in regions with different levels of economic development and areas with different degrees of damage. Agricultural production plays an irreplaceable role in the economic and social development of a country. It is not only the cornerstone of the development of the national economy related to food security, but also affects environmental quality and residents’ health. Agricultural production is a risky process. The risk of agricultural disasters has become a major hidden danger that threatens agricultural production activities. In order to avoid the significant negative externality of agricultural disaster risks, various countries and regions have implemented agricultural insurance and premium subsidies to transfer risks. Through risk transfer, farmers are encouraged to increase agricultural input to boost agricultural productivity and promote agricultural development. However, it has been proved that the implementation of agricultural insurance subsidy policies will aggravate soil pollution, caused by the application of fertilizers and pesticides, and air pollution, caused by improper disposal of straws, etc. Environmental pollution and residents’ health may be deteriorated over years. With the rise and promotion of concepts related to green sustainable development, the issue of green income growth in agricultural insurance policies has attracted wide attention. Whether green income growth can be achieved has become an important criterion for measuring an agricultural insurance policy .Notice on Launching the Pilot Work of Total Cost Insurance and Income Insurance for the Three Major Food Crops, which decided to start subsidizing TCI in 2018. This paper only analyzes the triple-effect of TCI, but does not analyze the effect of income insurance. The Chinese government has selected Inner Mongolia, Liaoning, Anhui, Shandong, Henan, and Hubei as the pilot provinces to carry out TCI of the three major crops. TCI covers major natural disasters, major plant diseases and insect pests and accidents, etc. The insured amount covers material and service costs with additional land costs and labor costs. The insurance targets are the three major grain crops, rice, wheat, and corn. The basic information of TCI is shown in During the decades of development of China’s agricultural insurance policy, farmers’ demand for agricultural insurance was relatively low. Therefore, low farmers’ insurance participation has lasted for a long time. Consequently, development of the agricultural insurance market is unsatisfactory. In this background, the Ministry of Finance, the Ministry of Agriculture and Rural Affairs, and the China Banking and Insurance Regulatory Commission jointly issued the On the basis that the self-payment ratio of farmers is no less than 30%, China’s fiscal administration subsidizes 40% of total funding in the central, western and northeastern regions, and 35% in the east during the implementation of TCI. The pilot provinces invested a total of 827,702,200 CNY in 2020. Specifically, of which the central government fund contribution was 327,466,900 CNY, the local fiscal fund contribution was 255,250,200 CNY, and the farmers’ self-paid insurance premium amount was 244,983,100 CNY. Regarding insurance and claims settlement, the pilot provinces insured a total area of 0.9413 million hectares in 2020, an increase of 9.28% over 2019. The total insurance coverage amounted to 1,208,124,900 CNY, and the total claims amount was 79,584,600 CNY. The kernel density function graph of TCI in the pilot provinces during 2018–2020 is shown in Kernel density estimation is a non-parametric estimation method of probability density function proposed by Rosenblatt . This meIn this context, this paper takes China’s TCI as an example to study the triple effect of TCI on farmers’ income, agricultural environment, and public health by employing a difference-in-difference model (DID). The study aims to find out whether TCI can achieve green income growth. The empirical research is based on the inter-provincial panel data from 31 provinces in China from 2009 to 2020. This paper not only explores the heterogeneity of policy effects, but also verifies the internal mechanism of TCI on farmers’ income, environmental pollution and public health. The empirical results can help governments around the world to pay more attention to potential environmental and health issues when optimizing agricultural insurance policies in the future. Additionally, the results help the administration to formulate agricultural insurance policies that take into account income growth, environmental protection and public health, and eventually achieve green income growth.There is an intense debate among scholars about the policy effects of agricultural insurance policy on farmers’ income. Some scholars have affirmed the effects of agricultural insurance subsidy policies. For example, Babcock , Coble aThe view that agricultural insurance policies can affect the agricultural environment and health has been confirmed by numerous studies. Some scholars believe that the agricultural insurance subsidy policy can help to reduce environmental pollution , and theTo sum up, the existing literature mainly focus on the analysis of the impact of agricultural insurance policies on farmers’ income. Most studies ignored the environmental pollution and public health caused by agricultural products and their disposal. There is a lack of comprehensive consideration of farmers’ income, environmental pollution, and residents’ health. In addition, the above papers are more concerned with the direct impact of agricultural insurance policies. They conducted empirical tests on the changes in food production and fertilizer use after the implementation of the policy, but they failed to clearly interpret the mechanism of the agricultural insurance policies affecting farmers’ income, environmental pollution and residents’ health. This paper attempts to make up for these shortcomings.Compared with the existing literature, the main breakthroughs of this paper are as follows: First, there is the innovation of research perspective. This paper takes TCI as an example to test whether TCI can achieve green income growth. Considering green factors such as environmental pollution and residents’ health, which are ignored in the previous literature, this paper creatively incorporates farmers’ income, environmental pollution and residents’ health together into the triple-effect evaluation of TCI. Second, there is the innovation of model design and method selection. This paper constructs DID model, continuous DID, and triple-difference model sequentially for causal effect inference ,31. The In the process of agricultural production, increasing the output of agriculture and farmers’ income has always been the topic supported by the agricultural insurance policies. However, with the concept of green and sustainable agricultural production rising, environmental pollution and residents’ health are increasingly important for measuring an agricultural insurance policy. Therefore, farmers’ income is no longer used as the singular measurement indicator. Green factors such as environment and health should be taken into consideration when evaluating the performance of agricultural insurance policies. This paper considers environmental pollution and residents’ health as the green factors . Taking Environmental pollution caused by agricultural production is mainly soil pollution caused by excessive application of chemical fertilizers and pesticides and air pollution caused by burning straw. Most of the chemical fertilizers and pesticides used in the world’s agricultural production are of hypo-toxicity, so the harm to human health and the environment can be ignored . TherefoThis paper selects the panel data of 31 province-level units in China from 2009 to 2020. The statistical software Stata 15  is used for empirical analysis. The data of various variables used in benchmark regression, robustness test, heterogeneity analysis and mechanism analysis come from the website of the National Bureau of Statistics of China (stats.gov.cn), China Agriculture Yearbook (cnki.net) and China Environmental Yearbook (environmentcnki.net). The descriptive statistics of each variable are shown in In order to analyze the triple-effect of TCI and test whether TCI can achieve green income growth, this paper uses the DID model for empirical analysis, referring to the methods of Beck et al. , Li et aand Fang  used theand Fang ,29. TherThis paper uses three methods to verify the accuracy of the conclusions. The first method is parallel trend test. The second method is the placebo test. In the third method, the explained variables in Equation 1) are replaced by net operating income of farmers’ households, the number of environmental incidents, and the death rate, respectively  are repl.One of the most important premises of the difference-in-difference model is to conform to the parallel trend hypothesis. The parallel trend means that the explained variables in the policy pilot provinces and the non-policy pilot provinces must have a common trend before the implementation of the policy. In this paper, referring to the test of the parallel trend hypothesis in the previous studies ,33, the In order to prove that the changes in farmers’ income, environmental pollution and residents’ health problems in the pilot provinces are indeed caused by TCI, instead of other unobservable factors, this paper conducts a placebo test referring to Lu et al. . SpecifiThe objective of this section is to verify the accuracy of benchmark regression analysis. According to related analysis in existing studies, this section selects the net operating income of farmers’ households (Operating income), the number of environmental incidents (Environment) and the death rate (Death) as the explained variables and performed the regression test after replacing Equation . We repluseholds  and the useholds . In partuseholds ,28. TablOperating income is also processed by taking the logarithm in order to unify the dimension. The results of the robustness test are shown in During the implementation of TCI, the proportions of central government’s premium subsidies to the eastern, central and western regions have been different, and the ratio has increased year by year. Therefore, the intensity of policy implementation is not constant during the implementation period. In order to measure the subsidies intensity of the TCI implementation, we employ a continuous DID model in this section. According to the quasi-difference method , this se × post) . The estThe continuous DID coefficients (Subsidy×post) are positive and basically significant at the 1% significance level. It is demonstrated that, on the one hand, TCI has promoted farmers’ income growth, but the emission of air pollutants and the incidence of major diseases has increased. On the other hand, the subsidies intensity of the TCI implementation has significantly increased year by year. It is consistent with the current situation. The government makes the effort to elevate the subsidy intensity of TCI, and constantly enhance the policy effect. During the implementation period of TCI, the proportions of central government’s premium subsidies to the eastern, central and western regions have been different, and the ratio has increased year by year . HoweverConsidering the great differences in the level of economic development and the severity of natural disasters among different regions in China, this paper conducts the heterogeneous analysis of the triple-effect of TCI on farmers’ income, environment, and public health. The heterogeneity analysis of regions is based on the classification of the samples into eastern, central, and western regions. According to the different regions and levels of economic development of different provinces, China can be divided into the following three regions: eastern, central, and western regions ,36. In aThe heterogeneity analysis of regions is to test whether there is heterogeneity in the effects of TCI among eastern, central, and western regions in China. This paper further merges the central and western provinces referring to Yuan et al.’s division of the three major regions of China . Due to The estimation results in The core content of the agricultural insurance policy is to ensure the stability of farmers’ income and to prevent farmers from returning to poverty after disasters. Therefore, it can be inferred that if the agricultural insurance policy achieves this objective to some extent, the policy effect in areas with severe agricultural disasters will be more obvious. This section still uses the triple-difference model to analyze the heterogeneous effect of TCI. First