Unravelling the interrelationships between ecosystem services and human wellbeing in the Bangladesh delta

Coupled social and ecological systems need to be understood from a dynamic perspective in order to operationalise complexity concepts, such as tipping points, for sustainable ecosystem management. In this study, we strive to achieve this type of conceptual understanding through the analysis of the relationships (e.g. strength, nonlinearity) between the trends of ecosystem services (ES) and human wellbeing (HWB) between 1960 and 2010 in the south-west Bangladesh delta using generalized additive and logistic regression models. We use sequential principal components analysis to investigate the connectedness within the social–ecological system as a measure of resilience. We also use published literature to help develop a system dynamic framework in order to investigate how ES and HWB are interlinked. Overall, our results support previous work, which depicts that material wellbeing (basic materials for a good life) having a strong relationship with provisioning services, which in turn, show a weak relationship with the quality of life (security and health). Moreover, our analysis confirms the ‘Environmentalist’s Paradox’ that HWB has increased despite the deterioration in ES. However, our results suggest that provisioning services are not the only important reason for the increases in observed HWB, as these have also been substantially influenced by technology and capital investment (aid and subsidy). In addition, worsening trends in regulation services and in ‘slow’ variables such as climate suggest that the resilience of the overall social-ecological system is decreasing. Such changes may have severe consequences if they continue, for example, if temperatures exceed the upper physiological limits of key provisioning services (e.g. rice, fish) in the Bangladesh delta. These indicators all suggest that although in terms of HWB the deltaic social–ecological system may be successfully adapting to environmental change, it may also be close to transgressing critical ecological boundaries in the near future

Primary stenting of the superficial femoral and popliteal artery

ObjectivesOver the last decade, the number of endovascular procedures performed on the superficial femoral (SFA) and popliteal arteries (PA) has significantly increased. There is no consensus on the optimal form of intervention used in this arterial segment. While some have advocated balloon angioplasty alone, others have championed either selective or primary stenting of these lesions. It is the purpose of this study to determine the efficacy and durability of primary stenting of the superficial femoral and popliteal artery.MethodsAll patients undergoing peripheral angioplasty by a single vascular surgeon were prospectively enrolled in an Institutional Review Board-approved, primary-stenting protocol. During a 44-month period, all patients undergoing percutaneous transluminal angioplasty of the SFA or PA also received primary arterial stenting with bare, self-expanding nitinol stents. Patient demographics and risk factors were identified. TransAtlantic InterSociety Consensus (TASC) classifications were determined for all lesions. Loss of primary patency was said to have occurred when an occlusion or a 50% or greater stenosis in any treated arterial segment was diagnosed by arterial duplex or angiography. Only time to loss of primary patency was recorded. Kaplan-Meier survival curves were plotted and differences between groups tested by log rank method.ResultsBetween January 16, 2004 and August 13, 2007, 201 angioplasties with primary stenting were performed on 161 patients. One hundred twenty-three stents were placed for claudication, and 78 for critical limb ischemia. Forty-six segments treated were TASC A, 82 were TASC B, 38 were TASC C, and 35 were TASC D. Patient follow-up ranged from three to 1329 days (mean: 426 days). Primary patency rates for TASC A and B lesions were 79%, 67%, and 57% at 12, 24, and 36 months. For TASC C and D lesions, primary patency rates were 52.7%, 36%, and 19% at the same time intervals. Primary patency rates for TASC A and B lesions were significantly higher than for C and D lesions (P < .001). The limb salvage rate was 88.5% in patients with critical limb ischemia. Distal runoff did not influence patency (P = .827).ConclusionsPrimary stenting of the SFA and PA provides durable results in patients with TASC A and B lesions and may be an effective treatment strategy. This approach is significantly less effective when used in treating those with TASC C and D disease. Based on the results in this series, the use of primary stenting does not extend the anatomic limits of the current treatment recommendations for catheter-based intervention in patients with infrainguinal occlusive disease

