Claiming space: Contested coastal commons in Mumbai

Many of the world’s cities are located on the coast, and coastal ecologies and livelihoods are under increasing pressure from rapid urban transformations and climate change. This necessitates paying attention to how coastal spaces are understood and governed, but the spatial dimensions of urban coastal commons has received comparatively little attention. How are coastal spaces framed, understood, and contested? Drawing on scholarship on socio-spatial relations, the ‘right to the city’, and spatial justice, we explore these questions through tracing the contestations around the coastal commons in Mumbai, particularly focusing on the Coastal Road project and how claims of rights and access by the Koli fishing community unfolded. The case untangles the multi-scalar framings of coastal commons as places that are intimately tied up with Koli identity, versus city planners’ view of coasts as mere ‘conduits’, with the transformation of fluid land-sea commons into legible and controllable territory. We make an argument for the notion of a ‘right to the coast as commons’ as being conducive for a more climate-resilient city that heeds the particular ecological interdependencies and stewardship of coastal communities.publishedVersio

Plastic bans in India – Addressing the socio-economic and environmental complexities

As one of the flagship amendments to the Plastic Waste Management (PWM) Rules, 2021, the pan-Indian ban on a group of single-use plastic products (SUPPs) introduced in mid-2022 provided a departure point towards more progressive plastic waste legislation. The amendments have mostly been welcomed, yet challenges persist to facilitate its implementation, assess potential environmental impacts of alternative materials, and socio-economic concerns raised by various stakeholders. Considering the recent amendments to the PWM Rules, we critically engage with and highlight key considerations and prevailing challenges with regards to phasing out SUPPs. We argue that to shape sustainable solutions that reduce plastic pollution, uncertainties related to the environmental fate of SUPP alternatives need to be better understood, whilst recognising and accounting for broader socio-economic impacts of SUPP bans, including industry concerns, impacts on socio-economically disadvantaged communities, and the informal recycling sector. A stronger knowledge base on these aspects can mitigate negative social and environmental externalities, including potentially harmful consequences of ambitious plastic pollution reduction measures.publishedVersio

Towards sustainable waste management in Myanmar – key results from the project ‘Capacity building on waste management in the Bago Region’

Prosjektleder: Ingrid NesheimThis report presents key results from the project ‘Capacity building on waste management in the Bago Region’. It synthesizes primary and secondary data on various aspects of waste management in the Bago Township, including a study of the formal and informal waste management systems and their key actors, and a study of microplastic pollution of the Bago River. Building on Action Research it further presents four pilot cases promoting sustainable waste management practices and behavioural change through a cleanup of a river side waste dump, waste management at the local market, new waste management systems and composting at selected monasteries.Royal Norwegian Embassy in MyanmarpublishedVersio

Transformation as Praxis: Responding to Climate Change Uncertainties in Marginal Environments in South Asia

This paper provides some of the conceptual and methodological underpinnings being developed in the ongoing TAPESTRY project which is part of the Transformations to Sustainability (T2S) Programme. We debate how the notion of transformation may be conceptualized from ‘below’ in marginal environments that are especially marked by high levels of climate-related uncertainties. We propose the notion of transformation as praxis — where the focus is on bottom-up change, identities, wellbeing and the recovery of agency by marginalized people and explore how ‘patches’ and the ‘marginal’ offer critical conceptual templates to examine whether and how systemic transformative changes are being assembled and effected on the ground by hybrid and transformative alliances. The article concludes by discussing potential challenges of such engagements, alongside pursuing a normative and political approach to T2S

Adaptation interventions and their effect on vulnerability in developing countries: Help, hindrance or irrelevance?

This paper critically reviews the outcomes of internationally-funded interventions aimed at climate change adaptation and vulnerability reduction. It highlights how some interventions inadvertently reinforce, redistribute or create new sources of vulnerability. Four mechanisms drive these maladaptive outcomes: (i) shallow understanding of the vulnerability context; (ii) inequitable stakeholder participation in both design and implementation; (iii) a retrofitting of adaptation into existing development agendas; and (iv) a lack of critical engagement with how ‘adaptation success’ is defined. Emerging literature shows potential avenues for overcoming the current failure of adaptation interventions to reduce vulnerability: first, shifting the terms of engagement between adaptation practitioners and the local populations participating in adaptation interventions; and second, expanding the understanding of ‘local’ vulnerability to encompass global contexts and drivers of vulnerability. An important lesson from past adaptation interventions is that within current adaptation cum development paradigms, inequitable terms of engagement with ‘vulnerable’ populations are reproduced and the multi-scalar processes driving vulnerability remain largely ignored. In particular, instead of designing projects to change the practices of marginalised populations, learning processes within organisations and with marginalised populations must be placed at the centre of adaptation objectives. We pose the question of whether scholarship and practice need to take a post-adaptation turn akin to post-development, by seeking a pluralism of ideas about adaptation while critically interrogating how these ideas form part of the politics of adaptation and potentially the processes (re)producing vulnerability. We caution that unless the politics of framing and of scale are explicitly tackled, transformational interventions risk having even more adverse effects on marginalised populations than current adaptation

Psychosocial impact of undergoing prostate cancer screening for men with BRCA1 or BRCA2 mutations.

OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PARTICPANTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographic characteristics and the following measures: the Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), 36-item short-form health survey (SF-36), Memorial Anxiety Scale for Prostate Cancer, Cancer Worry Scale-Revised, risk perception and knowledge. The results of the baseline questionnaire are presented. RESULTS: A total of 432 men completed questionnaires: 98 and 160 had mutations in BRCA1 and BRCA2 genes, respectively, and 174 were controls (familial mutation negative). Participants' perception of PCa risk was influenced by genetic status. Knowledge levels were high and unrelated to genetic status. Mean scores for the HADS and SF-36 were within reported general population norms and mean IES scores were within normal range. IES mean intrusion and avoidance scores were significantly higher in BRCA1/BRCA2 carriers than in controls and were higher in men with increased PCa risk perception. At the multivariate level, risk perception contributed more significantly to variance in IES scores than genetic status. CONCLUSION: This is the first study to report the psychosocial profile of men with BRCA1/BRCA2 mutations undergoing PCa screening. No clinically concerning levels of general or cancer-specific distress or poor quality of life were detected in the cohort as a whole. A small subset of participants reported higher levels of distress, suggesting the need for healthcare professionals offering PCa screening to identify these risk factors and offer additional information and support to men seeking PCa screening

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Utvikling i et klima i endring : lokale virkninger av India's national rural employment guarantee act i Attappady, Kerala

The thesis analyses the role of one of India’s central social security schemes, the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), in the context of climate change adaptation. A conceptual exploration and empirical analysis form the core parts of this multi-scalar study. The conceptual part explores it from the perspective of a mainstreamed, climate change adaptation policy and the empirical parts draw on data from the local level to examine its developmental effects, relevance, opportunities and limitations in this regard. A tribal development Block (Attappady) located in the south Indian state of Kerala, is the field study area and provides the core of empirical data. Located within a wider political economy frame, theoretical insights from social protection, vulnerability and adaptation thinking inform the research framework. This study shows that the MGNREGA is a relevant tool as part of India’s climate change adaptation policy and an important instrument to address proximate vulnerability patterns of its rural population. Research findings from Attappady also highlight shortcomings and limitations. Underlying structural factors continue to undermine the scheme’s efficaciousness and the potential for political misuse exists. While the argument of creating sustainable livelihoods through the MGNREGA cannot be supported and its most positive effects can be discerned by way of it providing a coping mechanism, albeit with limited build-up of adaptive capacities. Vulnerable and marginal population sections in Attappady are the prime beneficiaries with social outcomes being prioritised while physical productivity is a neglected aspect of the scheme. In order to exploit its potential as a tool for climate change adaptation, the MGNREGA needs to be reformed to explicitly acknowledge climate change adaptation concerns. Ultimately, the scheme can only be a constituent part in a wider process of change that addresses structural causes of vulnerability and factors that cause and contribute to anthropogenic climatic changes.Denne avhandlingen tar for seg et av Indias viktigste velferdsprogram, Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), og dets rolle i lys av tilpasninger til klimaendringer. En konseptuell utforskning og empirisk analyse utgjør hoveddelene av denne flernivåanalysen. Den konseptuelle delen undersøker MGNREGA fra et klimatilpasningspolitisk perspektiv, mens den empiriske delen baserer seg på data fra lokalt nivå for å kunne studere programmets utviklingseffekter, relevans, muligheter og begrenseringer. Avhandlingens empiriske materiale er hentet fra Attappady, en ”tribal development Block” i delstaten Kerala i det sørlige India. Forskningens rammeverk henter teoretisk innsikt fra relevant litteratur om sosial trygghet, sårbarhet, og tilpasning. Avhandlingens analyser viser at MGNREGA er et relevant verktøy i Indias klimatilpasningspolitikk og er et viktig instrument for å ta tak i landsbygdbefolkningens sårbarhet. Forskningens funn fra Attappady peker også på programmets tilkortkommenhet og begrensninger. Underliggende strukturelle forhold fortsetter å undergrave programmets virksomhet, samtidig som mulighetene for politisk misbruk er tilstede. Denne forskningen gir ikke støtte til tanken om at bærekraftige leveveier kan skapes gjennom MGNREGA, mens det mest positive bidraget er muligheten for at programmet tilbyr en mulighet for mestring, om enn med begrensede muligheter for styrking av tilpasningsevnen. Sårbare deler av befolkningen i Attappady er MGNREGAs hovedmålgruppe, og der programmets sosiale effekter er sterk vektlagt, er hensyn til fysisk verdiskaping et mer forsømt område. For å få utnyttet dets potensiale som et verktøy for klimatilpasning, må MGNREGA endres slik at det eksplisitt tar inn over seg klimatilpasningshensyn. I det lange løp vil programmet kun være ett bidrag i en bredere endringsprosess som tar tak i de strukturelle årsakene til sårbarhet og faktorene som bidrar til menneskeskapte klimaendringer