of all, this section refers to the classification of degree of damage in agriculture in various provinces by Liang . If the The results in The results above clearly demonstrate the triple effects of TCI. TCI can promote farmers’ income growth with the worsening of the environment and residents’ health, which means green income growth has not been achieved. Furthermore, the mechanism that generates the result above needs to be further explored. Referring to the existing theories and literature, this section poses the following theoretical analysis beforehand: On the one hand, the implementation of TCI will increase farmers’ participation in agricultural insurance. Therefore, demand for agricultural insurance is increasing. When the supply of agricultural insurance is stable, the trading volume of agricultural insurance under the equilibrium state has increased, thereby promoting the development of agricultural insurance. The development of agricultural insurance can effectively increase agricultural production inputs by transferring agricultural business risks, optimizing agricultural risk allocation and resource allocation, thereby increasing farmers’ income . On the In model (3), Then, the two methods, the test of the regression coefficient by stepwise regression and the bootstrap test, are used in this part to verify the two paths. The test of the regression coefficient by stepwise regression is used in the mechanism analysis first for the path test, and then the bootstrap test is used for further verification. Whether the insurance density is the mediator of TCI affecting farmers’ income can be determined. Additionally, whether the amount of straw burning is the mediator for the causal effects of TCI on the environment and health can be determined. The mechanism of TCI on farmers’ income, agricultural environment and residents’ health can be obtained. The test results of the mediation effect are shown in Furthermore, the bootstrap test is used to verify the results of mediation effect analysis mentioned above. The result can be seen in From the perspectives of farmers’ income, environmental pollution and residents’ health, this paper focuses on the triple-effect evaluation on TCI and test whether TCI can achieve green income growth. The empirical study is based on inter-provincial panel data from 2009 to 2020 in China, by using difference-in-difference model. The research method used in this paper is similar to that of Gao et al. . They usBased on the inter-provincial panel data from 31 provinces in China from 2009 to 2020, this paper takes China’s TCI as an example to study the triple-effect of TCI on farmers’ income, environment and public health. The study aims to find out whether agricultural insurance policies can achieve green income growth. The results show that TCI promotes farmers’ income, but deteriorates the environment and residents’ health, which indicates green income growth has not been achieved. Furthermore, there are significant heterogeneity characteristics in the effects of TCI on farmers’ income, environment and public health. Compared with central and western regions, farmers’ income is more likely to increase in the eastern regions. However, environmental pollution is more severe, and residents’ health deteriorates more, in eastern regions, during the implementation of TCI. In addition, the positive effect of TCI on farmers’ income and the deterioration of residents’ health is more obvious in areas with a higher degree of damage, while the negative effect of TCI on environment is more obvious in areas with a lower degree of damage. In terms of internal mechanism, on the one hand, TCI increases the insurance density, thereby increasing farmers’ income. On the other hand, TCI encourages farmers to burn straw emitting harmful gases, which is harmful to the environment and residents’ health to some extent, without achieving green income growth. The conclusions provided by empirical analysis can help governments around the world to formulate agricultural insurance policies that take environment and public health into consideration and then achieve green income growth. Based on the above empirical analysis and discussion, this paper puts forward the following recommendations about how to achieve green income growth:First, from the perspective of environment and health, TCI has not achieved green income growth. The government should not merely focus on the increase in food production and farmers’ income during the implementation of agricultural insurance policies, they should also pay more attention to environment and public health. It is required that governments of various countries pay attention to the green income-increasing effect that involves the environment and health. In this way, the well-being of residents can be truly improved. A reasonable increase in the subsidy standards is needed for farmers to use straw-processing equipment more actively. Additionally, the subsidies should be granted to special machinery purchase to encourage environmentally friendly production and post-processing of straw and to promote the construction of environmentally friendly agricultural facilities in rural areas. As a result, environmental pollution caused by straw burning can be reduced, and the health of residents can be guaranteed.Second, the government should implement differentiated agricultural insurance policies based on the heterogeneity of regions and degrees of disaster. To increase the level of government subsidies, the government should release policies that favor the central and western regions and areas that are not severely affected with regard to farmers’ income. In terms of reducing environmental pollution, policies that favor the central and western regions and severely affected areas should be implemented. In terms of the health of residents, the government should implement policies that favor the central and western regions and areas that are not severely affected.Third, the government should improve the agricultural insurance subsidy policy system, continue to expand the scope of subsidies, and form a subsidy system of “bulk agricultural products plus local advantageous varieties”. Not only should administration increase premium subsidies, but also promote reinsurance subsidies, management fee subsidies, and tax incentives, so as to increase farmers’ participation in agricultural insurance. With the increase in insurance density, farmers’ income can be increased continuously. Together with the promotion of the use of straw-processing equipment and the construction of environmentally friendly agricultural facilities, green income growth can be achieved in the future.