Population dynamics, delta vulnerability and environmental change: comparison of the Mekong, Ganges–Brahmaputra and Amazon delta regions

Tropical delta regions are at risk of multiple threats including relative sea level rise and human alterations, making them more and more vulnerable to extreme floods, storms, surges, salinity intrusion, and other hazards which could also increase in magnitude and frequency with a changing climate. Given the environmental vulnerability of tropical deltas, understanding the interlinkages between population dynamics and environmental change in these regions is crucial for ensuring efficient policy planning and progress toward social and ecological sustainability. Here, we provide an overview of population trends and dynamics in the Ganges–Brahmaputra, Mekong and Amazon deltas. Using multiple data sources, including census data and Demographic and Health Surveys, a discussion regarding the components of population change is undertaken in the context of environmental factors affecting the demographic landscape of the three delta regions. We find that the demographic trends in all cases are broadly reflective of national trends, although important differences exist within and across the study areas. Moreover, all three delta regions have been experiencing shifts in population structures resulting in aging populations, the latter being most rapid in the Mekong delta. The environmental impacts on the different components of population change are important, and more extensive research is required to effectively quantify the underlying relationships. The paper concludes by discussing selected policy implications in the context of sustainable development of delta regions and beyond

Recent changes in ecosystem services and human well-being in the Bangladesh coastal zone

This study takes an historical approach in order to establish how the form and function of the social-ecological system that represents the Bangladesh south-western coastal zone has changed over recent decades. Time series data for a range of ecosystem services and drivers are analysed to define the range of trends, the presence of change points, slow and fast variables and the significant drivers of change. Since the 1980s, increasing gross domestic product and per capita income mirror rising levels of food and inland fish production. As a result, the size of population below the poverty line has reduced by ~17 %. In contrast, non-food ecosystem services such as water availability, water quality and land stability have deteriorated. Conversion of rice fields to shrimp farms is almost certainly a factor in increasing soil and surface water salinity. Most of the services experienced statistically significant change points between 1975 and 1980, and among the services, water availability, shrimp farming and maintenance of biodiversity appear to have passed tipping points. An environmental Kuznets curve analysis suggests that the point at which growing economic wealth feeds back into effective environmental protection has not yet been reached for water resources. Trends in indicators of ecosystem services and human well-being point to widespread non-stationary dynamics governed by slowly changing variables with an increased likelihood of systemic threshold changes/tipping points in the near future. The results will feed into simulation models and strategies that can define alternative and sustainable paths for land management

Early warning of critical transitions in biodiversity from compositional disorder

Global environmental change presents a clear need for improved leading indicators of critical transitions, especially those that can be generated from compositional data and that work in empirical cases. Ecological theory of community dynamics under environmental forcing predicts an early replacement of slowly replicating and weakly competitive “canary” species by slowly replicating but strongly competitive “keystone” species. Further forcing leads to the eventual collapse of the keystone species as they are replaced by weakly competitive but fast‐replicating “weedy” species in a critical transition to a significantly different state. We identify a diagnostic signal of these changes in the coefficients of a correlation between compositional disorder and biodiversity. Compositional disorder measures unpredictability in the composition of a community, while biodiversity measures the amount of species in the community. In a stochastic simulation, sequential correlations over time switch from positive to negative as keystones prevail over canaries, and back to positive with domination of weedy species. The model finds support in empirical tests on multi‐decadal time series of fossil diatom and chironomid communities from lakes in China. The characteristic switch from positive to negative correlation coefficients occurs for both communities up to three decades preceding a critical transition to a sustained alternate state. This signal is robust to unequal time increments that beset the identification of early‐warning signals from other metrics

A 10-year experience of infection following carotid endarterectomy with patch angioplasty

