Long-term Recovery Trajectory Research Articles

Understanding post-pandemic spatiotemporal differences in the recovery of metro travel behavior among different groups by considering the built environment

Numerous studies have substantiated the substantial impact of COVID-19 on metro travel, which is expected to gradually recover once the pandemic is controlled. Given the potentially more severe repercussions of COVID-19 on vulnerable groups like the elderly and people with disabilities, recovery patterns may differ significantly among various demographic segments. However, limited research has addressed this notable disparity. To address this gap, we collected metro travel data in Wuhan from March 2019 to April 2021. We analyzed changes in travel characteristics among different groups, such as the elderly, people with disabilities, commuters, school students, and others, before and after the pandemic. By employing interrupted time series analysis, we explored the short-term impact of the pandemic on different groups and their long-term recovery trajectories. We also investigated the factors influencing the recovery of metro travel among diverse demographic groups. The findings indicate the following: (1) All groups experienced a sharp decline in travel ridership and frequency in the short term due to the pandemic. (2) There are distinct variations in long-term ridership recovery among different groups, with commuters and school students showing the quickest recovery. However, ridership among people with disabilities remained below pre-pandemic levels even a year after the pandemic. (3) Given the inherent spatiotemporal regularity in residents’ daily activities, post-pandemic metro travel patterns closely align with the pre-pandemic patterns. (4) Different built environment factors exert varying degrees of influence on the recovery of metro ridership among different groups, and distinctions are evident between weekdays and weekends. These findings enhance our comprehension of the pandemic’s impact on diverse demographic groups, which can guide government agencies and urban planners in formulating more resilient strategies for rail transit operations and land use optimization.

A qualitative longitudinal study of traumatic orthopaedic injury survivors’ experiences with pain and the long-term recovery trajectory

ObjectivesTo explore trauma patients’ experiences of the long-term recovery pathway during 18 months following hospital discharge.DesignLongitudinal qualitative study.Setting and participantsThirteen trauma patients with injuries associated with pain that had been...

Three-year mortality, readmission, and medical expenses in critical care survivors: A population-based cohort study

BackgroundDue to the increasing number of critical care survivors, population-based studies on the long-term outcomes after discharge are necessary to inform local decision-making. ObjectivesThis study aimed to investigate mortality and its risk factors, readmissions, and medical expenses of intensive care unit survivors for 3 years after hospital discharge. MethodsThis retrospective study analysed data from the National Health Insurance Service-National Sample Cohort in Korea. Of the 195,702 patients who survived and were discharged from hospital in 2012, 2693 intensive care unit patients were assigned to the case group for the study, and the remaining 193,009 were assigned to the comparison group. The primary outcome was all-cause mortality for 3 years after discharge. Secondary outcomes were all-cause hospital readmission and medical expenses in 3 years. We analysed risk factors for mortality using the Cox proportional hazard regression. The differences in hospital readmission and medical expenses between the case and comparison groups were analysed by multivariate logistic regression and independent t-tests. ResultsThe 1-year, 2-year, and 3-year cumulative mortality rates in the case group were 15.9%, 20.5%, and 24.4%, respectively, and older age, disability, medical admission, and longer hospital stay increased mortality. Almost 40% of intensive care unit survivors were readmitted to hospital within 6 months of discharge, and their odds of being readmitted were significantly higher than those of the comparison group. Medical expenses were also significantly higher in the case group, with the highest paid within 6 months. ConclusionsMortality, hospital readmission, and medical expenses for intensive care unit survivors were the worst within 6 months of discharge. In light of the long-term recovery trajectory of critical illness, it is necessary to investigate what factors may have contributed to the negative outcome during this period. Further research is needed to determine which services primarily contributed to the increase in medical expenses.

Long-term housing recovery among Mexican immigrants: How service providers navigate racialized anti-immigrant disaster recovery policies

Disasters are increasing in frequency and intensity. Much of the current disaster literature adopts a social vulnerability perspective, which considers how political, social, and economic factors influence pre-disaster preparation and post-disaster recovery. Even with this focus, however, there remains a dearth of literature on immigrant populations and their long-term recovery trajectories. This paper applies a racial formation framework to a disaster context. I seek to show how service providers from community-based organizations (CBOs) navigate racialized anti-immigrant disaster recovery policies to help the Mexican immigrant community in Houston, Texas with their long-term housing recovery after Hurricane Harvey. I conducted semi-structured interviews and ethnographic observations with service providers from CBOs located in Houston that serve this population with post-disaster housing. I argue that the disaster recovery system is comprised of racial structures and racialized anti-immigrant policies, passively and actively limiting the access to resources for the Mexican immigrant community. I found that to challenge the racial structures and racialized anti-immigrant policies of the disaster recovery system, service providers assist the community through direct assistance to Mexican immigrants excluded from other programs; collaboration with other organizations to combine limited resources; helping the community navigate racialized anti-immigrant bureaucracy; and building trust by embedding themselves in the victimized community. However, findings also show that these organizations face significant challenges in conducting their work. This research brings a much-needed theoretical expansion of race and racialization theories to disaster research.

