| 1. |
- Ruilope, LM, et al.
(författare)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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Ingår i: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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| 2. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Boonstra, Wiebren J., et al.
(författare)
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What are the major global threats and impacts in marine environments? Investigating the contours of a shared perception among marine scientists from the bottom-up.
- 2015
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Ingår i: Marine Policy. - : Elsevier BV. - 0308-597X .- 1872-9460. ; 60, s. 197-201
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Tidskriftsartikel (refereegranskat)abstract
- Marine scientists broadly agree on which major processes influence the sustainability of marine environments worldwide. Recent studies argue that such shared perceptions crucially shape scientific agendas and are subject to a confirmation bias. Based on these findings a more explicit engagement with scientists' (shared) perceptions of global change in marine environments is called for. This paper takes stock of the shared understanding in marine science of the most pertinent, worldwide threats and impacts that currently affect marine environments. Using results from an email survey among leading academics in marine science this article explores if a shared research agenda in relation to global change in marine environments exists. The analysis demonstrates that marine scientists across disciplines are largely in agreement on some common features of global marine change. Nevertheless, the analysis also highlights where natural and social scientists diverge in their assessment. The article ends discussing what these findings imply for further improvement of interdisciplinary marine science.
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| 5. |
- Lade, Steven J., et al.
(författare)
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An empirical model of the Baltic Sea reveals the importance of social dynamics for ecological regime shifts
- 2015
-
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. ; 112:35, s. 11120-11125
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Tidskriftsartikel (refereegranskat)abstract
- Regime shifts triggered by human activities and environmental changes have led to significant ecological and socioeconomic consequences in marine and terrestrial ecosystems worldwide. Ecological processes and feedbacks associated with regime shifts have received considerable attention, but human individual and collective behavior is rarely treated as an integrated component of such shifts. Here, we used generalized modeling to develop a coupled social-ecological model that integrated rich social and ecological data to investigate the role of social dynamics in the 1980s Baltic Sea cod boom and collapse. We showed that psychological, economic, and regulatory aspects of fisher decision making, in addition to ecological interactions, contributed both to the temporary persistence of the cod boom and to its subsequent collapse. These features of the social-ecological system also would have limited the effectiveness of stronger fishery regulations. Our results provide quantitative, empirical evidence that incorporating social dynamics into models of natural resources is critical for understanding how resources can be managed sustainably. We also show that generalized modeling, which is well-suited to collaborative model development and does not require detailed specification of causal relationships between system variables, can help tackle the complexities involved in creating and analyzing social-ecological models.
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| 6. |
- Pedersen, M. W., et al.
(författare)
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Trends in marine climate change research in the Nordic region since the first IPCC report
- 2016
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Ingår i: Climatic Change. - : Springer Science and Business Media LLC. - 0165-0009 .- 1573-1480. ; 134:1-2, s. 147-161
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Tidskriftsartikel (refereegranskat)abstract
- Oceans are exposed to anthropogenic climate change shifting marine systems toward potential instabilities. The physical, biological and social implications of such shifts can be assessed within individual scientific disciplines, but can only be fully understood by combining knowledge and expertise across disciplines. For climate change related problems these research directions have been well-established since the publication of the first IPCC report in 1990, however it is not well-documented to what extent these directions are reflected in published research. Focusing on the Nordic region, we evaluated the development of climate change related marine science by quantifying trends in number of publications, disciplinarity, and scientific focus of 1362 research articles published between 1990 and 2011. Our analysis showed a faster increase in publications within climate change related marine science than in general marine science indicating a growing prioritisation of research with a climate change focus. The composition of scientific disciplines producing climate change related publications, which initially was dominated by physical sciences, shifted toward a distribution with almost even representation of physical and biological sciences with social sciences constituting a minor constant proportion. These trends suggest that the predominantly model-based directions of the IPCC have favoured the more quantitatively oriented natural sciences rather than the qualitative traditions of social sciences. In addition, despite being an often declared prerequisite to successful climate science, we found surprisingly limited progress in implementing interdisciplinary research indicating that further initiatives nurturing scientific interactions are required.
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| 7. |
- Boonstra, Wiebren J., et al.
(författare)
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A sea of many colours - How relevant is Blue Growth for capture fisheries in the Global North, and vice versa?
