Socio-economic Pressures Research Articles

Are Residents Able to Perform a Laparoscopic Cholecystectomy with Acceptable Outcomes When the Attending Is Not Scrubbed?

Recent socioeconomic pressures in healthcare and work hour resections have limited opportunities for resident autonomy and independent decision-making. We sought to evaluate whether contemporary senior residents are being given the opportunity to operate independently and whether patient outcomes are affected when the attending is not directly involved in an operation. The VA Surgical Quality Improvement Program (VASQIP) Database was queried to identify patients undergoing elective laparoscopic cholecystectomy between 2004 and 2019. Cases were categorized as "attending" or "resident" depending on whether the attending surgeon was scrubbed. Cohorts were 1:1 propensity score-matched (PSM) for demographics, comorbidities, and facility case-mix. Clinical outcomes for matched cohorts were compared by standard methods. There were 23,831 records for patients who underwent laparoscopic cholecystectomy; 20,568 (86%) performed with the attending scrubbed, and 3,263 (14%) without the attending scrubbed. Over time there was a significant decrease in the proportion of cases without the attending scrubbed, 18% in 2004-2009 to 13% in 2015-2019 (p < 0.001). On PSM, 3,263 patients undergoing laparoscopic cholecystectomy by the residents without the attending scrubbed were successfully matched (1:1) to cases with the attending scrubbed. On comparison of matched cohorts, procedures performed without the attending scrubbed were statistically longer (102 vs 98 minutes, p = 0.001) but with no difference in rates of postoperative complications (5% vs 5%, p = 0.9). In comparison with cases done with more direct attending involvement, residents perform laparoscopic cholecystectomies efficiently without increased complications. Over time, attendings are more frequently scrubbed for the operation.

Climate change, institutional quality and SDGs: A narrative review with a focus on Yemen

The purpose of this paper is to undertake a narrative review on climate change, institutional quality, and SDGs within the context of Yemen. The methodology is a broad study of past and recent academic works related to the topic's keywords. In essence, a narrative review has been undertaken to incorporate the three interlacing issues; climate change, institutional quality, and SDG in the context of Yemen. The present research work reinforces the evidence that climate change effects are particularly more catastrophic in regions already under political, socio-economic, and cultural pressures. Eventually, the attainment of SDGs become increasingly challenging in contexts with intense climate variability and native disturbances. Besides, the lack of quality institutions and strong governance put in peril the stability of the country, thereby making it more prone to conflicts. This eventually leads to the formation of a vicious circle where low institutional quality fecund more conflicts, which in turn further destabilizes state institutions. Overall, climate change is making matters worse for countries like Yemen, and hence this study provides an insight into the Yemenite society and economy. Since this is a narrative review with an interpretive approach, further studies should aim to engage in more econometric analysis covering the interference relationships between climate change, institutional quality, and SDGs, especially in countries facing the turmoils of war and conflict.

Patterns of Post-socialist Urban Development in Russia and Germany

Since 1990, urbanization in post-socialist countries has frequently resulted in a loss of urban density in the existing building stock while land use patterns at the outskirts of growing city regions began to sprawl. Formerly state-planned and controlled housing forms as well as industrial and business enterprises were suddenly exposed to new market interests and finance-led investments in a globalizing world. In the initial adaptation to socio-economic transformation pressures after the fall of the iron curtain, the countries in question took different approaches in the governance of urbanization trends. The comparison of urban development between Russian and Eastern German city regions showcases two contrasting examples. Urban development in Russian city regions is largely driven by action-oriented political control of land market interests on the project level. Today's Eastern German city regions have adopted the spatial planning regime of former West Germany. Where the German planning regime aims to coordinate long-term planning and decision-making between different tiers of government with an emphasis to empower land use management on the local community level, land use decisions in Russia are formally free of such regulatory frameworks. According to urban metrics that monitor the sustainability of urban development, both approaches result in increasing urban sprawl and related potential adverse impacts on multiple public goods. Experts interviewed for this article frequently attribute this outcome to “catch-up development” that prioritizes economic development over other land use interests. The cumulative negative effects of urban sprawl on land use efficiency are increasingly being recognized, but they are still frequently subordinate to urban development interests.