We’re all in this together? Community resilience and recovery in Kaikōura following the 2016 Kaikōura-Hurunui earthquake

ABSTRACT The magnitude 7.8 earthquake that struck North Canterbury, on the east coast of New Zealand’s South Island on 14 November 2016 had significant impacts and implications for the community of Kaikōura and surrounding settlements. The magnitude and scope of this event has resulted in extensive and ongoing geological and geophysical research into the event. The current paper complements this research by providing a review of existing social science research and offering new analysis of the impact of the earthquake and its aftermath on community resilience in Kaikōura over the past five years. Results demonstrate the significant economic implications for tourism, and primary industries. Recovery has been slow, and largely dependent on restoring transportation networks, which helped catalyse cooperation among local hospitality providers. Challenges remain, however, and not all sectors or households have benefited equally from post-quake opportunities, and long-term recovery trajectories continue to be hampered by COVID-19 pandemic. The multiple ongoing and future stressors faced by Kaikōura require integrated and equitable approaches in order to build capability and capacity for locally based development pathways to ensure long-term community resilience.

Housing type matters for pace of recovery: Evidence from Hurricane Ike

Rapid and broad-based housing recovery is key to successful, resilient community recovery, due to the significant share of housing in disaster losses, population retention, and its importance for household and business recovery. In the literature, there is relative consensus on how housing damage is shaped by pre-impact conditions at household and neighborhood levels. However, systematic longitudinal studies that compare the recovery trajectories of different types of housing are rare. Here, we examine long-term recovery trajectories after Hurricane Ike (2008) in Galveston, Texas using parcel level data for multifamily, single-family, and duplexes over an eight-year period. Overall, we found that recovery trajectories differed significantly across housing types. Multifamily housing and duplex homes recover more slowly compared to single-family houses after controlling for damage and socioeconomic characteristics of neighborhoods. These findings substantiate conclusions of previous research and call for disaster recovery assistance programs targeting recovery disparities among residential types to better ensure broad-based housing recovery.

Ecosystem services supply and interactions along secondary tropical dry forests succession

Secondary forests will likely dominate future tropical landscapes, and the ecosystem services they provide to humanity will be particularly relevant. However, few empirical studies provide quantitative evidence of how the supply of ecosystem services change along secondary forest succession. The need for such information is particularly pressing for tropical dry forests because of their extensive global coverage and a high degree of disturbance. Here we examine the changes in the potential supply of ecosystem services and the interactions among them along secondary tropical dry forest succession for a site on the Mexican Pacific coast. Using data from a chronosequence of twelve sites followed over ten years, we characterized changes in five ecosystem services along a successional gradient from abandoned farmland to old-growth forests: forage, multiple forest resources, microclimate regulation, carbon storage and carbon sequestration. The long-term recovery trajectory for each service was modelled using linear and non-linear mixed models. Interactions among them were examined over different timeframes using Spearman correlations. The results showed rapid non-linear recovery of multiple forest resources provision, microclimate regulation and carbon storage within the first two decades of succession. Carbon sequestration increased slightly over time, while the supply of forage showed no clear trend. The strength of the interactions among pairs of services changed through successional time, being particularly higher in farmlands and old-growth forests. Our findings suggest that adaptive forest management practices that foster the natural regeneration of tropical dry forests are cost-effective mechanisms to recover the supply of critical ecosystem services for local actors by meeting their livelihood needs as well as those for the global community through climate change mitigation. Maintaining tropical dry forest resilience will highly depend on the maintenance of diversity in terms of species and ecosystem services.

The Social Consequences of Disasters: Individual and Community Change

We review findings from the last decade of research on the effects of disasters, concentrating on three important themes: the differences between the recovery of places versus people, the need to differentiate between short- and long-term recovery trajectories, and the changing role of government and how it has exacerbated inequality in recovery and engendered feedback loops that create greater vulnerability. We reflect the focus of the majority of sociological studies on disasters by concentrating our review on studies in the United States, but we also include studies on disasters throughout the world if they contribute to our empirical and theoretical understanding of disasters and their impacts. We end with a discussion of the inevitability of more severe disasters as climate change progresses and call on social scientists to develop new concepts and to use new methods to study these developments.