- 2018
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Ingår i: Marine Policy. - : Elsevier BV. - 0308-597X .- 1872-9460. ; 87, s. 340-349
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Tidskriftsartikel (refereegranskat)abstract
- Blue Growth is a relatively new term that is meant to realize economic growth based on the exploitation of marine resources, while at the same time preventing their degradation, overuse, and pollution. This article discusses the relevance and usefulness of this new concept for the development of capture fisheries, a sector where growth largely seems impossible without ecological devastation. An analytical distinction between intensive and extensive growth is used to argue that certain development trajectories of capture fisheries might qualify as Blue Growth. Such trajectories of growth are illustrated with the development of the Swedish bleak roe trawl fishery in the Bothnian Bay and Norwegian whitefish fishery in the Barents Sea. Comparison of the cases highlights aspects that Blue Growth advocates might want to include if they choose to consider capture fisheries as a relevant economic activity. These aspects include: a) adding value through certification; b) technological development to make more efficient use of resources used up in the fishing operation, and to upgrade their fish as commodity; and c) specialization.
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| 8. |
- Boonstra, Wiebren J., et al.
(författare)
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Adaptation to climate change as social-ecological trap : a case study of fishing and aquaculture in the Tam Giang Lagoon, Vietnam
- 2015
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Ingår i: Environment, Development and Sustainability. - : Springer Science and Business Media LLC. - 1387-585X .- 1573-2975. ; 17:6, s. 1527-1544
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Tidskriftsartikel (refereegranskat)abstract
- The ways in which people respond to climate change are frequently analyzed and explained with the term adaptation. Conventionally, adaptation is understood as adjustments in behavior either to mitigate harm or to exploit opportunities emerging from climate change. The idea features prominently in scientific analyses as well as in policy programs. Despite its growing popularity over the years, the concept has also received critique. Social scientists in particular take issue with the implicit assumptions about human behavior and fitness advantages (or optimal behavior) that come with the term. Clearly, not all human and animal behavioral responses are optimal or display fitness advantages. To the contrary, sub-optimal and maladaptive behavior is rather widespread. Explaining the possibility of maladaptive or sub-optimal behavior led scholars to introduce the idea of traps. Trap situations refer to a mismatch between behavior and the social and/or ecological conditions in which this behavior takes place. This paper reviews the analytical value of traps for the study of human responses to climate change. It first lays out the theoretical assumptions underpinning the concept. A case study of the Tam Giang Lagoon, in central Vietnam, is used to evaluate how well the trap concept captures the sub-optimality and variety of human responses to climate change.
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| 9. |
- Boonstra, Wiebren J., et al.
(författare)
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Classifying fishers' behaviour. An invitation to fishing styles
- 2016
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Ingår i: Fish and Fisheries. - : Wiley. - 1467-2960 .- 1467-2979. ; 17:1, s. 78-100
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Tidskriftsartikel (refereegranskat)abstract
- The study and classification of fishers’ behaviour remains a much debated topic. There is a tension between detailed empirical studies, which highlight the variety and diversity of fisheries, and the parsimony and generalization required to satisfy science and policy demands. This study contributes to this debate. The first sec- tion reviews quantitative methods currently used for classifying fishing practices. The review uncovers significant weaknesses in quantitative classification methods, which, we argue, can be improved through the complementary use of qualitative methods. To this purpose, we introduce the concept of ‘fishing style’, which integrates quantitative classification methods with qualitative analysis. We explain the scientific premises of the fishing-style concept, outline a general methodological framework and present a fishing-style analysis of Swedish Baltic Sea fisheries. Based on these results, we conclude that it is possible to classify fishing practices in a rel- atively uniform and limited number of styles that can highlight the rich, empirical diversity of fishers’ behaviour. We therefore propose that fishing-style analysis, based on an integration of quantitative and qualitative methods, can be an impor- tant step towards more effective and sustainable fisheries management.
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| 10. |
- Boonstra, Wiebren J.
(författare)
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Conceptualizing power to study social-ecological interactions
- 2016
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Ingår i: Ecology and Society. - 1708-3087. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- My aim is to conceptualize power using social science theory and to demonstrate why and how the concept of power can complement resilience studies and other analyses of social-ecological interaction. Social power as a scientific concept refers to the ability to influence both conduct and context. These two dimensions of power (conduct and context) can be observed by differentiating between various sources of power, including, for example, technology or mental power. The relevance of the conceptualization of power presented here is illustrated with the example of fire as a source of social-ecological power. I conclude by discussing how attention to power can help to address issues of social justice and responsibility in social-ecological interactions.