The adoption of care policies in Costa Rica: A multiple streams approach

AbstractThis study explains the adoption of the National Childcare and Development Network in Costa Rica using John Kingdon's multiple streams approach. Traditionally, the literature on social policies argues that in the presence of socioeconomic transformations and pressures from women's movements and from left or center‐left governments, the adoption of care policies is more likely to happen. Yet, Costa Rica adopted its care policy during a fiscal crisis, with a lack of demands for care policies from the women's movement, and with a right‐wing party in government. Drawing data from documents and semistructured interviews, this article demonstrates the applicability of the multiple streams approach to understand care policy‐making processes in developing countries. The study finds that the multiple streams approach effectively explains the adoption of the policy as the product of top‐down decisions from the national women's agency that constructs the problem, a close‐knit policy design led by technocrats and bureaucrats, and the politicization of care policies to gain electoral support.

‘It’s About Survival’: Court constructions of socio-economic constraints on women offenders in Australian human trafficking for sexual exploitation cases

Women make up more than half of the offenders convicted for human trafficking for sexual exploitation in Australia since 2005. This article explores how courts construct the financial motivations for women’s offending to examine how gendered structural constraints are considered in Australian trafficking cases. We explore data from the sentencing remarks and appeal transcripts from the ten cases of women convicted for human trafficking and analyse the two most recent cases to explore how women’s financial considerations are underpinned by the gendered socio-economic pressure of supporting family members. Using data from interviews with Australian judges and anti-trafficking experts, we examine the relationship between structural constraints and women’s agency and the relative weight each of these factors are given in sentencing women trafficking offenders. In doing this, we explore the overlap between victimisation and offending and the tensions between structural constraints and agency, arguing that the former must be taken into consideration when sentencing women trafficking offenders.

Ecosystem Stability Assessment of Yancheng Coastal Wetlands, a World Natural Heritage Site

By evaluating the stability of coastal wetland ecosystems, health conditions of regional ecosystems can be revealed and the sustainable development of coastal wetlands can be promoted. Coastal wetlands have been scarcely involved in present ecosystem stability evaluation studies, these being performed with relatively simple evaluation data sources. Therefore, in this research, a comprehensive and representative ecosystem stability evaluation index system was constructed by using the pressure-state-response model and multi-source datasets from perspectives of internal and external environmental changes of the Yancheng coastal wetlands, Jiangsu, China. The analysis results indicated that: (1) The ecosystem stability of the Yancheng coastal wetlands was at an early warning stage, and all segments except the Binhai segment (relatively stable) were in an early warning state. (2) In the criterion layer, the Dafeng District and the whole Yancheng District were faced with the highest pressure, followed by the Dongtai, Xiangshui and Binhai segments, successively. The Sheyang segment reached the highest state level, followed by the Binhai, Xiangshui and Dafeng segments in succession. (3) In the factor layer, the whole Yancheng District was faced with high resource and socioeconomic double pressures, with a poor water quality state and relatively low environmental pressure; favorable soil, biological and landscape states; and positive response to wetland protection. Various factors varied from county to county. (4) In the index layer, the ecosystem stability of the Yancheng coastal wetlands was significantly influenced by the invasion of alien species, change rate of natural wetland area (D32), change rate of artificial wetland area, increment of aquafarm area, intensity of fertilizer application and coverage of dominant vegetations. The novel significance of this research lies in enriching global coastal wetlands ecosystem stability evaluation investigations by providing a typical case study.

Determining the suitability of rainwater harvesting for the achievement of sustainable development goals in Wadi Watir, Egypt using GIS techniques

Scarcity of water has emerged as a major problem globally due to climate change and population growth, especially in semi-arid and arid regions. Egypt is currently experiencing serious water challenges due to its limited water resources. The water challenges require optimal and sustainable water management, which should be linked to sustainable development goals. In this context, rainwater harvesting (RWH) is an efficient technique for sustainable management of water resources. This research aims to determine the optimal implementation of RWH systems considering the biophysical and socioeconomic characteristics of the study area. This research combines geographic information systems, remote sensing, multi-criteria analysis, and hydrological modeling in a case study in Wadi Watir in the Sinai Peninsula, Egypt. It then determines optimal sites for RWH structures using a combination of Boolean analysis, weighted linear combination, and depression depth technique. The study's findings are linked to the sustainable development goals to develop a sustainable RWH plan for the first time. The results indicated that 19% (666 km2) of the study area is highly suitable for RWH. The possibility of RWH is restricted to 16% (573 km2) of the watershed. The study results identified 12 optimal sites for checking dams and 14 locations for percolation tanks along the streams. This research puts forward a novel technique to address the challenges of water scarcity along with socioeconomic and environmental pressures while achieving sustainable development goals.

