Restoration versus transformative adaptation of community drinking water systems after Hurricanes Irma and Maria in Puerto Rico.

Hurricane Irma then Maria hit Puerto Rico in September 2017, exposing the heightened vulnerability of the island's Critical Infrastructure Systems and Processes (CRISPs) and putting the resilience of some of the most impoverished communities to the test. Being one of these CRISPs, the island's centralized drinking water system operated by the Puerto Rico Aqueduct and Sewer Authority suffered heavy damage leaving over 200,000 people off-grid for months. Decentralized community aqueducts were also affected. However, most were able to sustain operations, with only 15 percent incapacitated during the first few weeks after Maria. Of the 205 community aqueducts serving low-income communities in the island's central mountainous areas, only 35 failed. This article explores how and why these systems failed and what actions the communities should take to recover in a relatively short time in comparison to the centralized system. It defines the factors that account for the differences, the systems' capacity to meet water quality requirements, and potentially transformative adaptations generated to face future disturbances. We were interested in understanding (a) how system capacity was affected by the restoration process, (b) if adaptation resulted in significant operational changes, and (c) community member engagement. Finally, we explored governance transformations that increased stakeholder's participation, including community aqueducts representatives in decision-making and policy-making. Data collection included interviews with water system managers, government, and nongovernmental organization (NGO) representatives who regulate these systems or assisted communities in recovering their systems. We also surveyed water systems that had operational problems within the first 3 weeks. The data revealed a diversity of actions along the disaster cycle through which communities prepared for, restored, recovered, and cocreated transformative adaptations to their systems. Findings reflect that despite economic deficiencies and lack of emergency plans, many communities were able to improvise and restore their water systems soon after the disaster. As part of their postdisaster organization, communities increased their collaborative networks with governmental and NGOs to cocreate improvement projects to enhance resiliency. Adaptations included (1) increased community autonomy, (2) system redundancy, and (3) improved capacity to participate in government discussion forums related to their systems.

Patient and Caregiver Priorities for Outcomes in CKD: A Multinational Nominal Group Technique Study.

RATIONALE & OBJECTIVE: Patients with chronic kidney disease (CKD) are at an increased risk for premature death, cardiovascular disease, and burdensome symptoms that impair quality of life. We aimed to identify patient and caregiver priorities for outcomes in CKD. STUDY DESIGN: Focus groups with nominal group technique. SETTING & PARTICIPANTS: Adult patients with CKD (all stages) and caregivers in the United States, Australia, and United Kingdom. ANALYTICAL APPROACH: Participants identified, ranked, and discussed outcomes that were important during the stages of CKD before kidney replacement therapy. For each outcome, we calculated a mean importance score (scale, 0-1). Qualitative data were analyzed using thematic analysis. RESULTS: 67 (54 patients, 13 caregivers) participated in 10 groups and identified 36 outcomes. The 5 top-ranked outcomes for patients were kidney function (importance score, 0.42), end-stage kidney disease (0.29), fatigue (0.26), mortality (0.25), and life participation (0.20); and for caregivers, the top 5 outcomes were life participation (importance score, 0.38), kidney function (0.37), mortality (0.23), fatigue (0.21), and anxiety (0.20). Blood pressure, cognition, and depression were consistently ranked in the top 10 outcomes across role (patient/caregiver), country, and treatment stage. Five themes were identified: re-evaluating and reframing life, intensified kidney consciousness, battling unrelenting and debilitating burdens, dreading upheaval and constraints, and taboo and unspoken concerns. LIMITATIONS: Only English-speaking participants were included. CONCLUSIONS: Patients and caregivers gave highest priority to kidney function, mortality, fatigue, life participation, anxiety, and depression. Consistent reporting of these outcomes in research may inform shared decision making based on patient and caregiver priorities in CKD.

Climate Change as an Involuntary Exposure: A Comparative Risk Perception Study from Six Countries across the Global Development Gradient.

Climate change has been referred to as an involuntary exposure, meaning people do not voluntarily put themselves at risk for climate-related ill health or reduced standard of living. The purpose of this study is to examine people's risk perceptions and related beliefs regarding (1) the likelihood of different risks occurring at different times and places and (2) collective (government) responsibility and personal efficacy in dealing with climate change, as well as (3) explore the ways in which climate risk may be amplified when posed against individual health and well-being. Previous research on this topic has largely focused on one community or one nation state, and so a unique characteristic of this study is the comparison between six different city (country) sites by their development and national wealth. Here, we collected 401 surveys from Phoenix (USA), Brisbane (Australia), Wellington (New Zealand), Shanghai (China), Viti Levu (Fiji), and Mexico City (Mexico). Results suggest that the hyperopia effect characterized the sample from each study site but was more pronounced in developed sites, suggesting that the more developed sites employ a broader perspective when approaching ways to mitigate their risk against climate-related health and well-being impacts.

Co-Producing Interdisciplinary Knowledge and Action for Sustainable Water Governance: Lessons from the Development of a Water Resources Decision Support System in Pernambuco, Brazil.

One of the most pressing global challenges for sustainable development is freshwater management. Sustainable water governance requires interdisciplinary knowledge about environmental and social processes as well as participatory strategies that bring scientists, managers, policymakers, and other stakeholders together to cooperatively produce knowledge and solutions, promote social learning, and build enduring institutional capacity. Cooperative production of knowledge and action is designed to enhance the likelihood that the findings, models, simulations, and decision support tools developed are scientifically credible, solutions-oriented, and relevant to management needs and stakeholders' perspectives. To explore how interdisciplinary science and sustainable water management can be co-developed in practice, the experiences of an international collaboration are drawn on to improve local capacity to manage existing and future water resources efficiently, sustainably, and equitably in the State of Pernambuco in northeastern Brazil. Systems are developed to model and simulate rainfall, reservoir management, and flood forecasting that allow users to create, save, and compare future scenarios. A web-enabled decision support system is also designed to integrate models to inform water management and climate adaptation. The challenges and lessons learned from this project, the transferability of this approach, and strategies for evaluating the impacts on management decisions and sustainability outcomes are discussed.

