Rules for the governance of coastal and marine ecosystem services: An evaluative framework based on the IAD framework

There is an increasing need for a comprehensive institutional understanding pertaining to ecosystem services (ESs) in coastal and marine fields. This paper develops a systematic framework to inform coastal and marine governance about the integration of ES concepts. First, as a theoretical basis, we analyze the generic rules that are part of the Institutional Analysis and Development (IAD) framework. Second, by an extensive literature review, we formulate a set of ES-specific rules and develop an evaluative framework for coastal and marine governance. Third, we examine this evaluative framework in a specific action situation, namely coastal strategic planning concerning Qingdao, China. Results from the literature review and the case study reveal that when designing ES-specific rules for coastal and marine governance, there are several socio-spatial and economic aspects that should be taken into account: (1) conceive of stakeholders as ES users, (2) capture the effect of ecological scaling, (3) understand ES interactions and clarify indirect impacts and causalities, (4) account for ES values, and (5) draw on economic choices for use rights to deal with ES issues.

A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India

Purpose. Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. Method. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Results. Patients in the control group (n = 15) had significantly decreased body weight (P = .003), mid–upper-arm circumference (P = .002), and body fat (P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat (P = .002) was observed; moreover, patients reported a significant improvement in fatigue (P = .002) and appetite scores (P = .006) under quality-of-life domains at the end of intervention. Conclusions. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.