Pulmonary Hypertension in Rural Minnesota

<h3>Purpose</h3> Pulmonary arterial hypertension (PAH) is a progressive disease with high morbidity and mortality. The purpose of this study is to describe the prevalence and natural history of pulmonary hypertension in rural communities. <h3>Methods</h3> Retrospective review of patients with suspected PH seen at an outreach cardiology practice in rural Minnesota between 1/1/2010 and the present. Patients were ≥18 years old, with echocardiography and right heart catheterization (RHC) procedures. All patients with mean pulmonary artery pressure > 20 mmHg on RHC were included. Patients were grouped into pulmonary arterial hypertension (PAH) or chronic thromboembolic PH (group 1), combined pre- and post-capillary PH (CPC-PH/fxoup 1*), and non-group 1 PH (groups 2, 3, and 5) using standard definitions. <h3>Results</h3> Of 272 patients, 61 patients had PAH, 48 patients had CPC-PH, and 163 patients had non-group 1 PH. Female sex was predictive of PAH (OR 2.37, 95% CI: 1.28, 4.37), as was higher RVSP on echo (OR 1.02, 95% CI: 1.01, 1.04). Moderate-severe left atrial enlargement on echo (OR 0.39, 95% CI: 0.21, 0.73), coronary artery disease (OR 0.50, 95% CI: 0.27, 0.91), and atrial fibrillation (OR 0.31, 95% CI: 0.16, 0.59) were predictive of non-group 1 PH. Patient mortality increased with age at diagnosis (<b>Figure 1</b>, p=0.002). Patient mortality was similar among group 1, CPC-PH, and non-group 1 PH. <h3>Conclusion</h3> PAH and CPC-PH patients have different baseline characteristics compared to non-group 1 PH patients yet have similar mortality. Age at diagnosis remains a critical factor in patient prognosis with higher mortality among older patients. Interestingly, males are overrepresented in this rural subset when compared to prior literature. Because rural patients often have difficulty accessing care and unique socioeconomic pressures, continued vigilant screening may result in more accurate diagnoses and improved patient morbidity and mortality.

Qualifying the earthquake resilience of vernacular masonry buildings along the Himalayan arc

Vernacular masonry building types located along the Himalayan arc and incorporating specific earthquake-resilient features have exhibited good seismic performance in past earthquakes. Such buildings are a manifestation of a culture of seismic awareness that developed in these communities over the centuries in response to the local technological, socio-cultural, economic, and environmental contexts. This culture of seismic awareness has eroded in recent years due to socio-economic pressure associated with a desire for modernity of construction. To identify an appropriate balance between traditional and modern construction materials and practices, thereby enabling greater resiliency to the peril of earthquakes in the Himalayas, it is essential to understand the positive and negative attributes of earthquake-resilient vernacular masonry building types. Presented herein is an overview of the identified earthquake-resilient vernacular masonry building types located along the Himalayan arc, as well as an evaluation of the seismic resilient features of these buildings in the context of modern seismic design requirements. The work presented herein shows that earthquake-resilient buildings are feasible when constructed of locally available materials such as stone, mud, and timber, and when using traditional construction techniques, provided that the identified earthquake-resilient features are properly implemented.

Will the regime ever break? Assessing socio-political and economic pressures to climate action and European oil majors’ response (2005-2019)