Historical ecology is an important tool in deciphering human–environment interactions imprinted on landscapes throughout time. However, gaps of knowledge still remain regarding the land use legacies hidden in the current Atlantic Forest landscape; and also regarding how this information can help management of the remaining forest cover. The social-ecological systems framework was applied to understand charcoal production in the urban forests of Rio de Janeiro, from the nineteenth to mid-twentieth century, and their current social-ecological legacies. Charcoal production carried out by former enslaved populations, allowed for rapid forest regeneration. Forest thinning instead of forest felling was carried out by small groups in these urban remnant forests, sparing large native trees and facilitating natural regeneration. Currently, more than one thousand former charcoal production sites are accounted for hidden underneath the forest cover. The forest landscape of today is a result of novel forest successional trajectories that recovered structural and functional attributes of the forest ecosystem. However, this came at the cost of social invisibility and marginalization of these populations. The management practices of charcoal production dispersed in the landscape is one of Rio de Janeiro's most important, albeit hidden, land use legacies. Currently, the forested landscape is comprised of regenerated forests, both structurally and functionally sound, though with significant changes in species composition including the introduction of exotic species throughout recent centuries. These urban forests are today a complex mosaic of novel ecosystems, with rich biocultural diversity, and together with managed lands and well conserved forest tracts, provide not only livelihood and sustenance for forest dwelling families, but also important ecosystem services for the entire population of Rio de Janeiro. We believe that these concepts and frameworks can offer practical solutions for urban forest management, taking into account the biocultural diversity of Rio de Janeiro, increasing awareness of sustainability and promoting food security. This statement becomes more evident with a broader understanding that we currently live in the Anthropocene—the human epoch . Tropica. 1.11In a globalized society there are no ecosystems without humans nor people that live without the benefits of ecosystem functions . These tSocial-ecological system research has also been used in social research today, as the results of past human–environment interactions have implications for the common future of humanity. Thus, historical ecology, environmental history and historical geography are positioned as a tool key to the resolution of concrete problems and the proposition of public policies related to social-ecological systems . Underst. 1.2Some sub-fields and disciplinary traditions have contributed to constructing an approach that seeks to overcome the separation between nature and society . Among tHistorical ecology is defined as ‘the study of past ecosystems by charting the change in landscapes over time’ , p. 6. AGeography is a discipline that has a lot to contribute to the investigation of human–environment interactions because it offers a conceptual contribution to address the relationship between society and nature. It can contribute to the cross-scaling understanding of biophysical factors and of power relations . The speDespite the differences between historical ecology, environmental history and historical geography, these three fields offer fundamental tools for the historical understanding of the relationships between cultures and nature. In addition to the temporal approach, such fields are open to interdisciplinarity, emphasize the landscape as a fundamental category of analysis and operate from an evidential paradigm , observi. 1.3From the perspective of applied historical ecology, concepts have emerged as important tools to support the decision-making process, especially when considering the complexity of the social-ecological system and the limited resources to solve real-world problems. After human activities are abandoned, ecosystems go through different successional trajectories and self-regulation processes, giving rise to novel species configurations with their own ecological dynamics. Furthermore, novel or emerging ecosystems have composition and relative abundance patterns not previously seen in a given biome. They have arisen from anthropogenic environmental changes, changes in land use, introduction of exotic species or a combination of these factors . These eet al. [There is an ongoing debate whether the novel ecosystem conceptual framework is useful for restoration ecologists and managers or a nuisance and inconvenient proposal ,30. Someet al.  proposedet al. .It is our understanding that the novel ecosystem concept has clear intellectual links with another novel conceptual framework: biocultural diversity. Both of these conceptual frameworks are clear attempts to frame humans and the environment in a non-dichotomous, ‘people as part of nature’ mode of investigation. Biocultural diversity, defined as the diversity of life in all its manifestations , has come to be understood as inter-related within complex and adaptive social-ecological systems . Therefo. 