3D printing is an essential technology for clinical decision-making, affording significant improvements over conventional imaging alone. Product usefulness surveys offer potential in measuring the quality and impact of 3DP to assist clinical decision-making and patient communication. A narrative literature review (Scoping Review articles only) frames the benefits and limitations of 3D print surgical workflow and user experiences. A usability survey was co-designed with a company to measure the impact of their 3D prints on surgical practice, and secondary data analysis was conducted of to understand the effectiveness and usefulness of the technology in a real-world healthcare setting. Three categories of usefulness and relevance were identified. High-value relevance (positive Likert scores over 70%) related to pre-operative planning, clinical communication, and the value of the technology. Moderate scores (50% to 69%) related to time saving with pre-operative surgery, and effectiveness of patient care and diagnosis. Minor relevance (less than 50%) included direct cost savings, physical resource efficiencies, time in intra-operative surgery, or intra-operative risks. This research considers 3D printings relationship to medical error prevention, limitations and future recommendations for usability surveys of this type and it identified issues around gender inclusion in Design for Health research.

Over 200 health journals call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must betackledtogethertopreservehealthandavoidcatastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28 th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16 th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: "Only by considering climate and biodiversity as parts of thesamecomplexproblem…cansolutionsbedevelopedthat a v o i dm a l a d a p t a t i o na n dm a x i m i z et h eb e n e fi c i a lo u t c o m e s (Otto-Portner et al., 2021)." As the health world has recognised with the development of theconceptofplanetaryhealth,thenaturalworldismadeup of one overall interdependent system. Damage to one subsystem can create feedback that damages another-for example, drought, wildfires, floods and the other effects of rising global temperatures destroy plant life, and lead to soil erosion and so inhibit carbon storage, which means more global warming (Ripple et al., 2023) . Climate change is set to overtake deforestation and other land-use change as the primary driver of nature loss (European Academies Science Advisory Council 2021). Nature has a remarkable power to restore. For example, deforested land can revert to forest through natural regeneration, and marine phytoplankton, which act as natural carbon stores, turn over one billion tonnes of photosynthesising biomass every eight days (Falkowski, 2012) . Indigenous land and sea management has a particularly important role to play in regeneration and continuing care (Dawson et al., 2021) . Restoring one subsystem can help another-for example, replenishing soil could help remove greenhouse gases from theatmosphereonavastscale (Bossioetal.,2020). But actions that may benefit one subsystem can harm another-for example, planting forests with one type of tree can remove carbon dioxide from the air but can damage the biodiversity that is fundamental to healthy ecosystems (Levia et al., 2020) .