Resilience: An Annotated Bibliography

This annotated bibliography provides an account of the research that has been done on engineering resilience, ecological resilience, and social-ecological resilience. Undertaken as part of the WEPGN research project titled “Applying resilience analysis to a transboundary river system: Developing surrogates for institutions and governance”, this annotated bibliography investigates factors that lead to greater resilience, with a focus on institutions and governance. Citations for key scholarly publications related to three types of resilience – engineering, ecological, and social-ecological – are listed in the first three sections along with a brief summary of each work. The fourth and final section of the document provides additional resources on resilience

Impact of orphan drugs on Latvian budget

Publisher Copyright: © 2016 Logviss et al.Background: Number of orphan medicinal products on the market and number of rare disease patients, taking these usually expensive products, are increasing. As a result, budget impact of orphan drugs is growing. This factor, along with the cost-effectiveness of orphan drugs, is often considered in the reimbursement decisions, directly affecting accessibility of rare disease therapies. The current study aims to assess the budget impact of orphan drugs in Latvia. Methods: Our study covered a 5-year period, from 2010 to 2014. Impact of orphan drugs on Latvian budget was estimated from the National Health Service's perspective. It was calculated in absolute values and relative to total pharmaceutical market and total drug reimbursement budget. A literature review was performed for comparison with other European countries. Results: Orphan drug annual expenditure ranged between EUR 2.065 and 3.065 million, with total 5-year expenditure EUR 12.467 million. It constituted, on average, 0.84 % of total pharmaceutical market and 2.14 % of total drug reimbursement budget, respectively. Average annual per patient expenditures varied widely, from EUR 1 534 to EUR 580 952. The most costly treatment was enzyme replacement therapy (Elaprase) for MPS II. Glivec had the highest share (34 %) of the total orphan drug expenditure. Oncological drugs represented more than a half of the total orphan drug expenditure, followed by drugs for metabolic and endocrine conditions and medicines for cardiopulmonary diseases. Three indications: Ph+ CML, MPS II, and PAH accounted for nearly 90 % of the total orphan drug expenditure. Conclusions: Budget impact of orphan drugs in Latvia is very small. It increased slightly over a period of five years, due to the slight increase in the number of patients and the number of orphan drugs reimbursed. Current Latvian drug reimbursement system is not sufficient for most orphan drugs.publishersversionPeer reviewe

Pushing the Boundaries of Freshwater Ecosystem Restoration: Evaluating a Conservation Initiative in Terms of Social-Ecological Resilience

Freshwater ecosystems are among the most transformed systems on Earth despite their critical importance to human well-being. This research utilized a single case, embedded case study design to explore the possibility of an approach to aquatic ecosystem restoration informed by social-ecological resilience as a way of applying current understandings of complex adaptive systems to restoration for improved outcomes. Trout Unlimited Canada’s Stream Rehabilitation, From Form to Function Training Program was assessed and restoration initiatives informed by the program were evaluated in terms of social-ecological resilience. The findings from this study indicate that the approach to restoration taught in the training program, along with the initiatives informed by the program, reflect principles for building resilience. Furthermore, the outcomes of the restoration initiatives informed by the program were found to be positive. These findings provide encouraging evidence in support of a new approach to restoration informed by social-ecological resilience

Rare diseases and orphan drugs : Latvian story

Publisher Copyright: © 2014 Logviss et al.; licensee BioMed Central Ltd.Background: Ten years have passed since Latvia became a Member State of the EU in 2004. As a result European regulations, including those related to rare diseases and orphan drugs, have been applied to Latvian legislative system. Orphan diseases have been recognized as a priority area for action in the public health system, though there are significant differences in the national healthcare services for rare diseases among the EU States. This study aims to determine situation in the field of rare diseases in Latvia and compare it with other European countries. Methods: We used the national plan for rare diseases, EUCERD reports, Orphanet data, Latvian and European regulations, publicly available data from the state agencies, and directly contacted drug manufacturers and wholesalers. Results: National plan for rare diseases was developed and approved in 2013. Although there are no official designated centers of expertise as well as no specific register for rare diseases. Newborns are screened for only two disorders: phenylketonuria and congenital hypothyroidism. Currently 34 orphan drugs are available on Latvian market. Three medicines (8.8%) are included in the reimbursement drug list, all indicated for Ph + CML. 15 drugs (44.1%) were reimbursed within the framework of individual reimbursement system, and five drugs (14.7%) were provided within the program of medicinal treatment of rare diseases in children. Conclusions: Majority of orphan drugs authorized in the EU are not available in Latvia, moreover those drugs that are available are often not accessible because they are insufficiently reimbursed. Besides, approval of the national plan might be an important step towards improving situation in the field of rare diseases.publishersversionPeer reviewe

Influence of severe carotid stenosis on cognition, depressive symptoms and quality of life

