109 research outputs found

    Can we be both resilient and well, and what choices do people have? Incorporating agency into the resilience debate from a fisheries perspective.

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    In the midst of a global fisheries crisis, there has been great interest in the fostering of adaptation and resilience in fisheries, as a means to reduce vulnerability and improve the capacity of fishing society to adapt to change. However, enhanced resilience does not automatically result in improved well-being of people, and adaptation strategies are riddled with difficult choices, or trade-offs, that people must negotiate. This paper uses the context of fisheries to explore some apparent tensions between adapting to change on the one hand, and the pursuit of well-being on the other, and illustrates that trade-offs can operate at different levels of scale. It argues that policies that seek to support fisheries resilience need to be built on a better understanding of the wide range of consequences that adaptation has on fisher well-being, the agency people exert in negotiating their adaptation strategies, and how this feeds back into the resilience of fisheries as a social-ecological system. The paper draws from theories on agency and adaptive preferences to illustrate how agency might be better incorporated into the resilience debate

    Developing a people-centred approach to the coastal management of Pulicat lake, a threatened coastal lagoon in South India

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    Multiple dimensions of wellbeing in practice

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    In 2005 the Millennium Ecosystem Assessment (MA) placed the relationship between human wellbeing and ecosystems firmly at the centre of the agenda for academics and policy makers concerned with sustainable development for the following decades (MA, 2005). The decision to use the concept of human wellbeing was relatively novel and ambitious at the time. Four years later, that decision was decisively underlined by the Commission on the Measurement of Economic Performance (Stiglitz et al., 2009), commissioned by the then French President Nicolas Sarkozy and chaired by Joe Stiglitz, Amartya Sen and Jean-Paul Fitoussi. This report made a comprehensive case that if we are to achieve sustainable and inclusive development in our societies, then it is necessary to reform our major systems of statistical data collection from being focused on measuring progress in terms of production and consumption, to measuring it in terms of human wellbeing. Since that report there has been an explosion of initiatives to conceptualise and measure human wellbeing, and to put it into practice in academia and policy (Bache and Reardon, 2016; Helliwell et al., 2017)

    Money, use and experience: Identifying the mechanisms through which ecosystem services contribute to wellbeing in coastal Kenya and Mozambique

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    Despite extensive recent research elucidating the complex relationship between ecosystem services and human wellbeing, little work has sought to understand how ecosystem services contribute to wellbeing and poverty alleviation. This paper adopts concepts from the “Theory of Human Need” and the “Capability Approach” to both identify the multitude of links occurring between ecosystem services and wellbeing domains, and to understand the mechanisms through which ecosystem services contribute to wellbeing. Focus Group Discussions (N = 40) were carried out at 8 sites in Mozambique and Kenya to elicit how, why, and to what extent benefits derived from ecosystem services contribute to different wellbeing domains. Our results highlight three types of mechanisms through which ecosystem services contribute to wellbeing, monetary, use and experience. The consideration of these mechanisms can inform the development of interventions that aim to protect or improve flows of benefits to people. Firstly, interventions that support multiple types of mechanisms will likely support multiple domains of wellbeing. Secondly, overemphasising certain types of mechanism over others could lead to negative social feedbacks, threatening the future flows of ecosystem services. Finally, the three mechanism types are interlinked and can act synergistically to enhance the capacities of individuals to convert ecosystem services to wellbeing

    Why gender matters for biodiversity conservation

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    Addressing gender inequality in biodiversity conservation is fundamental to meeting the goals and targets of the Convention on Biological Diversity’s (CBD) Post-2020 Global Biodiversity Framework, and building synergies with the Sustainable Development Goals. There are positive outcomes for nature, equity and sustainability, and for overall community wellbeing when women access and control biodiversity and natural resources, can benefit equally from nature, and participate meaningfully in biodiversity-related decision making. This briefing provides evidence of the value of integrating gender into conservation interventions, suggesting that Parties to the CBD should therefore prioritise the gender-responsive implementation of the Post-2020 Global Biodiversity Framework, using the Gender Plan of Action as a guiding mechanism. It identifies key avenues for effective action on the ground, based on evidence from successful interventions

    Regional cerebral blood flow single photon emission computed tomography for detection of Frontotemporal dementia in people with suspected dementia.