Recovery, risk and resilience: Post-disaster tourism experiences in Kaikōura, New Zealand

Tourists are essential to a destination's social and economic recovery following disaster, reducing future risk and enhancing resilience. Drawing on the results of visitor surveys in Kaikōura, New Zealand, we analyse visitors' experiences and their consideration of natural hazard risk and response abilities in relation to a damaging earthquake in the region in 2016. Despite widespread national media and significant disruption, findings suggest the disaster had very little impact on visitors' perceptions and experiences and did not translate into greater preparedness. Instead, tourists reported only limited knowledge about what to do or where to go in the event of a natural hazard event. Results suggest tourists' resilience – and Kaikōura's resilience as a whole – would be enhanced by improving knowledge sharing and awareness building. Furthermore, by considering tourists as part of a linked social-ecological system, targeted interventions to improve understanding of natural hazards can support long-term recovery trajectories and minimize future losses.

History of Alcohol and Opioid Use Impacts on the Long-Term Recovery Trajectories of Methamphetamine-Dependent Patients.

Methamphetamine (MA) has become one of the most widely used illicit substances in China and the rest of the world as well. Relapse, incarceration or death was observed after compulsory rehabilitation. However, the knowledge of recovery patterns among MA-dependent patients, early or late occurrence of these negative consequences, is limited. The aims were to explore the long-term recovery patterns and associated factors among MA-dependent patients in Shanghai, China. MA-dependent patients discharged from Shanghai compulsory rehabilitation facilities in 2009–2012 were recruited in a baseline survey. The baseline data of 232 patients were then linked with their long-term follow-up data from official records. Group-based trajectory modeling was applied to identify distinctive trajectories of the occurrence of negative consequences (incarceration, or readmission to compulsory rehabilitation, or death). Patients with monthly status data were found recovering with three distinctive trajectories: rare, late, and early occurrence groups. Multinomial logistic regression showed that having alcohol use history was associated with an increased likelihood of being in the late occurrence group relative to the rare occurrence group. Having opioid use history was associated with an increased likelihood of being in the early occurrence group relative to the rare occurrence group. In addition, being female was associated with decreased likelihood of being in the late occurrence group relative to the rare occurrence group.

Longitudinal assessments highlight long-term behavioural recovery in disorders of consciousness.

Accurate diagnosis and prognosis of disorders of consciousness is complicated by the variability amongst patients’ trajectories. However, the majority of research and scientific knowledge in this field is based on cross-sectional studies. The translational gap in applying this knowledge to inform clinical management can only be bridged by research that systematically examines follow-up. In this study, we present findings from a novel longitudinal study of the long-term recovery trajectory of 39 patients, repeatedly assessed using the Coma Recovery Scale-Revised once every 3 months for 2 years, generating 185 assessments. Despite the expected inter-patient variability, there was a statistically significant improvement in behaviour over time. Further, improvements began approximately 22 months after injury. Individual variation in the trajectory of recovery was influenced by initial diagnosis. Patients with an initial diagnosis of unresponsive wakefulness state, who progressed to the minimally conscious state, did so at a median of 485 days following onset—later than 12-month period after which current guidelines propose permanence. Although current guidelines are based on the expectation that patients with traumatic brain injury show potential for recovery over longer periods than those with non-traumatic injury, we did not observe any differences between trajectories in these two subgroups. However, age was a significant predictor, with younger patients showing more promising recovery. Also, progressive increases in arousal contributed exponentially to improvements in behavioural awareness, especially in minimally conscious patients. These findings highlight the importance of indexing arousal when measuring awareness, and the potential for interventions to regulate arousal to aid long-term behavioural recovery in disorders of consciousness.

Adding insult to injury: Ship groundings are associated with coral disease in a pristine reef.

In 2013, the remote Tubbataha Reef UNESCO World Heritage Site, in the western Philippines, experienced two ship groundings within four months: the USS Guardian (USSG), a US military vessel, and the Min Ping Yu (MPY), an illegal Chinese fishing vessel. Here, we present the results of coral disease assessments completed two years post-grounding and recovery patterns monitored annually within these grounding sites. Site assessments were undertaken in three distinct zones: ‘ground zero’, where reef was scoured to its limestone base by direct ship impact; the ‘impact border’, containing surviving upright but damaged, abraded and fragmented colonies injured during ship movement; and undamaged ‘control’ sites, remote from the ship groundings but located on the same atoll. Coral diseases were dominated by white syndromes, and prevalence was an order of magnitude higher within the impact border zones than within the other zones two years after the events. Hard coral cover has steadily increased at a mean rate of 3% per year within the scoured USSG site at a rate comparable to control sites. In contrast, recovery has been negligible within the rubble-dominated MPY site, suggesting that substrate quality strongly influenced recovery processes such as recruitment, as larvae do not survive well on unstable substrates. Long-term recovery trajectories from these two grounding events appeared strongly influenced by movement of the ship during and after each event, and site-specific wave-influenced persistence of rubble and debris. High prevalence of coral disease among damaged but surviving colonies two years post-grounding suggested long-term impacts which may be slowing recovery and creating localized pockets of higher persistent disease prevalence than that of the surrounding population.