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| 11. |
- Boonstra, Wiebren J., et al.
(författare)
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The quality of compliance : investigating fishers' responses towards regulation and authorities
- 2017
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Ingår i: Fish and Fisheries. - : Wiley. - 1467-2960 .- 1467-2979. ; 18:4, s. 682-697
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Tidskriftsartikel (refereegranskat)abstract
- A substantial amount of scientific effort goes into understanding and measuring compliance in fisheries. Understanding why, how and when fishers follow or violate rules is crucial for designing effective fishery policies that can halt overfishing. Non-compliance was initially explained almost exclusively with reference to economic and self-interested motivations. More recently, however, most explanations involve a combination of economic, social, political and environmental factors. Despite this recent development towards more holistic explanations, many scientists continue to frame the issue in binary terms: fishers either follow rules, or they don't. In this article we challenge this binary interpretation and focus attention on the diversity of fishers' dispositions and perceptions that underpin compliant behaviour. To this aim we construct a typology of fishers' responses towards regulation and authorities, thereby developing conceptual tools to understand different motivations and attitudes that underlie compliance outcomes. For this purpose, we identify the motivational postures of 'creativity' and 'reluctance', and then highlight their empirical relevance with an interview study of Swedish fishers. Reasons for studying the quality and diversity of fishers' motivations and responses are not purely academic. Conceptualizing and observing the quality of compliance can help policymakers and managers gauge and anticipate the potentiality of non-compliant fishing practices that may threaten the resilience of marine ecosystems.
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| 12. |
- Cooke, Benjamin, et al.
(författare)
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Dwelling in the biosphere : exploring an embodied human-environment connection in resilience thinking
- 2016
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Ingår i: Sustainability Science. - : Springer Science and Business Media LLC. - 1862-4065 .- 1862-4057. ; 11:5, s. 831-843
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Forskningsöversikt (refereegranskat)abstract
- Resilience has emerged as a prominent paradigm for interpreting and shaping human-environment connections in the context of global environmental change. Resilience emphasizes dynamic spatial and temporal change in social-ecological systems where humans are inextricably interwoven with the environment. While influential, resilience thinking has been critiqued for an under-theorized framing of socio-cultural dynamics. In this paper, we examine how the resilience concepts of planetary boundaries and reconnecting to the biosphere frame human-environment connection in terms of mental representations and biophysical realities. We argue that focusing solely on mental reconnection limits further integration between the social and the ecological, thus countering a foundational commitment in resilience thinking to social-ecological interconnectedness. To address this susceptibility we use Tim Ingold's 'dwelling perspective' to outline an embodied form of human-environment (re)connection. Through dwelling, connections are not solely produced in the mind, but through the ongoing interactivity of mind, body and environment through time. Using this perspective, we position the biosphere as an assemblage that is constantly in the making through the active cohabitation of humans and nonhumans. To illustrate insights that may emerge from this perspective we bring an embodied connection to earth stewardship, given its growing popularity for forging local to global sustainability transformations.
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| 13. |
- Enqvist, Johan, 1982-, et al.
(författare)
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Against the current : rewiring rigidity trap dynamics in urban water governance through civic engagement
- 2016
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Ingår i: Sustainability Science. - : Springer Science and Business Media LLC. - 1862-4065 .- 1862-4057. ; 11:6, s. 919-933
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Tidskriftsartikel (refereegranskat)abstract
- This paper investigates how the agency of local residents can affect persistent and unsustainable practices in urban water supply governance. Using a case study from Bangalore, India, we analyze a social-ecological trap which developed after a shift to external water provision paired with rapid urbanization. The reluctance of forsaking initial investments in infrastructure and competence, and the subsequent loss of the local network of lakes built for harvesting rainwater, reinforced dependence on external sources while undermining groundwater levels in the city. These feedbacks made water scarcity a structurally persistent feature of Bangalore. This situation started to change when local residents recently started organizing to preserve and restore Bangalore's lakes. By entering collaborative management agreements with municipal authorities, these lake groups have restored and established effective protection of five lakes. Through a case study of this civic engagement we show that the lake restorations have the potential to counteract trap mechanisms by restoring ecological functions, and by reducing water scarcity as groundwater levels rise and authorities are relieved from maintenance and monitoring tasks. Importantly, these lake groups have also created opportunities for over a dozen similar groups to form across the city. This demonstrates that social movements can be an important source of change in social-ecological traps.