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    BACKGROUND: In the UK, dementia affects 5% of the population aged over 65 years and 25% of those over 85 years. Frontotemporal dementia (FTD) represents one subtype and is thought to account for up to 16% of all degenerative dementias. Although the core of the diagnostic process in dementia rests firmly on clinical and cognitive assessments, a wide range of investigations are available to aid diagnosis.Regional cerebral blood flow (rCBF) single-photon emission computed tomography (SPECT) is an established clinical tool that uses an intravenously injected radiolabelled tracer to map blood flow in the brain. In FTD the characteristic pattern seen is hypoperfusion of the frontal and anterior temporal lobes. This pattern of blood flow is different to patterns seen in other subtypes of dementia and so can be used to differentiate FTD.It has been proposed that a diagnosis of FTD, (particularly early stage), should be made not only on the basis of clinical criteria but using a combination of other diagnostic findings, including rCBF SPECT. However, more extensive testing comes at a financial cost, and with a potential risk to patient safety and comfort. OBJECTIVES: To determine the diagnostic accuracy of rCBF SPECT for diagnosing FTD in populations with suspected dementia in secondary/tertiary healthcare settings and in the differential diagnosis of FTD from other dementia subtypes. SEARCH METHODS: Our search strategy used two concepts: (a) the index test and (b) the condition of interest. We searched citation databases, including MEDLINE (Ovid SP), EMBASE (Ovid SP), BIOSIS (Ovid SP), Web of Science Core Collection (ISI Web of Science), PsycINFO (Ovid SP), CINAHL (EBSCOhost) and LILACS (Bireme), using structured search strategies appropriate for each database. In addition we searched specialised sources of diagnostic test accuracy studies and reviews including: MEDION (Universities of Maastricht and Leuven), DARE (Database of Abstracts of Reviews of Effects) and HTA (Health Technology Assessment) database.We requested a search of the Cochrane Register of Diagnostic Test Accuracy Studies and used the related articles feature in PubMed to search for additional studies. We tracked key studies in citation databases such as Science Citation Index and Scopus to ascertain any further relevant studies. We identified 'grey' literature, mainly in the form of conference abstracts, through the Web of Science Core Collection, including Conference Proceedings Citation Index and Embase. The most recent search for this review was run on the 1 June 2013.Following title and abstract screening of the search results, full-text papers were obtained for each potentially eligible study. These papers were then independently evaluated for inclusion or exclusion. SELECTION CRITERIA: We included both case-control and cohort (delayed verification of diagnosis) studies. Where studies used a case-control design we included all participants who had a clinical diagnosis of FTD or other dementia subtype using standard clinical diagnostic criteria. For cohort studies, we included studies where all participants with suspected dementia were administered rCBF SPECT at baseline. We excluded studies of participants from selected populations (e.g. post-stroke) and studies of participants with a secondary cause of cognitive impairment. DATA COLLECTION AND ANALYSIS: Two review authors extracted information on study characteristics and data for the assessment of methodological quality and the investigation of heterogeneity. We assessed the methodological quality of each study using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool. We produced a narrative summary describing numbers of studies that were found to have high/low/unclear risk of bias as well as concerns regarding applicability. To produce 2 x 2 tables, we dichotomised the rCBF SPECT results (scan positive or negative for FTD) and cross-tabulated them against the results for the reference standard. These tables were then used to calculate the sensitivity and specificity of the index test. Meta-analysis was not performed due to the considerable between-study variation in clinical and methodological characteristics. MAIN RESULTS: Eleven studies (1117 participants) met our inclusion criteria. These consisted of six case-control studies, two retrospective cohort studies and three prospective cohort studies. Three studies used single-headed camera SPECT while the remaining eight used multiple-headed camera SPECT. Study design and methods varied widely. Overall, participant selection was not well described and the studies were judged as having either high or unclear risk of bias. Often the threshold used to define a positive SPECT result was not predefined and the results were reported with knowledge of the reference standard. Concerns regarding applicability of the studies to the review question were generally low across all three domains (participant selection, index test and reference standard).Sensitivities and specificities for differentiating FTD from non-FTD ranged from 0.73 to 1.00 and from 0.80 to 1.00, respectively, for the three multiple-headed camera studies. Sensitivities were lower for the two single-headed camera studies; one reported a sensitivity and specificity of 0.40 (95% confidence interval (CI) 0.05 to 0.85) and 0.95 (95% CI 0.90 to 0.98), respectively, and the other a sensitivity and specificity of 0.36 (95% CI 0.24 to 0.50) and 0.92 (95% CI 0.88 to 0.95), respectively.Eight of the 11 studies which used SPECT to differentiate FTD from Alzheimer's disease used multiple-headed camera SPECT. Of these studies, five used a case-control design and reported sensitivities of between 0.52 and 1.00, and specificities of between 0.41 and 0.86. The remaining three studies used a cohort design and reported sensitivities of between 0.73 and 1.00, and specificities of between 0.94 and 1.00. The three studies that used single-headed camera SPECT reported sensitivities of between 0.40 and 0.80, and specificities of between 0.61 and 0.97. AUTHORS' CONCLUSIONS: At present, we would not recommend the routine use of rCBF SPECT in clinical practice because there is insufficient evidence from the available literature to support this.Further research into the use of rCBF SPECT for differentiating FTD from other dementias is required. In particular, protocols should be standardised, study populations should be well described, the threshold for 'abnormal' scans predefined and clear details given on how scans are analysed. More prospective cohort studies that verify the presence or absence of FTD during a period of follow up should be undertaken

