It has long been claimed that a better understanding of human or social dimensions of environmental issues will improve conservation. The social sciences are one important means through which ...researchers and practitioners can attain that better understanding. Yet, a lack of awareness of the scope and uncertainty about the purpose of the conservation social sciences impedes the conservation community's effective engagement with the human dimensions. This paper examines the scope and purpose of eighteen subfields of classic, interdisciplinary and applied conservation social sciences and articulates ten distinct contributions that the social sciences can make to understanding and improving conservation. In brief, the conservation social sciences can be valuable to conservation for descriptive, diagnostic, disruptive, reflexive, generative, innovative, or instrumental reasons. This review and supporting materials provides a succinct yet comprehensive reference for conservation scientists and practitioners. We contend that the social sciences can help facilitate conservation policies, actions and outcomes that are more legitimate, salient, robust and effective.
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•A better understanding of the human dimensions of environmental issues can improve conservation.•Yet there is a lack of awareness of the scope and uncertainty about the purpose of the conservation social sciences.•We review 18 fields and identify 10 distinct contributions that the social sciences can make to conservation.•This review paper provides a succinct reference for those wishing to engage with the conservation social sciences.•Greater engagement with the social sciences will facilitate more legitimate, salient, robust and effective conservation.
Despite broad recognition of the value of social sciences and increasingly vocal calls for better engagement with the human element of conservation, the conservation social sciences remain ...misunderstood and underutilized in practice. The conservation social sciences can provide unique and important contributions to society's understanding of the relationships between humans and nature and to improving conservation practice and outcomes. There are 4 barriers—ideological, institutional, knowledge, and capacity—to meaningful integration of the social sciences into conservation. We provide practical guidance on overcoming these barriers to mainstream the social sciences in conservation science, practice, and policy. Broadly, we recommend fostering knowledge on the scope and contributions of the social sciences to conservation, including social scientists from the inception of interdisciplinary research projects, incorporating social science research and insights during all stages of conservation planning and implementation, building social science capacity at all scales in conservation organizations and agencies, and promoting engagement with the social sciences in and through global conservation policy-influencing organizations. Conservation social scientists, too, need to be willing to engage with natural science knowledge and to communicate insights and recommendations clearly. We urge the conservation community to move beyond superficial engagement with the conservation social sciences. A more inclusive and integrative conservation science—one that includes the natural and social sciences—will enable more ecologically effective and socially just conservation. Better collaboration among social scientists, natural scientists, practitioners, and policy makers will facilitate a renewed and more robust conservation. Mainstreaming the conservation social sciences willfacilitate the uptake of the full range of insights and contributions from these fields into conservation policy and practice. A pesar del reconocimiento general del valor de las ciencias sociales y los crecientes llamados por un mejor compromiso con el elemento humano de la conservación, las ciencias sociales de la conservación siguen siendo malentendidas y poco utilizadas en la práctica. Las ciencias sociales de la conservación pueden proporcionar contribuciones únicas e importantes para el entendimiento de la sociedad de las relaciones entre los humanos y la naturaleza y para la mejora de las prácticas de la conservación y sus resultados. Existen cuatro barreras - ideológicas, institucionales, de conocimiento y de capacidad - para la integración significativa de las ciencias sociales dentro de la conservación. Proporcionamos una guia práctica sobre cómo sobreponerse a estas barreras paraJncorporar la perspectiva de las ciencias sociales a la ciencia, las prácticas y las políticas de conservación. En general, recomendamos promover el conocimiento sobre el alcance y las contribuciones de las ciencias sociales para la conservación, incluir a los científicos sociales desde el origen de los proyectos de investigación interdisciplinaria, incorporar la investigación de las ciencias sociales y las percepciones durante todas las fases de la planificación y la implementación de la conservación, construir la capacidad de las ciencias sociales en todas las escalas de las organizaciones y agencias de conservación y promover el compromiso con las ciencias sociales en y a través de organizaciones de conservación con influencia política. Los científicos sociales de la conservación, también, necesitan estar dispuestos a involucrarse con el conocimiento de las ciencias naturales y a comunicar percepciones y recomendaciones de manera clara. Le urgimos a la comunidad de la conservación que vaya más allá del compromiso superficial con las ciencias sociales de la conservación. Una ciencia de la conservación más incluyente y integradora - una que incluya a las ciencias sociales y naturales - permitirá una conservación más justa socialmente y más efectiva ecológicamente. Una mejor colaboración entre los científicos sociales, los científicos naturales, los practicantes y quienes elaboran las políticas facilitará una conservación más renovada y más sólida. Incorporar la perspectiva de las ciencias sociales de la conservación facilitará la absorción de la extensión completa de conocimiento y contribuciones de estos campos a la práctica y las políticas de la conservación.