ABSTRACT The extensive use of fossil fuels in recent decades is a well-known cause of the climate crisis. Climate action inevitably requires the strategic reorientation of industries that are part of the fossil fuel regime. International oil companies are central to this regime and possess the incumbent’s characteristic power and influence to steer this process. However, European international oil companies continue to invest in fossil fuels, even as they acknowledge the climate crisis imperative. Socio-political and economic dynamics can either reinforce the oil regime or pressure firms to take climate action. We aim to comprehensively analyse the dynamics between external socio-political and economic actors’ pressures to climate action on the one side, and the industry response on the other, from 2005 to 2019, using Geels Triple Embeddedness Framework. Drawing on a wide range of qualitative and quantitative longitudinal data (e.g. regulations, oil and renewables market trends, companies’ investments in oil, renewables, and low-carbon technologies), we characterised the pressures and responses of the different analytical categories and established three phases. The results indicate that policy pressure on the oil regime in this period lacked constancy and comprehensiveness. The Kyoto Protocol ratification produced an initial momentum that prompted some companies to invest in alternative fuels and renewables, but efforts faded after 2010. Societal calls for a transition from fossil fuels and divestments from oil companies have risen since 2017. Recent socio-economic pressures combined with policy pledges for net-zero emissions have prompted all companies to invest beyond fossil fuels. However, efforts are still marginal and additional advancements in climate policy are necessary to foster the renewables market and to promote the phase-out of oil. Key policy insights Europe lacks a comprehensive policy framework to support the fast deployment of available alternative fuels. Policies need to foster the development and adoption of alternatives to petrochemical products, alongside their reduction and recycling. Apart from supporting renewable energy and other alternatives to oil, policies also need to target the phase-out of oil and send a clear signal to companies.

A Middle East Cooperation and Security Process: Has the Time Come?

AbstractFor many years, there has been discussion of the idea of creating an inclusive regional cooperation and security system in the Middle East. This discussion is gathering increased interest today as several events and trends have focused attention on the rapid changes in the region and how they may be dealt with. These include profound socioeconomic and political pressures in the region; the violent breakdown of governing authority in places like Syria and Yemen; the Iran nuclear issue; perceptions that the regional roles of major external powers, most notably the United States and China, may be changing; and the evolving relationship between Israel and certain Arab countries. This article outlines the ideas and concepts that arose from a multi‐year series of studies on this issue by regional experts as to how such a system might be established and what its key provisions and structures might be. The article describes and proposes a model of an inclusive, multi‐tiered regional process that will encourage regional dialogue on key social, economic, security, and political issues.

Stressors and coping strategies in Chinese family caregivers of people with dementia in long-term care facilities: A qualitative descriptive study.

This study aimed to explore the stressors along with coping strategies in Chinese family caregivers whose relative with dementia had been placed into a long-term care facility. A qualitative descriptive study was conducted with 17 Chinese family caregivers of institutionalised older adults with dementia, recruited via purposeful sampling. Information regarding stressors along with coping strategies was collected through face-to-face semi-structured individual interviews. The interviews were audio-recorded, transcribed, anonymised and imported into MAXQDA 2018.2. Data were analysed with qualitative content analysis. Three categories of stressors emerged: socioeconomic pressure, hassles arising from continuing caregiving and suboptimal care provided by the facility. In particular, the family caregivers' experienced tremendous pressure of negative comments from people around since long-term care placement was traditionally viewed as unfilial in Chinese societies. Various coping strategies were adopted by Chinese family caregivers to deal with the stressors; however, they were not always adaptive. Health care authorities and professionals should recognise family caregivers' stressors after long-term care placement of a relative with dementia with the consideration of the unique socio-cultural needs. Appropriate and effective interventions should be developed and implemented to facilitate family caregivers to cope with stressful situations after long-term care placement and further to safeguard their psychosocial well-being.

FROM SPRING TO WINTER: THE NEED FOR CONSISTENT SEASONAL VACCINATIONS

The cyclical interplay between seasons and diseases has long intrigued researchers and health professionals alike. With each seasonal transition, certain infectious diseases rise to the forefront, influenced by dynamic factors such as environmental conditions, shifts in human behavioral patterns, and varying biological rhythms. This article delves deep into the intricate relationship between these changes and the consequent surge in specific diseases, underlining the critical importance of timely and consistent vaccinations. Beyond the evident health implications, seasonal diseases exert tremendous socioeconomic pressures, stretching the capacities of healthcare facilities, causing productivity losses, and even impacting school attendance and business operations. Vaccinations, a marvel of modern medicine, emerge as a paramount defense mechanism. Through herd immunity, they not only protect the vaccinated individual but also reduce the overall transmission, especially when formulas adapt annually to the anticipated strains, as seen with influenza. Despite the undoubtable benefits, the global community grapples with challenges like public hesitancy towards vaccines, often fueled by misinformation, and logistical hurdles that affect distribution, especially in remote or underserved regions. Emphasizing the universal acceptance and enhanced accessibility of seasonal vaccines is pivotal for safeguarding global health. By ensuring widespread vaccination, societies can fortify their defense against the cyclical threat of seasonal diseases, promising a healthier future for all.