    Ecosystem services, well‐being benefits and urbanization associations in a Small Island Developing State

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    1. Urbanization is a key driver of social and environmental change world‐wide. However, our understanding of its impacts on the multidimensional well‐being benefits that people obtain from ecosystems remains limited. 2. We explored how the well‐being contributions from land‐ and seascapes varied with urbanization level in the Solomon Islands, a fast‐urbanizing Small Island Developing State. Drawing on the social well‐being framework, we compared perceived well‐being benefits derived from ecosystem services in paired urban and rural sites. 3. Our analysis of 200 semi‐structured interviews revealed complex associations between provisioning, regulating and cultural services and well‐being benefits, with all ecosystem services contributing to material, relational and subjective well‐being dimensions. 4. Although patterns of associations between ecosystem services and well‐being benefits were similar between urban and rural dwellers, urban dwellers reported significantly fewer material, relational and subjective well‐being benefits. The most important differences between urban and rural dwellers were in terms of meeting basic material needs (e.g. income and material comfort), feeling connected to nature and feeling happy and satisfied. 5. With urbanization, livelihood activities transition from being subsistence‐based to income‐generating, which is also associated with increased wealth in urban areas. Similar to the relationship between ecosystem service well‐being benefits and urbanization, material wealth was negatively associated with perceptions of well‐being benefits. People with less material wealth appeared more reliant on nature for their multidimensional well‐being. 6. Our findings demonstrate that the altered human–nature relationships in urban areas are associated with decreases in multidimensional well‐being that people derive from nature. Improving access to particular ecosystem services, which make clear contributions to multidimensional well‐being, could be a focus for urban planners and environmental management where enhanced human–nature relationships and poverty alleviation are central goals

    The Past, Present and Future of Sleep Measurement in Mild Cognitive Impairment and Early Dementia – Towards a Core Outcome Set:A Scoping Review

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    STUDY OBJECTIVES: Sleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment. METHODS: This review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure. RESULTS: Nineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters. CONCLUSIONS: Alongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions
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