Publisher Copyright: © 2017 Pucite et al.Background: Carotid artery disease is not just a causal risk factor of ischemic stroke, but may predispose patients to depressive symptoms and low health related quality of life (HRQoL). Objectives: The objectives of the present study were to assess the association between severe carotid artery stenosis (CAS) and cognitive impairment, frequency of depressive symptoms and status of HRQoL. Methods: Cross - sectional study involved 55 patients with severe CAS and 54 patients with lower extremity peripheral artery disease (PAD). Cognitive impairment was assessed using Montreal Cognitive Assessment Scale (MoCA), depressive symptoms - PHQ-9 scale. HRQoL was measured using Medical Outcome Survey Short Form version 2 (SF-36v2). Results: Median MoCA score 24 [23;26] was significantly lower in patients with severe CAS than in patients with PAD - 26 [25-28],(p=0.005; effect size r=0.3). There was no statistically significant difference of median PHQ-9 scores the in CAS group (median PHQ-9 score 4.0 [5]) and in the PAD group (median PHQ-9 score 5.5 [7]), (p=0.08, effect size r=0.18). Mean SF-36v2 scores were similar in CAS and PAD groups except for bodily pain (p=0.001, Cohen's d value = 0.77) and vitality (p=0.02, Cohen's d value = 0.49). Conclusion: In summary, our findings indicate that severe CAS could play a role in cognitive decline. Further studies should be conducted using larger patient cohorts without ischemic brain lesions and with balanced vascular risk profiles to investigate impact of CAS on cognition. There was no association between severe CAS and depressive symptoms in the present study. As patients with severe CAS did not exhibit physical symptoms, HRQoL was better for those patients than for patients with lower extremity PAD.publishersversionPeer reviewe

Changes in Cognition, Depression and Quality of Life after Carotid Stenosis Treatment

Background: Although several studies have evaluated the change of cognitive performance after severe carotid artery stenosis, the results still remain elusive. The objective of this study was to assess changes in cognitive function, depressive symptoms and Health Related Quality of Life (HRQoL) after carotid stenosis revascularisation and Best Medical Treatment (BMT). Methods: Study involved 213 patients with ≥70% carotid stenosis who underwent assessment of cognitive function using Montreal Cognitive Assessment scale (MoCA), depressive symptoms - using Patient Health Questionnaire-9 (PHQ-9) and HRQoL - using Medical Outcome Survey Short Form version 2 (SF-36v2). The assessment was performed before and at 6 and 12 months followup periods in patients who had Carotid Endarterectomy (CEA), Carotid Artery Stenting (CAS) or received BMT only. Results: Improvement in the total MoCA scores was observed after 6 and 12 months (p<0.001, Kendall's W=0.28) in the CEA group. In the CAS group - after 12 months (p=0.01, Kendall's W=0.261) whereas in the BMT group - no significant changes (p=0.295, Kendall's W=0.081) were observed. Reduction of depressive symptoms was not found in any of the study groups. Comparing mean SF-36v2 scores in the CEA group, there was no significant difference in any of 10 subscales. Likewise in the CAS group - no significant difference in 9 of 10 subscales (p=0.028, η2=0.343) was observed. Three subscales worsened in the BMT group during the 1-year follow-up period. Conclusion: Patients with severe carotid stenosis who underwent revascularisation enhanced their cognitive performance without exerting significant change of depressive symptoms. Preoperative HRQoL may be maintained for at least one year in the CEA group.publishersversionPeer reviewe

IMPACT OF CAROTID ENDARTERECTOMY ON COGNITIVE PERFORMANCE AND DEPRESSIVE SYMPTOMS

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The Incidence of Arterial Stent Fractures with Exclusion of Coronary, Aortic, and Non-arterial Settings

Background: This study aimed to review the literature regarding fracture of arterial stents, especially its relation to location of placement, clinical relevance, and type of stents. Material and methods: We searched published articles in PubMed up to February 2008 by using the terms: stent fracture or stent breakage. Results: Thirty-one articles met our inclusion and exclusion criteria. Most of the studies reported fractures in stents placed in the superficial femoral artery or popliteal arteries. The cumulative incidence of stent fractures ranged from 2% to 65%, i.e. 0.6 to 60 per 1000 person-months. Stent fractures occur more frequently in the superficial femoral artery and are common when multiple stents are deployed and overlap. Stent fractures are associated with a higher risk of in-stent restenosis and re-occlusion. Conclusion: The incidence of stent fracture, its location of placement, and type of stent used were diverse across studies. Stent fracture may cause clinical deterioration especially in the femoropopliteal segment, and it should be detected before clinical manifestation appears. Further studies with larger study population involving new type of stents for a longer follow up period are warranted.Peer reviewe

Multidisciplinary approach to treat ruptured abdominal aortic aneurysm into the vena cava

Funding Information: The editors and reviewers of this article have no relevant financial relationships to disclose per the Journal policy that requires reviewers to decline review of any manuscript for which they may have a conflict of interest. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.publishersversionPeer reviewe

Resilience in a Watershed Governance Context: A Primer

Watersheds are complex systems involving social, economic, and ecological dimensions that are constantly interacting and influencing each other, and governance of these systems involve a large and diverse cast of actors that add to the complexity and difficulty in deciding what is best for the watershed and people. Resilience thinking offers a way to understand and navigate the uncertainty, dynamics and complexity of watershed governance. This primer describes key ideas associated with resilience: more inclusive participation; building a shared understanding; inclusion of ecosystem services and functions in long-term planning; strong leadership; institutional and decision making flexibility; and, a decentralized system. This primer is an initial effort to translate the scholarly understanding of these key ideas and initiate a dialogue about their application in the context of watershed governance.Social Sciences and Humanities Research Council of Canada through the Water Economicsw, Policy and Governance Network Social Sciences and Humanities Research Council Insight Development Gran