1.4Ecosystem structure, on a wide scale, is predominantly explained by the variation in the physical environment, just as its current structure is strongly influenced by historical processes . Our appHistorically, the proximity of the mountains to the city of Rio de Janeiro was responsible for transforming the Atlantic Forest covered slopes into areas for coffee plantations in the nineteenth century. Forest cover was also converted into pastures for horses used in urban transport and mainly as a source of firewood and eventually becoming a centre for the manufacture of charcoal. The demand for this energy source  was considerable for the rising metropolis, becoming the main energy matrix for the city. Charcoal was used in factories, domestic use and in civil construction. Forges spread throughout the city, using charcoal as its basic input. They manufactured articles such as axes, hoes, sickles, car wheel rims and horseshoes, used for the hulls of the muar and equine troops. In Brazil, practically until the nineteenth century, a millenary process of direct reduction of ore  was performed in small ovens using charcoal in the process. This charcoal production by use of forest biomass caused numerous modifications of the Atlantic Forest; however, many of the forest attributes were regenerated through natural ecological succession. The successional trajectory of the natural regeneration, in many parts of the forest, consists of novel species assemblages, i.e. novel ecosystems.Although the Atlantic Forest is researched by several fields of scientific investigation, important knowledge gaps remain regarding its past use and dynamics. Furthermore, when carried out, research on the history of the Atlantic Forest is interested in a ‘macro history’ that considers major events such as coffee planting, deforestation, the water crisis and reforestation, using sources such as written documents and iconography. Our interest is to analyse the landscape transformations that occurred in the urban forests of Rio de Janeiro, considering the forms and practices spatially and temporally situated from the traces present in the forest today and taking the landscape in itself as a historical document . Our maiThe main goal of this paper is to investigate the practices of the charcoal workers and the legacies derived from their work, since the social invisibility at that time has now become an invisibility of their memory, their legacies in the forest and their crucial participation in the supply of energy for the city of Rio de Janeiro. Besides the ‘detective work’ in the landscape and the use of other documents, which are informed by historical geography, environmental history and historical ecology, we apply the social-ecological systems framework to gain insight and better understanding of the historical interconnectedness of charcoal producers with the forest, and to the underlying social-ecological legacies and biocultural diversity found in the contemporary urban forests of Rio de Janeiro, information without which it is not possible to carry out an adequate landscape management.. 2. 2.12 total territorial area, 600 km2 are urbanized, and with a population of 6 781 903 residents [2. The presence of these mountains generates a particular and uneven distribution of the city, composing an extremely diverse landscape. In this way, the presence of forests, beaches and mountain massifs contribute to the configuration and identity of the city, that also provide important ecosystem services.2 The juxtaposition of natural elements and the urban matrix is a hallmark of the city, producing a strong image with global recognition. This harmonious mixture led to UNESCO naming Rio, in 2012, the title of World Heritage in the Cultural Landscape category [Our study was conducted in two large urban forest remnants of the Atlantic Forest biome, in the city of Rio de Janeiro: Pedra Branca and Tijuca. The city of Rio de Janeiro is the second largest urban city in Brazil and one of the largest economic and cultural centres in Latin America. In its 1204 kmesidents . It has category . We intequilombola3 populations [In the last 500 years, Brazilian ecosystems have undergone major transformations, the Atlantic Forest being one of the biomes that suffered most from these changes. The social-ecological legacy imprinted on the Atlantic Forest landscape is derived from economic activities such as monocultures of sugar cane and coffee. The current configuration of this biome comprises extensive deforested areas, bare hillsides, silted rivers and forest remnants practically restricted to sloping and difficult to access land, in the form of secondary forests of different ages and successional trajectories ,42. The ulations . The pea. 2.2This paper in part synthesizes past studies conducted by two of the authors in the last decade, mostly published in Portuguese, and that can reach a new audience. We further apply the social-ecological systems framework proposed by Ostrom ,49, a noet al. [Our historical-ecological mode of investigation is closely associated to the retrospective studies tradition in historical geography ,50 and tet al. , or fromet al. .Ficus sp. genus) [rcGis 10.2.1 software and developed the maps using the UTM 23S projection and WGS 84 Datum [The present study was carried out in the two massifs in Rio de Janeiro city (Tijuca and Pedra Branca), that historically have been the open air laboratories for numerous ecological, social-ecological and historical-ecological ‘detective-work’ investigations by the authors in the past 20 years. Concerning sampling techniques, we employed field methods from historical ecology and geography to obtain spatial data on the location in the current forest remnants of important landscape legacies. Systematic and random field explorations were carried out in order to locate and georeference old charcoal kilns  ,58. All Throughout the past decade vegetation structure and composition inventories were carried out in different sites with evidence of charcoal production in the past, in both remnant forest areas, in order to understand how natural regeneration of the forest occurred and what successional pathway it went. We used field plots of 10 × 10 m or 5 × 20 m, depending on site characteristics, geographical aspects and charcoal production site distribution .et al. [The method for calculating the energy conversion of the produced charcoal is found in Oliveira et al.  and Olivet al. . For theet al. ).For the application of the social-ecological systems framework, we employed Ostrom's methodological approach ,49 also . 3. 