ObjectiveAlthough infection following carotid endarterectomy is rare, consequences of this seldom seen complication can be devastating. Polyester, polytetrafluoroethylene (PTFE), and vein patches have all been used by many institutions for patch angioplasty, each with reported cases of infection following surgery. Our institution has preferentially used PTFE for the majority of cases, and here, we report our experience with postoperative infection following endarterectomy over the last decade.MethodsFrom January 2000 through July 2009, we treated infections following carotid endarterectomy in 25 patients.ResultsOf the 25 patients undergoing treatment for postoperative infection, 21 had PTFE patches placed during the initial surgery. The remaining four consisted of two polyester patches and two bovine pericardial patches. Twenty-three of the 25 initial endarterectomies were performed at our institution, and the other two were referrals. The majority of cases (56%) were due to gram-positive organisms, with only two cases being polymicrobial. The interval from the original surgery to clinical presentation ranged from 7 days to 85 months, with 20 patients (80%) presenting within 60 days of the first operation. Thirteen patients underwent incision and drainage with antibiotics, and 12 patients underwent definitive surgical treatment. Four received patch excision with vein patch angioplasty, four received patch excision with vein interposition, and four received sternocleidomastoid flaps. The 30-day stroke rate was 8%, and the freedom from recurrent infection was 100% at a mean follow-up of 32 months.ConclusionInfection following carotid endarterectomy occurs <1% of the time; however, the potential for morbidity is significant. Our results show that most infections following PTFE patch angioplasty occur in the early postoperative period (<60 days) and that simple drainage with antibiotics may be an adequate form of treatment in select cases

Safe and just operating spaces for regional social-ecological systems

Humanity faces a major global challenge in achieving wellbeing for all, while simultaneously ensuring that the biophysical processes and ecosystem services that underpin wellbeing are exploited within scientifically informed boundaries of sustainability. We propose a framework for defining the safe and just operating space for humanity that integrates social wellbeing into the original planetary boundaries concept (Rockström et al., 2009a,b) for application at regional scales. We argue that such a framework can: (1) increase the policy impact of the boundaries concept as most governance takes place at the regional rather than planetary scale; (2) contribute to the understanding and dissemination of complexity thinking throughout governance and policy-making; (3) act as a powerful metaphor and communication tool for regional equity and sustainability. We demonstrate the approach in two rural Chinese localities where we define the safe and just operating space that lies between an environmental ceiling and a social foundation from analysis of time series drawn from monitored and palaeoecological data, and from social survey statistics respectively. Agricultural intensification has led to poverty reduction, though not eradicated it, but at the expense of environmental degradation. Currently, the environmental ceiling is exceeded for degraded water quality at both localities even though the least well-met social standards are for available piped water and sanitation. The conjunction of these social needs and environmental constraints around the issue of water access and quality illustrates the broader value of the safe and just operating space approach for sustainable development

Shifting perspectives on coastal impacts and adaptation

The Intergovernmental Panel on Climate Change reports reflect evolving attitudes in adapting to sea-level rise by taking a systems approach and recognizing that multiple responses exist to achieve a less hazardous coast.info:eu-repo/semantics/publishedVersio

BMQ

BMQ: Boston Medical Quarterly was published from 1950-1966 by the Boston University School of Medicine and the Massachusetts Memorial Hospitals

Administrative Managers – A Critical Link

Institutional responses to changes in the higher education environment have caused movements in the roles and identities of administrative managers in UK universities. These shifts have highlighted the problem for individuals of balancing traditional public service considerations of administration with institutional innovation and development. Administrative managers find themselves not only acting as independent arbiters, giving impartial advice on the basis of professional expertise, but also becoming involved in political judgements about institutional futures. They increasingly undertake an interpretive function between the various communities of the university and its external partners. As the boundaries of the university have become more permeable, administrative and academic management have inter-digitated, and hybrid roles have developed. In undertaking increasingly complex functions, therefore, administrative managers play a critical role in linking the academic and executive arms of governance in the university