My September 11th Greenberg, Alison Davis
Topics in stroke rehabilitation,
10/1/2003, 2003-10-00, 20031001, Letnik:
10, Številka:
3
Journal Article
Recenzirano
Greenberg discusses the experiences of dealing with a stroke at the age of 45. She now divides life into things that happened before the date of July 18, 2002 and things that have happened after the ...date of her stroke.
Intracerebral hemorrhage (ICH) is the most severe form of stroke. Survivors are at high risk of recurrence, death, and worsening functional disability.
To investigate the association between blood ...pressure (BP) after index ICH and risk of recurrent ICH.
Single-site, tertiary care referral center observational study of 1145 of 2197 consecutive patients with ICH presenting from July 1994 to December 2013. A total of 1145 patients with ICH survived at least 90 days and were followed up through December 2013 (median follow-up of 36.8 months minimum, 9.8 months).
Blood pressure measurements at 3, 6, 9, and 12 months, and every 6 months thereafter, obtained from medical personnel (inpatient hospital or outpatient clinic medical or nursing staff) or via patient self-report. Exposure was characterized in 3 ways: (1) recorded systolic and diastolic measurements; (2) classification as adequate or inadequate BP control based on American Heart Association/American Stroke Association recommendations; and (3) stage of hypertension based on Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 criteria.
Recurrent ICH and its location within the brain (lobar vs nonlobar).
There were 102 recurrent ICH events among 505 survivors of lobar ICH and 44 recurrent ICH events among 640 survivors of nonlobar ICH. During follow-up adequate BP control was achieved on at least 1 measurement by 625 patients (54.6% of total range, 49.2%-58.7%) and consistently (ie, at all available time points) by 495 patients (43.2% of total range, 34.5%-51.0%). The event rate for lobar ICH was 84 per 1000 person-years among patients with inadequate BP control compared with 49 per 1000 person-years among patients with adequate BP control. For nonlobar ICH the event rate was 52 per 1000 person-years with inadequate BP control compared with 27 per 1000 person-years for patients with adequate BP control. In analyses modeling BP control as a time-varying variable, inadequate BP control was associated with higher risk of recurrence of both lobar ICH (hazard ratio HR, 3.53 95% CI, 1.65-7.54) and nonlobar ICH (HR, 4.23 95% CI, 1.02-17.52). Systolic BP during follow-up was associated with increased risk of both lobar ICH recurrence (HR, 1.33 per 10-mm Hg increase 95% CI, 1.02-1.76) and nonlobar ICH recurrence (HR, 1.54 95% CI, 1.03-2.30). Diastolic BP was associated with increased risk of nonlobar ICH recurrence (HR, 1.21 per 10-mm Hg increase 95% CI, 1.01-1.47) but not with lobar ICH recurrence (HR, 1.36 95% CI, 0.90-2.10).
In this observational single-center cohort study of ICH survivors, reported BP measurements suggesting inadequate BP control during follow-up were associated with higher risk of both lobar and nonlobar ICH recurrence. These data suggest that randomized clinical trials are needed to address the benefits and risks of stricter BP control in ICH survivors.
Uphill shifts of species' distributions in response to historical warming are well documented, which leads to widespread expectations of continued uphill shifts under future warming. Conversely, ...downhill shifts are often considered anomalous and unrelated to climate change. By comparing the altitudinal distributions of 64 plant species between the 1930s and the present day within California, we show that climate changes have resulted in a significant downward shift in species' optimum elevations. This downhill shift is counter to what would be expected given 20th-century warming but is readily explained by species' niche tracking of regional changes in climatic water balance rather than temperature. Similar downhill shifts can be expected to occur where future climate change scenarios project increases in water availability that outpace evaporative demand.
Rapid climate change has the potential to affect economic, social, and biological systems. A concern for species conservation is whether or not the rate of on‐going climate change will exceed the ...rate at which species can adapt or move to suitable environments. Here we assess the climate velocity (both climate displacement rate and direction) for minimum temperature, actual evapotranspiration, and climatic water deficit (deficit) over the contiguous US during the 20th century (1916–2005). Vectors for these variables demonstrate a complex mosaic of patterns that vary spatially and temporally and are dependent on the spatial resolution of input climate data. Velocities for variables that characterize the climatic water balance were similar in magnitude to that derived from temperature, but frequently differed in direction resulting in the divergence of climate vectors through time. Our results strain expectations of poleward and upslope migration over the past century due to warming. Instead, they suggest that a more full understanding of changes in multiple climatic factors, in addition to temperature, may help explain unexpected or conflicting observational evidence of climate‐driven species range shifts during the 20th century.
