| 1. |
- Manzano-Nunez, Ramiro, et al.
(författare)
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A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients.
- 2018
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Ingår i: Journal of Trauma and Acute Care Surgery. - : Lippincott Williams & Wilkins. - 2163-0755 .- 2163-0763. ; 85:3, s. 626-634
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients.METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access. A meta-analysis of proportions was performed RESULTS: We 13 studies with a total of 424 patients. REBOA was inserted most commonly by trauma surgeons or emergency room physicians. Information regarding puncture technique was reported in 12 studies and was available for a total of 414 patients. Percutaneous access and surgical cutdown were performed in 304 (73.4%) and 110 (26.5%) patients respectively. Overall, complications related to groin access occurred in 5.6% of patients (n=24/424). Lower limb amputation was required in 2.1% of patients (9/424), of which three cases (3/424 [0.7%]) were directly related to the vascular puncture from the REBOA insertion. A meta-analysis which used the logit transformation showed a 5% (95% CI 3%-9%) incidence of complications without significant heterogeneity (LR test: χ2 = 0.73, p=0.2, Tau-square=0.2). In a second meta-analysis, we used the Freeman-Turkey double arcsine transformation and found an incidence of complications of 4% (95% CI 2%-7%) with low heterogeneity (I2 = 16.3%).CONCLUSION: We found that the incidence of complications related to groin access was of four to five percent based on a meta-analysis of 13 studies published worldwide. Currently, there are no benchmarks or quality measures as a reference to compare, and thus, further work is required to identify these benchmarks and improve the practice of REBOA in trauma surgery.LEVEL OF EVIDENCE: Systematic Review and Meta-analysis, Level III.
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| 2. |
- Manzano-Nunez, Ramiro, et al.
(författare)
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Could resuscitative endovascular balloon occlusion of the aorta improve survival among severely injured patients with post-intubation hypotension?
- 2018
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Ingår i: European Journal of Trauma and Emergency Surgery. - : Springer Berlin/Heidelberg. - 1863-9933 .- 1863-9941. ; 44:4, s. 527-533
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Forskningsöversikt (refereegranskat)abstract
- Current literature shows the association of post-intubation hypotension and increased odds of mortality in critically ill non-trauma and trauma populations. However, there is a lack of research on potential interventions that can prevent or ameliorate the consequences of endotracheal intubation and thus improve the prognosis of trauma patients with post-intubation hypotension. This review paper hypothesizes that the deployment of REBOA among trauma patients with PIH, by its physiologic effects, will reduce the odds of mortality in this population. The objective of this paper is to review the current literature on REBOA and post-intubation hypotension, and, furthermore, to provide a rational hypothesis on the potential role of REBOA in severely injured patients with post-intubation hypotension.
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| 3. |
- Carpenter, Stephen R., et al.
(författare)
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Program on ecosystem change and society : an international research strategy for integrated social-ecological systems
- 2012
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Ingår i: Current Opinion in Environmental Sustainability. - : Elsevier BV. - 1877-3435 .- 1877-3443. ; 4:1, s. 134-138
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Tidskriftsartikel (refereegranskat)abstract
- The Program on Ecosystem Change and Society (PECS), a new initiative within the ICSU global change programs, aims to integrate research on the stewardship of social-ecological systems, the services they generate, and the relationships among natural capital, human wellbeing, livelihoods, inequality and poverty. The vision of PECS is a world where human actions have transformed to achieve sustainable stewardship of social-ecological systems. The goal of PECS is to generate the scientific and policy-relevant knowledge of social-ecological dynamics needed to enable such a shift, including mitigation of poverty. PECS is a coordinating body for diverse independently funded research projects, not a funder of research. PECS research employs a range of transdisciplinary approaches and methods, with comparative, place-based research that is international in scope at the core.