3.1Charcoal was the energy matrix of the city of Rio de Janeiro from the nineteenth century to mid-twentieth century. This form of energy was used in industry, for locomotives, in iron manufacturing, for domestic use, all of which enabled urban sprawl . It was carvoeiros) are coated with racial discrimination and prejudice of social status [quilombolas. In addition, their work was located in the mountains and forests on the fringes of this booming city [A limited amount of written documentation exists about charcoal production prior to the twentieth century. References of charcoal producers, the main agents of this process, are even more scarce. In nineteenth century newspapers, the few mentions of these charcoal workers  and guaranteed relative independence. Owing to the sparse documentation, the activity of the charcoal workers must be understood through the remnants of their material culture, signs and traces of which are visible in the current landscape. These include landmarks such as ruins and plateaus, tools and objects and the structure and composition of the current vegetation.Socially and spatially marginalized,quadro geográfico), referring to geography as a way of structuring thought, as a graphic analysis in which we must consider different components  and as a composition on which the spatial relationships between such components should be analysed [Borrowing a concept from Brazilian Geographer Paulo Cesar da Costa Gomes, such evidence constitutes today a ‘geographical frame’  as a form of respect of its ancestral legacy, or for religious beliefs of both Christian and African based religions that valued large fig trees (Ficus sp.) owing to their religious meaning and representation5; and (ii) for practical reasons as felling and transporting large trees would require a great expenditure of labour. Taking this cultural practice into account and excluding individuals with a diameter greater than 40 cm, Sales et al. [3 firewood ha−1 for forest tracts at different successional stages. The preservation of larger trees facilitates ecological succession and constitutes a cultural practice and labour technique that reduces overexertion. The main result of this was selective logging instead of clear cutting for charcoal production, which would facilitate and accelerate natural regeneration in charcoal production sites. This small detail, driven by cultural values and labour techniques, was an important component of the workers' management planning that led to a decrease of biomass recovery time. This is the first step in understanding this invisible and artisanal practice as being ecologically less impactful (considering its landscape legacies), compared to other land uses of the period, such as coffee monoculture.Patzlaff et al.  propose et al. . Solórza [et al.  calculat [et al. . Howevers et al.  estimate. 3.26 we estimate that at least 3000 more charcoal production sites can be found in the urban remnant forests of Rio de Janeiro. The same forest space is shared by ruins (foundations) of old houses and coffee farms, water catchment systems, ancient bridges and stone paths. In the Pedra Branca forest 104 ruins were found and in the Tijuca Massif 107 ruins were found. It is possible to establish a relationship between the ruins and the charcoal labourers’ activities. It is very likely that the exploration being carried out in remote locations, on the slopes of these mountains, required the charcoal workers to live close to the production sites. Abandoned foundations made of stones are commonly found close to the charcoal production sites [7 was preferably located in steep and elevated areas, distant from level terrain and unsuitable for agriculture. This landscape occupation pattern is suggestive that the charcoal workers did not compete with farmers, who had their plantations and houses located in the piedmont region of the massifs. It also suggests that this exploitation was not being carried out at the behest of these wealthy landowners or by socially accepted farmers. It is very likely that they did not want to be seen or discovered. After the abolition of slavery, this occupation pattern of elevated forested areas was maintained, suggesting that it was a parallel and marginal occupation to the farmers and land owners.At present, 1176 charcoal kilns have been found and mapped in the Pedra Branca Massif and 346 in the Tijuca Massif , surrounding vegetation and physical factors  ,71. DespArtocarpus heterophyllus Lam.), a fruit species native of southeast Asia, was introduced to feed the slave populations in the farms and it was also consumed by the charcoal workers owing to its abundance and low cost [carioca8 culture with the jackfruit [a) and among old charcoal production sites (b), the jackfruit comprises up to 70% of relative density and dominance of these forest tracts. Thus, the jackfruit represents a legacy of human presence in the forest, as a biocultural element that makes up the social-ecological system of the Tijuca Forest, composing what has been classified as jackfruit novel ecosystems (b). Other fruit species such as mango (Mangifera indica L.), rose-apple (Syzigium jambos (L.) Alston), persimmon (Diospyros kaki Thunb.) and banana (Musa paradisiaca L.) can easily be found along the forest edge, in abandoned farm sites (Tijuca Massif) and intermixed with the forest in small orchards and plantations  [Species introduction in these forests provided a source of novelty and vegetation change. In the Pedra Branca and Tijuca Massif, jackfruit  ,52,58,742 ha−1. The participation of the jackfruit in the biomass resilience9 of the forest shows how valuable this species can be to the system. Retaining and expanding biomass, sequestering carbon from the atmosphere, providing tree cover and forest stratification, in addition to providing a rich and abundant food for both fauna and humans, are some of the important ecosystem services provided by these novel ecosystems [It is important to highlight that although species diversity is lower and composition is very distinct from its original state these novel ecosystems recovered forest biomass and functionality. In these novel ecosystem sites, basal area (an indicator for biomass), is as large or even larger than conserved or historical forest tracts, reaching up to 118 mosystems ,58.Guarea guidona L. (Sleumer), a native early-secondary tree species shows a pattern of high longevity, density and super dominance in sites of previous charcoal production [G. guidonia [G. guidonia can be used as an indicator species for areas used for charcoal production and agriculture in the nineteenth century, when presenting elevated density and dominance.Vegetation also changes in subtle ways, not only from exotic species introduction, but with modification of native species distribution, density and dominance pattern. Ecological novelty includes never before seen patterns of species composition and relative abundance in a given biome , that cooduction ,76,77. Tguidonia . Because. 