| 31. |
- Bratman, Gregory N., et al.
(författare)
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Nature and mental health : An ecosystem service perspective
- 2019
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Ingår i: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 5:7
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Forskningsöversikt (refereegranskat)abstract
- A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.
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| 32. |
- Bäckman, Carl G, et al.
(författare)
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A case-control study of the influence of the ICU-diary concept on mastery and hopelessness six months after critical illness
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The ICU-diary concept is associated with less post-traumatic stress syndrome and improved perceived health-related quality-of-life (HRQoL) after critical illness, but little is known about its effect on the coping- mastery process, or whether it reduces hopelessness. Objective: To see if the ICU-diary concept improves the patient’s ability to master his/her situation after critical illness, and if it reduces the feeling of hopelessness. Design: Case control study (subgroup analysis of a multi-centre study on health-related quality-of-life (HRQoL). Setting: Non-academic 8-bed general ICU. Patients: Adults admitted between March 2002 and June 2004. Measurements: Mastery and hopelessness were determined using validated questionnaires (the Mastery-Coping scale and a consolidated 2–item hopelessness questionnaire) which were sent home to patients 6 months after critical illness. Responses were compared between patients that received (Cases: n=38) or did not receive an ICU-diary (Controls: n=76) . Diaries were used when a long and complicated stay on the ICU was expected. Controls were matched with diary patients by gender and age. The effect of the ICU-diary was also examined using a multiple regression model. Results: The ICU-diary concept group scored significantly higher than the No-diary group in mastery (22.1 vs. 20.4, P<0.05) and lower in hopelessness scores (1.3 vs. 1.6, P<0.05). The positive influence of the ICU-diary disappeared after adjustment for confounding factors in a multiple regression model. Conclusion: We were unable to verify any positive influence of the ICU-diary concept on mastery and hopelessness 6 months after critical illness.
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| 33. |
- Bäckman, Carl G
(författare)
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The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives. : A descriptive and interventional study
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patients on the ICU often spend a great deal of their time either unconscious or heavily sedated. When they return from the zone between life and death they are often in a state of confusion where dreams and delusions are intertwined with reality and it is not always easy to distinguish them apart. These experiences could lead to psychological problems and post-traumatic stress disorder (PTSD). Recovery may be improved by filling in the significant memory gaps and explaining what really happened during the “chaotic” time on the ICU. The provision of a diary describing the patients’ stay in ICU on a day to day basis and a follow-up meeting (together named the ICU-diary concept), may help the whole family to understand.Aim: The principal aim of this thesis was to see if the ICU-diary concept was of help to patients and relatives in the recovery after critical illness. A further aim was to look for precipitants in the ICU of PTSD.Material and Methods: ICU patients in a handful of European countries and their relatives have been studied. The studies have been single and multi-centred and we have used descriptive observational, randomised controlled and cohort study designs, including matched case-control designs. Quantitative methods have been used with questionnaires and structured interviews using established instruments (i.e Post-traumatic stress syndrome screening-14, Post-traumatic diagnostic scale, ICU memory tool, Short Form-36, Pearlin-Schooler Mastery Scale, Hopelessness scale) as the principal means of data collection.Results: The ICU-diary concept was seen to be a positive and useful aid in helping patients and their relatives understand the events that took place during the time on the ICU. It also decreased the risk for PTSD among patients and relatives. Patients that were supported with the ICU-diary concept perceived a better health-related quality of life even 3 years after the ICU stay. We did not find any definite improvement by the ICU-diary concept in mastery and hope. Variations in how the patients were cared for in the ICU had a significant effect on the development of PTSD. The implementation of an ICU diary, for instance, was associated with a lower frequency of PTSD.Conclusions: The ICU-diary concept was found helpful by patients and their relatives. It was associated with a reduction in new onset PTSD and improved health-related quality of life. The results are encouraging and suggest that an ICU diary may represent an important first step to help patients and relatives come to terms with their experiences during critical illness.ISBN 978-
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| 34. |
- Bäckman, Carl, et al.