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| 4. |
- Eriksson, Hampus, 1979-
(författare)
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Managing sea cucumber fisheries and aquaculture : Studies of social-ecological systems in the Western Indian Ocean
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Collecting sea cucumbers to supply the high value Chinese dried seafood market is a livelihood activity available to many people in the Western Indian Ocean (WIO), making it an important part of local economies. These fisheries are generally not successfully managed and tropical sea cucumber fisheries show continuing signs of decline. This thesis takes a social-ecological systems approach to guide better management of sea cucumber fisheries and aquaculture in the WIO. Papers 1 and 2 analyse the fishery situation in Zanzibar and find that in the absence of effective management institutions and income alternatives among fishers, leading to dependence, there are unsustainable expanding processes. Paper 3 compares the unmanaged fishery in Zanzibar to the highly controlled situation in Mayotte. In Mayotte, a protection effect is evident and the commercial value of stocks is significantly higher than in Zanzibar. The analysis of the situation in Mayotte demonstrates the importance of matching the fishery – management temporal scales through prepared and adaptive management to avoid processes that reinforce unsustainable expansion. Paper 4 analyses sea cucumber community spatial distribution patterns at a coastal seascape-scale in Mayotte establishing baseline patterns of habitat utilization and abundance, which can be used as reference in management. Paper 5 reviews the potential for sea cucumber aquaculture in the WIO. The review illustrates that this activity, which is currently gaining momentum, does so based on inflated promises and with significant social-ecological risks. Emphasis for improvements is, in this thesis, placed on the importance of prepared and adaptive institutions to govern and control expanding processes of the fishery. These institutional features may be achieved by increasing the level of knowledge and participation in governance and by integration of sea cucumber resources management into higher-level policy initiatives.
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| 5. |
- Gelcich, Stefan, et al.
(författare)
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Navigating transformations in governance of Chilean marine coastal resources
- 2010
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 107:39, s. 16794-16799
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Tidskriftsartikel (refereegranskat)abstract
- Marine ecosystems are in decline. New transformational changes in governance are urgently required to cope with overfishing, pollution, global changes, and other drivers of degradation. Here we explore social, political, and ecological aspects of a transformation in governance of Chile's coastal marine resources, from 1980 to today. Critical elements in the initial preparatory phase of the transformation were (i) recognition of the depletion of resource stocks, (ii) scientific knowledge on the ecology and resilience of targeted species and their role in ecosystem dynamics, and (iii) demonstration-scale experimental trials, building on smaller-scale scientific experiments, which identified new management pathways. The trials improved cooperation among scientists and fishers, integrating knowledge and establishing trust. Political turbulence and resource stock collapse provided a window of opportunity that triggered the transformation, supported by new enabling legislation. Essential elements to navigate this transformation were the ability to network knowledge from the local level to influence the decision-making processes at the national level, and a preexisting social network of fishers that provided political leverage through a national confederation of artisanal fishing collectives. The resultant governance scheme includes a revolutionary national system of marine tenure that allocates user rights and responsibilities to fisher collectives. Although fine tuning is necessary to build resilience of this new regime, this transformation has improved the sustainability of the interconnected social-ecological system. Our analysis of how this transformation unfolded provides insights into how the Chilean system could be further developed and identifies generalized pathways for improved governance of marine resources around the world.
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| 6. |
- Huitric, Miriam, 1974-
(författare)
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Masking environmental feedback : Misfits between institutions and ecosystems in Belize and Thailand
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis analyses relationships between ecological and social systems in the context of coastal ecosystems. It examines human impacts from resource extraction and addresses management and governance behind resource exploitation. The main premises are that a lack of ecological knowledge leads to poor ecosystem management and that the dichotomy between social and natural systems is an artificial one. The thesis illustrates the importance of basing resource management on the ecological conditions of the resource and its ecosystem. It also demonstrates the necessity of accounting for the human dimension in ecosystem management and the challenges of organising human actions for sustainable use of ecosystem services in the face of economic incentives that push users towards short-term extraction.Many Caribbean coral reefs have undergone a shift from coral to macroalgal domination. An experiment on Glovers Reef Atoll in Belize manually cleared patch reefs in a no-take zone and a fished zone (Papers I and II). The study hypothesised that overfishing has reduced herbivorous fish populations that control macroalgae growth. Overall, management had no significant effect on fish abundance and the impacts of the algal reduction were short-lived. This illustrated that the benefits of setting aside marine reserves in impacted environments should not be taken for granted. Papers III and IV studied the development of the lobster and conch fisheries in Belize, and the shrimp farming industry in Thailand respectively. These studies found that environmental feedback can be masked to give the impression of resource abundance through sequential exploitation. In both cases inadequate property rights contributed to this unsustainable resource use. The final paper (V) compared the responses to changes in the resource by the lobster fisheries in Belize and Maine in terms of institutions, organisations and their role in management. In contrast to Maine’s, the Belize system seems to lack social mechanisms for responding effectively to environmental feedback. The results illustrate the importance of organisational and institutional diversity that incorporate ecological knowledge, respond to ecosystem feedback and provide a social context for learning from and adapting to change.