3.4Another aspect of the forest exploration concerns the energy produced from the charcoal workers' labour. In global terms, its production reaches very significant numbers, considering only the 1522 charcoal plants discovered so far in both massifs. Assuming that each one has been used on average eight times , the totIn the absence of studies referring to the study area we used data from nearby areas, obtained from the indicated research –80. The . 3.5In order to better understand the complex social and ecological interactions and legacies that involved charcoal production in the forests of the Tijuca and Pedra Branca massifs, we applied the social-ecological systems framework proposed by McGinnis & Ostrom . First, carioca society. We elaborated a schematic representation of this past social-ecological system  and subsequent second-tier variables with concise descriptions in l system  in order–60%. In other words, there was a return of tree biomass that was not accompanied by the recovery of forest diversity. Although the forest has recovered owing to the process of ecological succession that occurred after the abandonment of charcoal activities, the ecosystem has kept marks of this history in many of its attributes, such as long living early-secondary native and exotic species . In summary, from a strictly biological point of view, the forest recovered after the abandonment of charcoal manufacturing, with biomass resilience and the maintenance of structure and functionality but modification of species composition . It is necessary to understand the social-ecological system as a whole; that is, understanding social relations and also the biotic and abiotic world. The transformation of these forested mountain landscapes into natural parks  helped to crystallize, simultaneously, the resilience of the ecological system and the lack of memory in relation to the work incorporated in it. Of that history, the only document that remained are the landscape marks etched by the hands of poor charcoal workers, today transformed into beautiful natural parks, which hides, in the middle of a dense forest, an intense history of invisibility and inequality of an important segment of Rio's society.Regarding economical aspects, this activity was essential for urban-industrial growth, considering that the massive amount of charcoal produced was able to feed the expanding metropolis of Rio de Janeiro, especially at the turn of the nineteenth to the twentieth century. In this sense, the social-ecological metabolism of the city was completely interconnected with the forest dynamics and charcoal producers. However, with regard to the social conditions, practically nothing happened to the main actors involved in the entire process . They did not receive the social benefits of a growing city; on the contrary, they were cast aside as a population living in the fringes of a booming society. Most of the charcoal workers' descendants currently live in the city slums and are linked to the poorest sections of the population, with a low Human Development Index. Some still live in small rural communities or as isolated forest dwellers g. It is Today this complex social-ecological system of Rio de Janeiro can be understood as a result of hundreds of years of humans interacting with the forest. These urban forests are a complex mosaic of novel and hybrid ecosystems, together with managed lands and well conserved forest tracts, with people living in close contact to the forest and even within the large forest remnants. In other words, they are cultural forests with a rich history hidden beneath their canopy.favelas or quilombos, on the fringes of the forest massifs, or are currently forest dwelling subsistence farmers, all of whom are living in varying degrees of socio-economic vulnerability.The main takeaways from the social-ecological system analysis (organized in . 3.6c–g). Both are considered market crops and are grown together with other products that guarantee self-consumption or can also be sold. Banana trees and other crops (such as persimmon and manioc), in addition to guaranteeing the farmers social reproduction, also fulfil the role of marking the existence of farmers in the forested landscape. These hybrid forest-orchard systems are formed by paths, wooden houses, fences and pack animals. An in depth reflection regarding the coexistence between natural and agricultural environments implies considering the complexity of agricultural systems with all their elements—plants and animals, objects, food, techniques, forms of knowledge and space—since in situ conservation of agrobiodiversity represents the protection of cultural identities, social territories, local knowledge systems and corresponding ways of life. Also from the perspective of biocultural diversity, the savoir-faire and the cultural wealth of agricultural management techniques are also in themselves worthy of protection and heritage. It is important to note the efforts of flexible (and perhaps not purposeful) management of the Pedra Branca State Park to incorporate quilombo communities and areas of persimmon and banana production, important biocultural forest products, within its limits, albeit with some territorial conflicts unsolved. Thus, the complex mosaic of novel-hybrid-managed-conserved forest systems provides not only livelihood and sustenance for forest dwelling families but also important ecosystem services, such as areas for recreation and religious practice [According to Oliveira & Fernandez , bananasfigure 6practice , soil prfavela communities. The understanding of the historical and biocultural aspects of current jackfruit distribution in the forest, which developed into novel ecosystems, can be helpful for Tijuca National Park managers. Because jackfruit novel ecosystems have surpassed a social-ecological threshold and are a part of the forest ecosystem , management has focused on tree-barking techniques (i.e. killing adult trees) to control jackfruit populations from expanding towards core areas of the park. However, another management technique for population control would be to remove the fruits from jackfruit trees in critical areas, impeding new jackfruit seedlings and saplings from establishing and growing.10 A