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| 14. |
- Haider, L. Jamila, 1987-, et al.
(författare)
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Traps and Sustainable Development in Rural Areas : A Review
- 2018
-
Ingår i: World Development. - : Elsevier BV. - 0305-750X .- 1873-5991. ; 101, s. 311-321
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Forskningsöversikt (refereegranskat)abstract
- The concept of a poverty trap—commonly understood as a self-reinforcing situation beneath an asset threshold—has been very influential in describing the persistence of poverty and the relationship between poverty and sustainability. Although traps, and the dynamics that lead to traps, are defined and used differently in different disciplines, the concept of a poverty trap has been most powerfully shaped by work in development economics. This perspective is often constraining because, as many studies show, poverty arises from complex interactions between social and environmental factors that are rarely considered in development economics. A more integrated understanding of poverty traps can help to understand the interrelations between persistent poverty and key social and ecological factors, facilitating more effective development interventions. The aim of this paper is to provide a critical appraisal of existing trap conceptualizations in different disciplines, and to assess the characteristics and mechanisms that are used to explain poverty traps in rural contexts, thereby broadening the traps concept to better account for social-ecological interactions. Complementarities and tensions among different disciplinary perspectives on traps are identified, and our results demonstrate that different definitions of traps share a set of common characteristics: persistence, undesirability, and self-reinforcement. Yet these minimum conditions are not sufficient to understand how trap dynamics arise from complex social-ecological interactions. To broaden the utility of the concept we propose a more social-ecologically integrated definition of traps that includes four additional considerations: cross-scale interactions, path dependencies, the role of external drivers, and social-ecological diversity. Including these wider dimensions of trap dynamics would help to better account for the diverse social-ecological feedbacks that produce and maintain poverty traps, and could strengthen strategies to alleviate poverty in a more integrated way.
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| 15. |
- Hanh, Tong Thi Hai, et al.
(författare)
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Can income diversification resolve social-ecological traps in small-scale fisheries and aquaculture in the global south? A case study of response diversity in the Tam Giang lagoon, central Vietnam
- 2018
-
Ingår i: Ecology and Society. - 1708-3087. ; 23:3
-
Tidskriftsartikel (refereegranskat)abstract
- Small-scale fishers and aquaculturists in the global south often face reinforcing feedbacks between resource degradation and livelihood impoverishment, a situation conceptualized as a social-ecological trap. It is argued that these traps can be overcome through income diversification, i.e., livelihoods that are maintained from variable income sources. Our aim was to further scrutinize that claim using the concept of response diversity. To do so, we applied the concept and analyzed income diversification in the Tam Giang lagoon, central Vietnam. Based on our analysis, we argue that high diversity in income activities does not necessarily lead to an escape from social-ecological traps. Although diversity in income activities in the case of the Tam Giang lagoon is relatively high, fisheries-and aquaculture-related income activities continue to dominate livelihood portfolios. The various gear and structures that these activities include all exploit the same ecologies, habitats, and niches of the lagoon. This finding triggers questions concerning the relative contribution of income activities to household income, but also how activities are (differently) connected to natural environments. Income diversification can only sustain natural resources and improve human well-being if it truly transforms livelihoods by connecting local users in new ways to ecologies and societies.
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| 16. |
- Hanh, Tong Thi Hai, et al.
(författare)
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What prevents small-scale fishing and aquaculture households from engaging in alternative livelihoods? A case study in the Tam Giang lagoon, Viet Nam
- 2019
-
Ingår i: Ocean and Coastal Management. - : Elsevier BV. - 0964-5691 .- 1873-524X. ; 182
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Tidskriftsartikel (refereegranskat)abstract
- The adoption of alternative livelihoods is often considered as an effective way to reduce natural resource exploitation and improve local resource users' well-being. Nevertheless, studies demonstrate that especially for small-scale fishing and aquaculture households it often can be hard to engage in alternative livelihoods. The initiation and reproduction of alternative livelihoods are not straightforward but shaped by various social-economic factors and processes operating at different spatial and temporal scales. Yet, studies frequently limit their analysis to household or extra-household levels. This paper develops a conceptual framework for a cross-scale analysis of livelihood diversification and applies it in a case study of small-scale fisheries and aquacultural livelihoods in the Tam Giang lagoon, Viet Nam to explain how social and ecological processes limit and enable engagement in alternative livelihoods. The framework and case study aim to go beyond the identification of single factors to demonstrate combinations of factors and processes, and how these play out differently for generations. From this study, the paper confirms that improvements in education, labour skills and job availability are necessary for the engagement in alternative livelihoods. It further argues that the success of interventions aimed at diversifying rural livelihoods need to consider generational differences within households, and the specific social and ecological contexts in which households are situated.
