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Measures of climate change adaptation often involve modification of land use and land use planning practices. Such changes in land use affect the provision of various ecosystem goods and services. Therefore, it is likely that adaptation measures may result in synergies and trade-offs between a range of ecosystems goods and services. An integrative land use modelling approach is presented to assess such impacts for the European Union. A reference scenario accounts for current trends in global drivers and includes a number of important policy developments that correspond to on-going changes in European policies. The reference scenario is compared to a policy scenario in which a range of measures is implemented to regulate flood risk and protect soils under conditions of climate change. The impacts of the simulated land use dynamics are assessed for four key indicators of ecosystem service provision: flood risk, carbon sequestration, habitat connectivity and biodiversity. The results indicate a large spatial variation in the consequences of the adaptation measures on the provisioning of ecosystem services. Synergies are frequently observed at the location of the measures itself, whereas trade-offs are found at other locations. Reducing land use intensity in specific parts of the catchment may lead to increased pressure in other regions, resulting in trade-offs. Consequently, when aggregating the results to larger spatial scales the positive and negative impacts may be off-set, indicating the need for detailed spatial assessments. The modelled results indicate that for a careful planning and evaluation of adaptation measures it is needed to consider the trade-offs accounting for the negative effects of a measure at locations distant from the actual measure. Integrated land use modelling can help land use planning in such complex trade-off evaluation by providing evidence on synergies and trade-offs between ecosystem services, different policy fields and societal demands. © 2012 The Author(s).

<i>Objectives:</i> To assess the feasibility of case finding with regard to genetic disorders through the Primary Health Care Genetic Services System in the rural Northern Province, which is one of the poorest and least developed provinces in South Africa. <i>Methods:</i> Achondroplasia was used as the object of this pilot study. Genetically trained nurses invited patients with known or suspected achondroplasia to attend a clinic. The patients were seen by two medical students and a genetic scientist, who selected cases meeting predefined clinical and anthropometric criteria. X-rays were taken and blood was sampled for mutation analysis. The study took place in the period from March to August 1997. The patients were seen at six local hospitals. Reviewing of the X-rays and mutation analysis took place in Amsterdam, The Netherlands. <i>Results:</i> Thirty-one patients were selected and invited to the clinics. From this group, presented to the medical students, 17 patients were thought to have achondroplasia. The selection was based on clinical features and anthropometrical measurements. After reviewing the X-rays and adding the results from the mutation analysis, 15 out of these 17 patients were diagnosed as having achondroplasia. <i>Conclusion:</i> The genetic nursing system proved to be effective for case finding in this rural setting. The system may serve as a model for genetic services in other underdeveloped regions.