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| 7. |
- Lawniczak, Mara K. N., et al.
(författare)
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Standards recommendations for the Earth BioGenome Project
- 2022
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 0027-8424 .- 1091-6490. ; 119:4
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Tidskriftsartikel (refereegranskat)abstract
- A global international initiative, such as the Earth BioGenome Project (EBP), requires both agreement and coordination on standards to ensure that the collective effort generates rapid progress toward its goals. To this end, the EBP initiated five technical standards committees comprising volunteer members from the global genomics scientific community: Sample Collection and Processing, Sequencing and Assembly, Annotation, Analysis, and IT and Informatics. The current versions of the resulting standards documents are available on the EBP website, with the recognition that opportunities, technologies, and challenges may improve or change in the future, requiring flexibility for the EBP to meet its goals. Here, we describe some highlights from the proposed standards, and areas where additional challenges will need to be met.
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| 8. |
- Lewin, Harris A., et al.
(författare)
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The Earth BioGenome Project 2020 : Starting the clock
- 2022
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 0027-8424 .- 1091-6490. ; 119:4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Marín, Andrés, et al.
(författare)
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Disaster impacts on co-management networks : longitudinal and comparative analysis of Chilean small-scale fisheries
- 2023
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Ingår i: Frontiers in Marine Science. - 2296-7745. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have highlighted the relational nature of co-management and investigated which kinds of social network structures define its possibilities to perform, adapt and deal with uncertainty and change. However, there is less understanding about the impacts of disasters and abrupt perturbations on co-management networks. Here we present a social network analysis of the impacts of the 2010 tsunami on co-management in the Chilean fishery. Based on data collected in 21 fisher organizations in the Bio-Bío region, heavily impacted by the tsunami, we assess whether and how co-management facilitating and hindering social relationships have changed after the event, as compared to 16 non-impacted organizations in the Valparaíso region. Baseline data (i.e., 2008) from both regions allows for before-after longitudinal analysis. Our findings show that after the tsunami, co-management networks in Bio-Bío present reduced fragmentation and higher levels of perceived trust among actors in comparison to the non-affected region. A slightly lower tendency towards decentralization was also observed. These findings suggest that post-disaster adjustments have occurred within the same networks. Co-management networks were flexible enough to be rewired as a consequence of abrupt perturbations triggered by the tsunami. Participatory network-based interventions, such as the Chilean MEABR co-management policy, provide a stable and at the same time adaptive setting to respond to coastal disasters.
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| 10. |
- Marín, Andrés, et al.
(författare)
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Ecosystem Services and Abrupt Transformations in a Coastal Wetland Social-Ecological System : Tubul-Raqui after the 2010 Earthquake in Chile
- 2014
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Ingår i: Ecology & Society. - 1708-3087. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Natural disasters can trigger sudden transformations and move ecosystems to different states where the provision of ecosystem services is altered. These changes in ecosystem services affect local communities' well-being and challenge users' adaptation capacities. We used the ecosystem services framework to understand the impacts of abrupt transformations, in a coastal wetland, associated to a similar to 1.6 meter coseismic uplift after an 8.8 magnitude earthquake in Chile. Using mixed methods we (1) identified and prioritized ecosystem services from Tubul-Raqui wetland; (2) assessed conditions of services and human well-being before and after the earthquake; (3) investigated postcatastrophe human adaptations and responses; and (4) explored users' interests and visions about possible future social-ecological pathways. Results show spatially diversified effects of the uplift on ecosystem services, both negative and positive, representing threats and opportunities for different user groups around the wetland. The total loss of the cultivated seaweed pelillo is associated with the most manifest reduction in perceptions of well-being among coastal users. Adaptive capacities triggered by pre-existing livelihood portfolios generated intensification in the exploitation of less impacted or enhanced ecosystem services which could be reducing resilience. Results show that two years after the transformation there is little attempt to create untried, new beginnings in the Tubul-Raqui wetland from which user groups could evolve to a more innovative livelihood and resource management system after the shift. Although visions about the future are not homogeneous among users, common interests regarding the conservation of key services are shared. The analysis of abrupt transformations through an ecosystem services approach provides a powerful framework for the study of environmental change and associated impacts on local communities.
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