Knowledge and experiences of abortion among adolescent girls in Asia: a scoping review from 2010 to 2020

It has been estimated that 5.6 million abortions occur each year among adolescent girls aged 15 - 19 years, of which 3.9 million are unsafe. The situation in Asia is particularly complicated compared to other regions due to the distinction in socio-cultural characteristics. This study aimed to describe abortion knowledge and experiences of adolescent girls in Asian countries in the period 2010 - 2020. Among 22 included publications, 41% of the studies were conducted in South-East Asia. The percentage of girls lacked knowledge and had improper perceptions of abortion could be as high as 95.7%. Common reasons for abortion were health conditions and socio-economic pressures, such as poverty and the need to maintain social self-sufficiency. Medical and surgical abortion was common, and while many girls went to hospitals and legitimate health providers, some did it themselves or went to clandestine abortion. Physical complications included menstrual disorders, pain, fever, vaginal bleeding or even septic shock, while feeling guilty and stressed was flagged as emotional consequences. To improve the situation of teenage abortion in Asia, adolescents should be provided with adequate knowledge on abortion laws and care, parents should be more open to this issue and governments should consider permitting legal abortion among adolescents.

Forest Policies and Adaptation to Climate Change in Maine: Stakeholder Perceptions and Recommendations

Socioeconomic pressures require forest management to address the impacts of climate change. However, we must ask, Are current forest policies sufficient to deal with the impacts of climate change? Here, we report on two surveys of forest stakeholders in Maine including woodlot owners and forestry professionals and discuss their perceptions of the barriers to climate change adaptation. We conclude with several policy directions including reevaluating existing policies, expanding incentive-based policies, integrating adaptation efforts into mitigation efforts, and increasing communication and outreach.

Linking Cork to Cork Oak Landscapes: Mapping the Value Chain of Cork Production in Portugal

Traditional farming landscapes in South and Central Portugal, known as montados, are affected by global socio-economic and biophysical pressures, putting the sustainability of the systems in jeopardy. Cork oak trees (Quercus suber L.) are characteristic features of these complex agro-silvo-pastoral agroforestry systems, delivering a globally important product, cork. The increasingly distant, global scale of decision making and trade can consequently be observed on the local, landscape, scale. In this study, we use a value chain approach to test the concept that landscape products can ensure sustainable management of the landscape of origin. We interviewed agents—cork producers, intermediaries, industrial transformers, and winemakers—about the challenges they perceived in the business and how these were connected to the landscape of origin. We illustrate the network of agents and sub-actors involved in the sector and highlight the most prominent concerns. We conclude that this approach can reveal the major points for determining the future of the montado, and we suggest that collaboration amongst value chain agents can be a pathway to landscape sustainability.

Adaptive non-conform behaviour in accident investigations in the road based heavy goods transport sector

This paper presents findings from a study of 29 accident investigations in the heavy goods transportation sector in Norway. The investigations are performed by the Norwegian Safety Investigation Authority (NSIA). The NSIA has extensive multi-modal experience with accident investigation studying the holistic systems involved. Their approach is non-blame, in which the major goal is to provide information that triggers the involved actors’ learning. It is reasonable to assume that the NSIA will challenge system characteristics at the sharp end, close to the accident site, as well as characteristics towards the blunt end involving planning, managing and regulatory enterprises. The term adaptive non-conform behaviour cuts across all levels in the system and covers the outright violation of safety-related rules and regulations and activities that deviate from established good praxis. Non-conform behaviour can include strategic adaptations to external and internal socioeconomic pressures. Actors in the industry claim non-conform behaviour is a prominent characteristic of the day-to-day activities. Non-conformity with safety-related rules and regulations is currently common in the transport industry as a reaction to increased international competition. It can be regarded as an adaption to the local business environment. Thus, we subsequently claim that the NSIA investigations should reflect this context in order to reveal important risk influencing factors. NSIA rarely reflects non-conform behaviour in investigations. When non-conform behaviour is touched upon, it is not described as adaptations and established praxis in the industry. Adaptive non-conform behaviour seems not to be a systemic problem based on the aggregated analysis of the NSIA-investigations.