Objective
Oral anticoagulation treatment (OAT) resumption is a therapeutic dilemma in intracerebral hemorrhage (ICH) care, particularly for lobar hemorrhages related to amyloid angiopathy. We sought ...to determine whether OAT resumption after ICH is associated with long‐term outcome, accounting for ICH location (ie, lobar vs nonlobar).
Methods
We meta‐analyzed individual patient data from: (1) the multicenter RETRACE study (n = 542), (2) a U.S.‐based single‐center ICH study (n = 261), and (3) the Ethnic/Racial Variations of Intracerebral Hemorrhage study (n = 209). We determined whether, within 1 year from ICH, OAT resumption was associated with: (1) mortality, (2) favorable functional outcome (modified Rankin Scale = 0–3), and (3) stroke incidence. We separately analyzed nonlobar and lobar ICH cases using propensity score matching and Cox regression models.
Results
We included 1,012 OAT‐related ICH survivors (633 nonlobar and 379 lobar). Among nonlobar ICH survivors, 178/633 (28%) resumed OAT, whereas 86/379 (23%) lobar ICH survivors did. In multivariate analyses, OAT resumption after nonlobar ICH was associated with decreased mortality (hazard ratio HR = 0.25, 95% confidence interval CI = 0.14–0.44, p < 0.0001) and improved functional outcome (HR = 4.22, 95% CI = 2.57–6.94, p < 0.0001). OAT resumption after lobar ICH was also associated with decreased mortality (HR = 0.29, 95% CI = 0.17–0.45, p < 0.0001) and favorable functional outcome (HR = 4.08, 95% CI = 2.48–6.72, p < 0.0001). Furthermore, OAT resumption was associated with decreased all‐cause stroke incidence in both lobar and nonlobar ICH (both p < 0.01).
Interpretation
These results suggest novel evidence of an association between OAT resumption and outcome following ICH, regardless of hematoma location. These findings support conducting randomized trials to explore risks and benefits of OAT resumption after ICH. Ann Neurol 2017;82:755–765
Cerebral amyloid angiopathy-related inflammation (CAA-ri) is an important diagnosis to reach in clinical practice because many patients with the disease respond to immunosuppressive therapy. Reliable ...noninvasive diagnostic criteria for CAA-ri would allow some patients to avoid the risk of brain biopsy.
To test the sensitivity and specificity of clinical and neuroimaging-based criteria for CAA-ri.
We modified the previously proposed clinicoradiological criteria and retrospectively analyzed clinical medical records and magnetic resonance imaging fluid-attenuated inversion recovery and gradient-echo scans obtained from individuals with CAA-ri and noninflammatory CAA. At 2 referral centers between October 1, 1995, and May 31, 2013, and between January 1, 2009, and December 31, 2011, participants included 17 individuals with pathologically confirmed CAA-ri and 37 control group members with pathologically confirmed noninflammatory CAA. The control group was further divided into those with past lobar intracerebral hemorrhage (ICH) (n = 21) and those with cerebral microbleeds only and no history of ICH (n = 16). The dates of our analysis were September 1, 2012, to August 31, 2015.
The sensitivity and specificity of prespecified criteria for probable CAA-ri (requiring asymmetric white matter hyperintensities extending to the subcortical white matter) and possible CAA-ri (not requiring the white matter hyperintensities to be asymmetric).
The 17 patients in the CAA-ri group were a mean (SD) of 68 (8) years and 8 (47%) were women. In the CAA-ri group, 14 of 17 (82%) met the criteria for both probable and possible CAA-ri. In the control group having noninflammatory CAA with lobar ICH, 1 of 21 (5%) met the criteria for possible CAA-ri, and none met the criteria for probable CAA-ri. In the control group having noninflammatory CAA with no ICH, 11 of 16 (69%) met the criteria for possible CAA-ri, and 1 of 16 (6%) met the criteria for probable CAA-ri. These findings yielded a sensitivity and specificity of 82% and 97%, respectively, for the probable criteria and a sensitivity and specificity of 82% and 68%, respectively, for the possible criteria.
Our data suggest that a reliable diagnosis of CAA-ri can be reached from basic clinical and magnetic resonance imaging information alone, with good sensitivity and excellent specificity.
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