second step of this novel ecosystem management proposal would be to benefit local communities with the collected jackfruits, and even carefully planning and regulating jackfruit removal for personal consumption in communities that border the forest. This could address ecological goals (controlling the expansion of an exotic species for conservation management) and social objectives such as food security and community empowerment, which are also important goals of the biocultural diversity perspective. By applying a non-dichotomous framework—such as social-ecological systems, novel ecosystems and biocultural diversity—, there is a vast opportunity to control what is considered a harmful invasive species while benefiting local livelihoods, through an ‘eat it to beat it’ style of management [carioca perception of jackfruit, to its earlier historical view of a useful tree that offers abundant fruits. As vegetarian diets, local sustainable food consumption and agroforestry food production are becoming more popular in Rio de Janeiro, jackfruit has ample space for a growing market of conscious consumers.In the Tijuca Massif, we are met with other landscape legacies and challenges. Considered by many ecologists and park managers as being an invasive species , jackfrunagement . This wo. 4After almost two centuries of regeneration, the legacies of past human activities are observable in the structure, composition and functionality of the forest. The interaction of these land uses with natural processes and the intrinsic properties of the landscape combined to create the forest mosaic existing in the present. We can argue that, although not purposeful, the forest management carried out by the charcoal producers, in its spatial and temporal settings, facilitated ecological recovery , yet socially did not improve their own livelihood and wellbeing, as they remained invisible and marginalized. The artisanal technique used (with a simple axe and fire), the low population density, the spatial diffusion of its practice, their ecological knowledge about the forest, the practice of sparing large trees , as well as the natural regeneration coupled with the introduction of exotic species , leads to the conclusion that charcoal production by the marginalized population of the nineteenth and early twentieth centuries facilitated forest recovery and biomass resilience, at the cost of their own invisibility and marginalization.favelas.Other practices that have occurred in forested areas, such as coffee production or animal husbandry, left disastrous land use legacies. In the first case, an effort to expropriate coffee farms and the implementation of the first reforestation project in Brazil was necessary to induce and assist forest regeneration. In the second case, the social-ecological legacies led to a total alteration of the structure, composition and functionality of the system that remained ‘frozen’ in an alternative state of plant succession, where exotic grasses dominate the landscape. Few trees are able to survive in an environment that has become prone to periodic fires, resembling it to a novel savannah-grassland ecosystem, notably in the northern slopes of the two forest massifs. Reforestation efforts in the north facing slopes of Tijuca and Pedra Branca massifs have a low success rate and is further hindered by the difficult access to these areas, which are surrounded by drug traffic controlled Charcoal production was the main source of energy and played a central role in the construction of Rio de Janeiro's social-ecological history. This chapter of history is slowly coming into light through recent publication of historical geography and historical ecology. These interdisciplinary disciplines, which are now part of the emerging field of environmental humanities, have raised important awareness on how forest and society are interconnected and interdependent, in the past and present, providing useful information for policy makers and park managers. The application of the social-ecological systems framework helped to elucidate some points of interconnection between the charcoal workers and the forest, not only as energy suppliers to the city, but as important producers of their living and working domains, generating palaeo-territories and novel ecosystems that today we find hidden in the forest. Although this paper considers the practice of charcoal production in the nineteenth to twentieth centuries to allow for forest natural regeneration, we do not advocate that this practice be resumed today. On the contrary, the forest reserves that were implemented as a national and state park have an important role in maintaining important ecosystem services for the city, conserving the rich remaining biodiversity, sheltering native (and exotic) species of flora and fauna and spaces for recreation and spiritual practices with the forest.Exotic species are often seen as inherently bad or negative to the ecological system, incorporating conservation values more often than scientific evidence. For instance, jackfruit is at the centre of this debate, where many environmentalists consider it to be an invasive species that needs to be eliminated from the forest in order to achieve the historical baseline of species composition . However, the overwhelming evidence confirming that humans are changing Earth in unprecedented ways (i.e. the Anthropocene) has led to the understanding of shifting historical baselines (of biotic communities and abiotic environments). Therefore, the decision for any specific baseline is a political one, based on a specific set of values (such as pristine nature) and not a scientific one . A sociaet al. [Novel and hybrid ecosystems are fundamentally social and ecological. They emerge from the intersection of self-regulated nature and human intervention. In addition to being partly social-cultural creations novel ecosystems provide many important goods and services, including places to connect with nature, sources of drinking water, resources for local livelihoods and refuges for different species . Accordiet al. , there met al.  and worket al. . This paet al. .We believe that these concepts and frameworks can offer practical solutions for urban forest management. Exotic fruit species are an inherent element of the biocultural diversity of Rio de Janeiro ,89 that Click here for additional data file.