Interactive voice response technology for symptom monitoring and as an adjunct to the treatment of chronic pain

Chronic pain is a medical condition that severely decreases the quality of life for those who struggle to cope with it. Interactive voice response (IVR) technology has the ability to track symptoms and disease progression, to investigate the relationships between symptom patterns and clinical outcomes, to assess the efficacy of ongoing treatments, and to directly serve as an adjunct to therapeutic treatment for chronic pain. While many approaches exist toward the management of chronic pain, all have their pitfalls and none work universally. Cognitive behavioral therapy (CBT) is one approach that has been shown to be fairly effective, and therapeutic interactive voice response technology provides a convenient and easy-to-use means of extending the therapeutic gains of CBT long after patients have discontinued clinical visitations. This review summarizes the advantages and disadvantages of IVR technology, provides evidence for the efficacy of the method in monitoring and managing chronic pain, and addresses potential future directions that the technology may take as a therapeutic intervention in its own right

Impacts of climate change on marine resources in the Pacific Island region

Springer Nature Switzerland AG 2020. In the Pacific Island region, marine resources make vital contributions to food security, livelihoods and economic development. Climate change is expected to have profound effects on the status and distribution of coastal and oceanic habitats, the fish and invertebrates they support and, as a result, the communities and industries that depend on these resources. To prepare for and respond to these impacts-and ensure the ongoing sustainability of marine ecosystems, and the communities and industries that rely on them economically and culturally-it is necessary to understand the main impacts and identify effective adaptation actions. In particular, declines in coral reef habitats and associated coastal fisheries productivity, more eastward distribution of tuna and impacts of more intense storms and rainfall on infrastructure are expected to present the greatest challenges for Pacific communities and economies. Some species of sharks and rays, and aquaculture commodities with calcareous shells, will also be impacted by habitat degradation, ecosystem changes, increasing temperature and ocean acidification. The projected declines in coastal fish and invertebrate populations will widen the gap between fish needed by growing human populations and sustainable harvests from coastal fisheries, with shortages expected in some nations (e.g. Papua New Guinea, Solomon Islands) by 2035. There will also be a need to diversify livelihoods based on fisheries, aquaculture and tourism because some of these operations are expected to be negatively affected by climate change. In some cases, building the resilience of Pacific communities to climate change will involve reducing dependence on, or finding alternatives, vulnerable marine resources

Impacts of climate change on marine resources in the Pacific Island region

In the Pacific Island region, marine resources make vital contributions to food security, livelihoods and economic development. Climate change is expected to have profound effects on the status and distribution of coastal and oceanic habitats, the fish and invertebrates they support and, as a result, the communities and industries that depend on these resources. To prepare for and respond to these impacts—and ensure the ongoing sustainability of marine ecosystems, and the communities and industries that rely on them economically and culturally—it is necessary to understand the main impacts and identify effective adaptation actions. In particular, declines in coral reef habitats and associated coastal fisheries productivity, more eastward distribution of tuna and impacts of more intense storms and rainfall on infrastructure are expected to present the greatest challenges for Pacific communities and economies. Some species of sharks and rays, and aquaculture commodities with calcareous shells, will also be impacted by habitat degradation, ecosystem changes, increasing temperature and ocean acidification. The projected declines in coastal fish and invertebrate populations will widen the gap between fish needed by growing human populations and sustainable harvests from coastal fisheries, with shortages expected in some nations (e.g. Papua New Guinea, Solomon Islands) by 2035. There will also be a need to diversify livelihoods based on fisheries, aquaculture and tourism because some of these operations are expected to be negatively affected by climate change. In some cases, building the resilience of Pacific communities to climate change will involve reducing dependence on, or finding alternatives, vulnerable marine resources