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| 17. |
- Hentati Sundberg, Jonas, et al.
(författare)
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Management Forcing Increased Specialization in a Fishery System
- 2015
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Ingår i: Ecosystems (New York. Print). - : Springer Science and Business Media LLC. - 1432-9840 .- 1435-0629. ; 18:1, s. 45-61
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Tidskriftsartikel (refereegranskat)abstract
- Fisheries systems are shaped by dynamic social-ecological interactions that determine their capacity to provide ecosystem services. Human adaptation is often considered a key uncertainty, and there are few quantitative empirical analyses that address long-term social and ecological change in the analyses of fisheries systems. The aim of this study was twofold: (i) to understand how different drivers influenced the adaptations by fishers, and (ii) to evaluate different consequences of such adaptations, especially with regard to diversity of social and ecological links. We used the Baltic Sea as a case study, a system with different fisheries, largely managed with a single-stock advice, in a top-down basis. The study period 1995-2009 was characterized by profound inter-annual fluctuations in fish stock status and prices, and introduction of new types of management measures. We used multivariate statistical methods to define longitudinal changes in fishing tactics and strategies based on logbook data. Our results indicate that changes in fishing strategies have mainly been driven by regulations, and there were only weak linkages between fishing activities, fish stocks, and price fluctuations. We found contrasting trends between large- and small-scale fishers, where large-scale fishers became more specialized and inflexible, whereas small-scale fishers diversified over time. We conclude that management has had a dominating role in shaping fishing patterns, leading to a reduction of important qualities related to the resilience in this social-ecological system.
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| 18. |
- Koh, Niak Sian, et al.
(författare)
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How much of a market is involved in a biodiversity offset? A typology of biodiversity offset policies
- 2019
-
Ingår i: Journal of Environmental Management. - : Elsevier BV. - 0301-4797 .- 1095-8630. ; 232, s. 679-691
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Tidskriftsartikel (refereegranskat)abstract
- Biodiversity offsets (BO) are increasingly promoted and adopted by governments and companies worldwide as a policy instrument to compensate for biodiversity losses from infrastructure development projects. BO are often classified as 'market-based instruments' both by proponents and critics, but this representation fails to capture the varieties of how BO policies actually operate. To provide a framing for understanding the empirical diversity of BO policy designs, we present an ideal-typical typology based on the institutions from which BO is organised: Public Agency, Mandatory Market and Voluntary Offset. With cross-case comparison and stakeholder mapping, we identified the institutional arrangements of six BO policies to analyse how the biodiversity losses and gains are decided. Based on these results, we examined how these six policies relate to the BO ideal types. Our results suggested that the government, contrary to received wisdom, plays a key role not just in enforcing mandatory policies but also in determining the supply and demand of biodiversity units, supervising the transaction or granting legitimacy to the compensation site. Mandatory BO policies can be anything from pure government regulations defining industry liabilities to liability-driven markets where choice sets for trading credits are constrained and biodiversity credit prices are negotiated under state supervision. It is important to distinguish between two processes in BO: the matching of biodiversity losses and gains (commensurability) and the trading of biodiversity credits (commodification). We conclude that the commensurability of natural capital is restricted in BO policies; biodiversity is always exchanged with biodiversity. However, different degrees of commodification are possible, depending on the policy design and role of price signals in trading credits. Like payments for ecosystem services, the price of a biodiversity credit is most commonly based on the cost of management measures rather than the 'value' of biodiversity; which corresponds to a low degree of commodification.
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| 19. |
- Schlüter, Maja, et al.