(författare)
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Long-term effect of the ICU-diary concept on quality of life after critical illness
- 2010
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Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA. - : Blackwell Publishing Ltd. - 0001-5172 .- 1399-6576. ; 54:6, s. 736-743
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Tidskriftsartikel (refereegranskat)abstract
- Background Critically ill patients often spend time in the intensive care unit (ICU) either unconscious or sedated. On recovery, they are often in a state of confusion with memory loss that may be associated with a longstanding reduction in health-related quality of life (QoL). We hypothesised that the ICU-diary concept could improve their QoL by filling in their memory gaps. Methods A non-randomised, prospective study in a non-academic eight-bedded general ICU. A group of patients (n=38) were selected to receive the ICU-diary concept (keeping a diary with photos while on the ICU plus a follow-up meeting) when a long and complicated course was expected. Health-related QoL at 6, 12, 24 and 36 months was compared with a group that did not receive the ICU-diary (n=224). The Medical Outcomes Study 36-Item Short-Form (SF-36) was used to measure health-related QoL. Multiple regression models adjusted for age, sex, illness severity, pre-existing disease and diagnostic category was used to analyse the effects of the ICU-diary concept at 6 months, and changes over time were analysed using repeated measures MANOVA. Results Crude and adjusted scores for two dimensions of SF-36 (general health and vitality) and the physical component summary score were significantly higher at 6 months in the ICU-diary group (P andlt; 0.05) and some of the effects remained during the 3-year follow-up period (P andlt; 0.05). Conclusion The ICU-diary concept was associated with improved health-related QoL during the 3-year follow-up period after a critical illness. The effect of this intervention needs to be confirmed in a larger randomised study.
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| 35. |
- Carpenter, Stephen R., et al.
(författare)
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Allowing variance may enlarge the safe operating space for exploited ecosystems
- 2015
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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. ; 112:46, s. 14384-14389
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Tidskriftsartikel (refereegranskat)abstract
- Variable flows of food, water, or other ecosystem services complicate planning. Management strategies that decrease variability and increase predictability may therefore be preferred. However, actions to decrease variance over short timescales (2-4 y), when applied continuously, may lead to long-term ecosystem changes with adverse consequences. We investigated the effects of managing short-term variance in three well-understood models of ecosystem services: lake eutrophication, harvest of a wild population, and yield of domestic herbivores on a rangeland. In all cases, actions to decrease variance can increase the risk of crossing critical ecosystem thresholds, resulting in less desirable ecosystem states. Managing to decrease short-term variance creates ecosystem fragility by changing the boundaries of safe operating spaces, suppressing information needed for adaptive management, cancelling signals of declining resilience, and removing pressures that may build tolerance of stress. Thus, the management of variance interacts strongly and inseparably with the management of resilience. By allowing for variation, learning, and flexibility while observing change, managers can detect opportunities and problems as they develop while sustaining the capacity to deal with them.
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| 36. |
- Carpenter, Stephen R., et al.
(författare)
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Dancing on the volcano : social exploration in times of discontent
- 2019
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Ingår i: Ecology & Society. - 1708-3087. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Radical recent developments such as Brexit, the rise of extreme nationalism, the gilets jaunes, polarizing leaders, the Arab Spring, and fundamentalist movements are indications of societal discontent with the status quo. Other societal phenomena such as gender fluidity, veganism, and bartering are also associated with a perceived need to change. The context is the Anthropocene, a humandominated biosphere challenging the resilience of a livable planet. Such a broad set of developments may be interpreted in the light of new insights from theory of complex systems about what happens as resilience of the current pathway (societal organization as we know it) decreases. Rising fluctuations characterize a phase of uncertainty and exploration, potentially leading into a transition of the system toward a new pathway. We reflect on global changes that may contribute to social destabilization such as rising wealth concentration and environmental degradation and ask how responses may be understood from social-psychological forces such as the need for group identity and managing the terror of mortality. The emerging image is that of a society engaged in multifaceted experimentation. Maintaining such experimentation may help inspire novel pathways to desirable futures, but there is a risk of societies becoming trapped in backward-looking narratives that threaten long-term sustainable outcomes.
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| 37. |
- Carpenter, S. R., et al.
(författare)
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General resilience to cope with extreme events
- 2012
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 4:12, s. 3248-3259
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Tidskriftsartikel (refereegranskat)abstract
- Resilience to specified kinds of disasters is an active area of research and practice. However, rare or unprecedented disturbances that are unusually intense or extensive require a more broad-spectrum type of resilience. General resilience is the capacity of social-ecological systems to adapt or transform in response to unfamiliar, unexpected and extreme shocks. Conditions that enable general resilience include diversity, modularity, openness, reserves, feedbacks, nestedness, monitoring, leadership, and trust. Processes for building general resilience are an emerging and crucially important area of research.
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| 38. |
- 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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| 39. |
- Carpenter, Stephen R., et al.
(författare)
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Resilience : Accounting for the Noncomputable
- 2009
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Ingår i: Ecology & Society. - 1708-3087. ; 14:1, s. 13-
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Tidskriftsartikel (refereegranskat)abstract
- Plans to solve complex environmental problems should always consider the role of surprise. Nevertheless, there is a tendency to emphasize known computable aspects of a problem while neglecting aspects that are unknown and failing to ask questions about them. The tendency to ignore the noncomputable can be countered by considering a wide range of perspectives, encouraging transparency with regard to conflicting viewpoints, stimulating a diversity of models, and managing for the emergence of new syntheses that reorganize fragmentary knowledge.
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| 40. |
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