“[F]earful Hard Work”: The Possibilities and Pitfalls of a Victorian Eco-Georgic

As a form of literature that engages with the lived realities of farming life, the Georgic offers an insight into the kind of close working relationship that is possible between humans and nature, a relationship that may in turn be described as ecological in its concern with adaptation and sustainability. This essay focuses on three examples of Georgic literature that highlight both the possibilities and pitfalls of making this association: Thomas Hardy’s Tess of the d’Urbervilles (1891), Richard Jefferies’s Amaryllis at the Fair (1887), and Hubert Crackanthorpe’s short story, “Anthony Garstin’s Courtship” (1896). All three were written during the Victorian period, when innovations in “high farming” had made it possible to increase yields without overly exploiting the land. As these narratives illustrate, this form of farming nevertheless involved back-breaking, exploitative and often poorly paid work. Moreover, farmers were already under pressure to mechanize their processes where possible, maximising yield regardless of long-term consequences. Small farms were themselves are threat, because less economically viable. Whatever ecological balance high farming embodied, it could not long survive these wider socio-economic pressures. In their concern with these particularities, these narratives nevertheless offer an insight into what an eco-Georgic might mean, as a form of writing properly attentive to the challenges of reconciling human and nonhuman needs, and accommodating both within a global, capitalist framework. These works are, furthermore, alert to the difficulty of how best to (re)present those challenges; each shifts away from conventional realism and towards new literary modes better able to confront the idealising, pastoral expectations of an urban readership. As such, these works emerge as prototypical forms of a modern, self-reflexive form of (eco-)Georgic mindful of the practical difficulties of sustainable living, and flexible enough to find innovative ways of representing them.

SARS-CoV-2 Psychiatric Sequelae: A Review of Neuroendocrine Mechanisms and Therapeutic Strategies.

From the earliest days of the coronavirus disease 2019 (COVID-19) pandemic, there have been reports of significant neurological and psychological symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. This narrative review is designed to examine the potential psychoneuroendocrine pathogenic mechanisms by which SARS-CoV-2 elicits psychiatric sequelae as well as to posit potential pharmacologic strategies to address and reverse these pathologies. Following a brief overview of neurological and psychological sequelae from previous viral pandemics, we address mechanisms by which SARS-CoV-2 could enter or otherwise elicit changes in the CNS. We then examine the hypothesis that COVID-19–induced psychiatric disorders result from challenges to the neuroendocrine system, in particular the hypothalamic-pituitary-adrenal stress axis and monoamine synthesis, physiological mechanisms that are only further enhanced by the pandemic-induced social environment of fear, isolation, and socioeconomic pressure. Finally, we evaluate several FDA-approved therapeutics in the context of COVID-19–induced psychoneuroendocrine disorders.

The rapidly changing Arctic and its societal implications

AbstractThe Arctic is undergoing rapid climate change and is projected to experience the most warming this century of any world region. We review the societal aspects of these current and projected changes. Indigenous knowledge and local knowledge holders living in communities across the Arctic have detected unprecedented increases in temperature, altered precipitation regimes, and changing weather patterns, documenting impacts on terrestrial and marine environments. These local observations situate climate change as one of multiple interacting stressors. Arctic societies have exhibited resilience to climate change, but vulnerabilities are emerging at the nexus of changing environmental conditions and socioeconomic pressures. Infrastructure is highly susceptible to permafrost thaw, coastal erosion, and sea level rise, compounded by the age of infrastructure, maintenance challenges, and cost of adapting. Livelihoods and cultural activities linked to subsistence harvesting have been affected by changes to wildlife, with coping mechanisms undermined by long‐term processes of land dispossession and landscape fragmentation. Reduced sea ice coverage and changing ice dynamics are creating opportunities for enhanced shipping, oil and gas production, and deep‐water fisheries. Legal, infrastructural, economic, and climatic challenges are expected to constrain such developments, with concerns over the distribution of potential benefits. Adaptation is already taking place in some sectors and regions, with efforts directly targeting climate impacts and also addressing underlying determinants of vulnerability. Barriers and limits to adapting are evident. Research that develops projections of future climate impacts is advancing, but studies examining the implications of such changes for communities or economies remain in their infancy.This article is categorized under: Trans‐Disciplinary Perspectives &gt; Regional Reviews