(författare)
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Toward a methodology for explaining and theorizing about social-ecological phenomena
- 2019
-
Ingår i: Current Opinion in Environmental Sustainability. - : Elsevier BV. - 1877-3435 .- 1877-3443. ; 39, s. 44-53
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Forskningsöversikt (refereegranskat)abstract
- Explanations that account for complex causation, emergence, and social-ecological interdependence are necessary for building theories of social-ecological phenomena. Social-ecological systems (SES) research has accumulated rich empirical understanding of SES; however, integration of this knowledge toward contextualized generalizations, or middle-range theories, remains challenging. We discuss the potential of an iterative and collaborative process that combines generalizing from case studies with agent-based modelling as an abductive methodology to successively build and test explanations rooted in complexity thinking. Collaboration between empirical researchers, theoreticians, practitioners, and modellers is imperative to accommodate this process, which can be seen as a first step toward building middle-range theories.
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| 20. |
- Spijkers, Jessica, et al.
(författare)
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Environmental change and social conflict : the northeast Atlantic mackerel dispute
- 2017
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Ingår i: Regional Environmental Change. - : Springer Science and Business Media LLC. - 1436-3798 .- 1436-378X. ; 17:6, s. 1835-1851
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Tidskriftsartikel (refereegranskat)abstract
- A recurrent critique of the proposition of a causal relation between environmental change and social conflict is that it fails to account for the complexities and dynamics of processes of social-ecological change. In this article, we open the black box of contextual factors that influence the causal pathway from environmental change to social conflict. Firstly, we argue for the consideration of three social factors that influence that pathway: (a) institutions, (b) power, and (c) knowledge. Taking a deductive approach, we ascertain their causal importance in the case of the mackerel dispute, an interstate conflict that unfolded after the abrupt and rapid change in distribution of the northeast Atlantic mackerel stock after 2007. We analyze the historical development of the mackerel dispute through process tracing and demonstrate the importance and causal role of the three factors. Secondly, based on our assessment, we argue to increase the diversity of the scope conditions relevant for the environmental change-social conflict nexus. We propose to consider a wider variety of conflicts as outcome of environmental change, high-income regions as an arena for those conflicts, and a wider variety of environmental change, such as alterations in abundance in the context of climate change. Lastly, we discuss how future research on this topic can handle the wider scope conditions and greater case variability.
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| 21. |
- Xin, Huang, et al.
(författare)
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Impact of chronic obstructive pulmonary disease on prognosis after percutaneous coronary intervention and bypass surgery for left main coronary artery disease: An analysis from the EXCEL trial
- 2019
-
Ingår i: European Journal of Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 55:6, s. 1144-1151
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Tidskriftsartikel (refereegranskat)abstract
- Percutaneous coronary intervention (PCI) is often favoured over coronary artery bypass grafting (CABG) surgery for revascularization in patients with chronic obstructive pulmonary disease (COPD). We studied whether COPD affected clinical outcomes according to revascularization in the Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial, in which PCI with everolimus-eluting stents was non-inferior to CABG for the treatment of patients with left main coronary artery disease and low or intermediate SYNTAX scores. Patients with a history of COPD were propensity score matched to those without COPD. Outcomes at 30 days and 3 years in both groups were compared in patients randomized to PCI versus CABG. RESULTS: COPD status was available for 1901 of 1905 randomized patients (99.8%), 148 of whom had COPD (7.8%). Propensity score matching yielded 135 patients with COPD and 675 patients without COPD. Patients with COPD had higher 3-year rates of the primary composite end point of death, myocardial infarction or stroke (31.7% vs 14.5%, P 0.0001), death (17.1% vs 7.5%, P = 0.0005) and myocardial infarction (18.3% vs 7.3%, P 0.0001), but not stroke (3.3% vs 2.9%, P = 0.84). There were no statistically significant interactions in the relative risks of PCI versus CABG for the primary composite end point in patients with and without COPD at 30 days [hazard ratio (HR) 0.39, 95% confidence interval (CI) 0.12 1.21 vs HR 0.55, 95% CI 0.29 1.06; Pinteraction = 0.61] or at 3 years (HR 0.85, 95% CI 0.46 1.56 vs HR 1.28, 95% CI 0.84 1.94; Pinteraction = 0.27). CONCLUSIONS: In the EXCEL trial, COPD was independently associated with poor prognosis after left main coronary artery disease revascularization. The relative risks of PCI versus CABG at 30 days and 3 years were consistent in patients with and without COPD..
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