Post-Fire Changes in Forest Biomass Retrieved by Airborne LiDAR in Amazonia

Fire is one of the main factors directly impacting Amazonian forest biomass and dynamics. Because of Amazonia’s large geographical extent, remote sensing techniques are required for comprehensively assessing forest fire impacts at the landscape level. In this context, Light Detection and Ranging (LiDAR) stands out as a technology capable of retrieving direct measurements of vegetation vertical arrangement, which can be directly associated with aboveground biomass. This work aims, for the first time, to quantify post-fire changes in forest canopy height and biomass using airborne LiDAR in western Amazonia. For this, the present study evaluated four areas located in the state of Acre, called Rio Branco, Humaitá, Bonal and Talismã. Rio Branco and Humaitá burned in 2005 and Bonal and Talismã burned in 2010. In these areas, we inventoried a total of 25 plots (0.25 ha each) in 2014. Humaitá and Talismã are located in an open forest with bamboo and Bonal and Rio Branco are located in a dense forest. Our results showed that even ten years after the fire event, there was no complete recovery of the height and biomass of the burned areas (p < 0.05). The percentage difference in height between control and burned sites was 2.23% for Rio Branco, 9.26% for Humaitá, 10.03% for Talismã and 20.25% for Bonal. All burned sites had significantly lower biomass values than control sites. In Rio Branco (ten years after fire), Humaitá (nine years after fire), Bonal (four years after fire) and Talismã (five years after fire) biomass was 6.71%, 13.66%, 17.89% and 22.69% lower than control sites, respectively. The total amount of biomass lost for the studied sites was 16,706.3 Mg, with an average loss of 4176.6 Mg for sites burned in 2005 and 2890 Mg for sites burned in 2010, with an average loss of 3615 Mg. Fire impact associated with tree mortality was clearly detected using LiDAR data up to ten years after the fire event. This study indicates that fire disturbance in the Amazon region can cause persistent above-ground biomass loss and subsequent reduction of forest carbon stocks. Continuous monitoring of burned forests is required for depicting the long-term recovery trajectory of fire-affected Amazonian forests.

Long-term recovery trajectory after stroke: an ongoing negotiation between body, participation and self

Purpose: Research has mainly focused on the first year of recovery trajectory after stroke, but there is limited knowledge about how stroke survivors manage their long-term everyday lives. This study seeks to fill this gap by exploring the long-term (1–13 years) negotiations of stroke survivors when they experience progress, wellbeing and faith in the future. Method: Repeated in-depth interviews were conducted with nine people living with moderate impairment after stroke and their closest relatives. Concepts from phenomenology and critical psychology constituted the frame of reference of the study. Results: The long-term stroke recovery trajectory can be understood as a process of struggling to overcome tensions between three phenomena under ongoing change: the lived body, participation in everyday life and sense of self. During the recovery process, stroke survivors experience progress, well-being and faith in the future when moving towards renewed relationships, characterised by (1) a modified habitual body, (2) repositioned participation in specific everyday life contexts and (3) a transformed sense of self. Conclusions: This study stresses the importance of developing new forms of professional support during the long-term recovery trajectory, to stimulate and increase interaction and coherence in the relationship between the stroke survivor's bodily perception, participation in everyday life and sense of self.Implications for RehabilitationThe study deepening how the long-term recovery trajectory after stroke is about ongoing embodied, practical and socially situated negotiations.The study demonstrates that the recovery trajectory is a long term process of learning where the stroke survivor, as an embodied agent, gradually modifies new bodily habits, re-position participation and transforming of the self.Health personnel are usually available in the acute and early rehabilitation period. The three phenomenons under ongoing change; “body”, “participation” and “self” are at this point just about being moved toward a renewed and a more coherent relationship in the stroke survivor long-lasting everyday life situated recovery trajectory.Available rehabilitation services at the municipal level supporting stroke survivors and relatives practical, social and interpersonal long-term challenges in everyday life can be important for minimizing their struggles and for promoting the experience progress, wellbeing and faith in the future.