Common knowledge promotes risk pooling in an experimental economic game.

Risk management is a problem humans have faced throughout history and across societies. One way to manage risk is to transfer it to other parties through formal and informal insurance systems. One informal method of self-insurance is limited risk pooling, where individuals can ask for help only when in need. Models suggest that need-based transfer systems may require coordination and common knowledge to be effective. To explore the impact of common knowledge on social coordination and risk pooling in volatile environments, we designed and ran a Risk Pooling Game. We compared participants who played the game with no advance priming or framing to participants who read one of two texts describing real-world systems of risk pooling. Players in the primed games engaged in more repetitive asking and repetitive giving than those in the control games. Players in the primed games also gave more in response to requests and were more likely to respond positively to requests than players in the control games. In addition, players in the primed games were more tolerant of wide differences between what the two players gave and received. These results suggest that the priming texts led players to pay less attention to debt and repayment and more attention to the survival of the other player, and thus to more risk pooling. These results are consistent with findings from fieldwork in small-scale societies that suggest that humans use need-based transfer systems to pool risk when environmental volatility leads to needs with unpredictable timing. Models suggest that the need-based transfer strategy observed in this experiment can outperform debt-based strategies. The results of the present study suggest that the suite of behaviors associated with need-based transfers is an easily triggered part of the human behavioral repertoire.

Effects of place identity, place dependence, and experience-use history on perceptions of recreation impacts in a natural setting.

It is generally accepted that recreation use in natural environments results in some degree of negative social and environmental impact. Environmental managers are tasked with mitigating the impact while providing beneficial recreation opportunities. Research on the factors that influence visitors' perceptions of environmental and social conditions is necessary to inform sound environmental management of protected natural areas. This study examines the effect of prior experience with the setting and two dimensions of place attachment (i.e., place identity and place dependence) on visitors' perceptions of three types of recreation impacts (i.e., depreciative behavior, environmental impacts, and recreation conflict). Principal components analysis, confirmatory factor analysis, and structural equation modeling were used to test the study hypotheses using data collected from 351 visitors through on-site questionnaires (response rate of 93 percent). The results show that prior experience exhibited a moderate and significant direct positive effect on place identity, place dependence, and visitors' perceptions of recreation impacts. Contrary to study hypotheses and prior research, neither place dependence nor place identity exhibited a significant effect on the dependent variables. The results show that prior experience causes visitors to be more sensitive to depreciative behaviors, environmental impacts, and recreation conflict. These findings raise concerns over potential visitor displacement and deterioration of site conditions. Implications for resource managers are discussed, which include education, modifying visitor use patterns, and site design strategies.

An interpretive study of Yosemite National Park visitors' perspectives toward alternative transportation in Yosemite Valley.

The National Park Service (NPS) is increasingly focusing on alternative transportation systems in national parks to address environmental and social problems arising from a historical reliance on personal automobiles as the primary means of visitor access. Despite the potential advantages, alternative transportation may require a reorientation in the way that Americans have experienced national parks since the advent of auto-tourism in the early twentieth century. Little research exists, however, on visitor perspectives towards alternative transportation or the rationale underlying their perspectives. It remains unclear how transportation systems affect visitors' experiences of the park landscape or the factors influencing their travel behavior in the parks. This report presents an interpretive study of visitor perspectives toward transportation management in the Yosemite Valley area of Yosemite National Park, California. Qualitative analysis of 160 semi-structured interviews identified individual psychological factors as well as situational influences that affect visitors' behavior and perspectives. Individual psychological factors include perceived freedom, environmental values and beliefs, prior experience with Yosemite National Park and other national parks, prior experience with alternative transportation in national parks, and sensitivity to subjective perceptions of crowding. Situational factors included convenience, access, and flexibility of travel modes, as well as type of visit, type of group, and park use level. Interpretive communication designed to encourage voluntary visitor use of alternative transportation should focus on these psychological and situational factors. Although challenges remain, the results of this study suggest approaches for shaping the way Americans visit and experience their national parks to encourage environmental sustainability.

Ultra-high-throughput microarray generation and liquid dispensing using multiple disposable piezoelectric ejectors.

The authors have constructed an array of 12 piezoelectric ejectors for printing biological materials. A single-ejector footprint is 8 mm in diameter, standing 4 mm high with 2 reservoirs totaling 76 micro L. These ejectors have been tested by dispensing various fluids in several environmental conditions. Reliable drop ejection can be expected in both humidity-controlled and ambient environments over extended periods of time and in hot and cold room temperatures. In a prototype system, 12 ejectors are arranged in a rack, together with an X - Y stage, to allow printing any pattern desired. Printed arrays of features are created with a biological solution containing bovine serum albumin conjugated oligonucleotides, dye, and salty buffer. This ejector system is designed for the ultra-high-throughput generation of arrays on a variety of surfaces. These single or racked ejectors could be used as long-term storage vessels for materials such as small molecules, nucleic acids, proteins, or cell libraries, which would allow for efficient preprogrammed selection of individual clones and greatly reduce the chance of cross-contamination and loss due to transfer. A new generation of design ideas includes plastic injection molded ejectors that are inexpensive and disposable and handheld personal pipettes for liquid transfer in the nanoliter regime.