Severe and Very Severe Myalgic Encephalopathy/Chronic Fatigue Syndrome ME/CFS in Norway: Symptom Burden and Access to Care.

There is a striking lack of systematic knowledge regarding the symptom burden, capacity for activities of daily living, and supportive measures for the most severely ill ME/CFS patients. The present study seeks to address this through a national, Internet-based survey targeting patients with severe and very severe ME/CFS and their carers. Responses from 491 patients were included, with 444 having severe and 47 very severe ME/CFS with the classification based on the best estimate from patient responses. In addition, 95 respondents were reclassified from patients' own classification to moderate and included for comparison. The onset was before 15 years of age for 45% in the very severe and 32% in the severe group. Disease duration was more than 15 years for 19% in the very severe and 27% in the severe group. Patient symptom burden was extensive. The most severely affected were totally bedridden, unable to talk, and experienced dramatic worsening of symptoms after minimal activity or sensory stimuli. Care and assistance from healthcare and social services were often described as insufficient or inadequate, often worsening the symptom load and burden of care. A substantial lack of disease knowledge among healthcare providers in general was reported. Yet approximately 60% in the severe and very severe groups found services provided by occupational therapists and family doctors (general practitioners) helpful, while a smaller proportion experienced appropriate help from other health personnel groups. This indicates that help and support are highly needed and possible to provide. On the other hand, this must be approached carefully, as a substantial number of patients experienced deterioration from contact with healthcare personnel. Family carers described an extensive burden of care with often inadequate help from healthcare providers or municipal authorities. Patient care by family members of very severe ME/CFS patients constituted more than 40 h a week for 71% of this patient group. The carers described a large negative impact on their work and financial situation, and on their mental wellbeing. We conclude that childhood onset was common, burden of disease was extensive, and support from responsible societal health and social support providers was commonly grossly inadequate.

Slowing deforestation in Indonesia follows declining oil palm expansion and lower oil prices.

Much concern about tropical deforestation focuses on oil palm plantations, but their impacts remain poorly quantified. Using nation-wide interpretation of satellite imagery, and sample-based error calibration, we estimated the impact of large-scale (industrial) and smallholder oil palm plantations on natural old-growth ("primary") forests from 2001 to 2019 in Indonesia, the world's largest palm oil producer. Over nineteen years, the area mapped under oil palm doubled, reaching 16.24 Mha in 2019 (64% industrial; 36% smallholder), more than the official estimates of 14.72 Mha. The forest area declined by 11% (9.79 Mha), including 32% (3.09 Mha) ultimately converted into oil palm, and 29% (2.85 Mha) cleared and converted in the same year. Industrial plantations replaced more forest than detected smallholder plantings (2.13 Mha vs 0.72 Mha). New plantations peaked in 2009 and 2012 and declined thereafter. Expansion of industrial plantations and forest loss were correlated with palm oil prices. A price decline of 1% was associated with a 1.08% decrease in new industrial plantations and with a 0.68% decrease of forest loss. Deforestation fell below pre-2004 levels in 2017-2019 providing an opportunity to focus on sustainable management. As the price of palm oil has doubled since the start of the COVID-19 pandemic, effective regulation is key to minimising future forest conversion.

Subjective wellbeing and income: Empirical patterns in the rural developing world.

A commonality in the economics of happiness literature is that absolute income matters more for the subjective wellbeing of people at low income levels. In this article, we use a large sample of people in rural areas of developing countries with relatively low income levels to test whether subjective wellbeing an increasing function of absolute income in our sample, and to analyze the existence of adaptation and social comparison effects on subjective wellbeing. Our sample includes 6973 rural households in 23 countries throughout Asia, Africa, and Latin America. The average total income per adult equivalent in our sample was US$1555, whereas levels of subjective wellbeing resembled levels found in previous research using cross-country data. We find that, despite low levels of absolute income, levels of subjective wellbeing of our respondents resemble levels found in previous research using cross-country data. We also find remarkable similarities in many of the determinants of subjective wellbeing previously tested. Our data show that absolute income covariates with subjective wellbeing, but -as for richer samples- the magnitude of the association is lower once we control for adaptation and social comparison. Finally, our results suggest that social comparison has a stronger effect than adaptation in explaining the subjective wellbeing of our sample. Our findings highlight the importance of adaptation and social comparison even at low levels of absolute income.

Environmental Income and Rural Livelihoods: A Global-Comparative Analysis.

This paper presents results from a comparative analysis of environmental income from approximately 8000 households in 24 developing countries collected by research partners in CIFOR's Poverty Environment Network (PEN). Environmental income accounts for 28% of total household income, 77% of which comes from natural forests. Environmental income shares are higher for low-income households, but differences across income quintiles are less pronounced than previously thought. The poor rely more heavily on subsistence products such as wood fuels and wild foods, and on products harvested from natural areas other than forests. In absolute terms environmental income is approximately five times higher in the highest income quintile, compared to the two lowest quintiles.

Back to the forest: exploring forest transitions in Candelaria Loxicha, Mexico.

Declining profitability of agriculture and/or higher prices of forest products and services typically drive an increase in forest cover. This article examines changes in forest cover in Candelaria Loxicha, Mexico. Forest cover increased in the area as a result of coffee cultivation in coffee forest-garden systems. Dependence on forest products and services, and not prices of forest products, drive the process in our study site. Low international coffee prices and high labor demand outside the community might pull farmers out of agriculture, but they do not completely abandon the lands. A diversification in income sources prevents land abandonment and contributes to maintaining rural populations and coffee forest gardens.

Policies for reduced deforestation and their impact on agricultural production.

Policies to effectively reduce deforestation are discussed within a land rent (von Thünen) framework. The first set of policies attempts to reduce the rent of extensive agriculture, either by neglecting extension, marketing, and infrastructure, generating alternative income opportunities, stimulating intensive agricultural production or by reforming land tenure. The second set aims to increase either extractive or protective forest rent and--more importantly--create institutions (community forest management) or markets (payment for environmental services) that enable land users to capture a larger share of the protective forest rent. The third set aims to limit forest conversion directly by establishing protected areas. Many of these policy options present local win-lose scenarios between forest conservation and agricultural production. Local yield increases tend to stimulate agricultural encroachment, contrary to the logic of the global food equation that suggests yield increases take pressure off forests. At national and global scales, however, policy makers are presented with a more pleasant scenario. Agricultural production in developing countries has increased by 3.3-3.4% annually over the last 2 decades, whereas gross deforestation has increased agricultural area by only 0.3%, suggesting a minor role of forest conversion in overall agricultural production. A spatial delinking of remaining forests and intensive production areas should also help reconcile conservation and production goals in the future.