Traditional Owners and Sea Country in the Southern Great Barrier Reef – Which Way Forward?

[Extract] For over 20 years, Traditional Owners (TOs) from across the Great Barrier Reef (GBR) have been coming together to explore and call for a collective approach to achieving their aspirations for ownership, access to, and involvement in the management of sea country. Over these years, people have made real progress in securing improved recognition of their rights and developing local capacities to govern and manage their sea country. Despite these wins, and good engagement by Commonwealth and State governments on occasions, there has been no lasting, continuously improving GBR-wide approach to engaging TOs. With the future health of the GBR under threat, the current Reef 2050 Long Term Sustainability Plan (Reef 2050) recognises the significance of Traditional Owner rights and interests in the management of sea country and the Marine Park. There are considered and significant Indigenous implementation actions embedded right across Reef 2050. Implementation, however, lies ahead. Given the long history of Traditional Owner attempts to influence sea country management across the GBR, they consider that, without strong partnerships, there could be a real risk of implementation failure. At this point, the mechanisms for cohesive and coordinated implementation of the Reef 2050 do not yet fundamentally engage Traditional Owners as real partners in the long-term management of sea country, consistent with international guidelines for their engagement in protected area management, which emphasise the required for prior informed consent and ongoing equity

Traditional Owners of the Great Barrier Reef: the next generation of Reef 2050 actions

In short, this Report: Confirms that there are two options for progressing the integration of Traditional Owner interests in the Reef 2050 Plan. Option 1 (Business As Usual) represents a continuation of the current approach of Government-based review and refinement of the (now 23) Traditional Owner actions in the Reef 2050 Plan. Option 2 (Towards Genuine Co-governance) represents Government taking a far more negotiated approach at the GBR-wide level (and subsequently down to local scales) that applies the principles of Free Prior and Informed Consent. Based on extensive engagement concerning the aspirations of Traditional Owners and their support organisations across the GBR, the overwhelming stated desire and demand is for genuine partnership in the overarching governance of the Reef and far deeper ownership of, and participation in, its active day to day management (Option 2). There is an unambiguous view that the foundations set in the Reef 2050 Plan (Option 1), while a step in the right direction, simply reflect Traditional Owner aspirations in someone else’s planning. Meanwhile, a consistent message from Traditional Owners, fuelled by their existing and emerging rights in sea country, is that this more passive form of involvement cannot continue into the future; that a genuine form of agreement making and active implementation (from GBR to local scales) must emerge

Tissue cell stress response to obesity and its interaction with late gestational diet

Intra-uterine growth restriction in late pregnancy can contribute to adverse long term metabolic health in the offspring. We utilised an animal (sheep) model of maternal dietary manipulation in late pregnancy, combined with exposure of the offspring to a low activity, obesogenic environment after weaning, to characterise the effects on glucose homeostasis. Dizygotic twin-pregnant sheep were either fed to 60% of requirements (nutrient restriction (R)) or fed ad libitum (~ 140% of requirements (A)) from 110 days gestation until term (~147d). After weaning (~3 months of age), their offspring were kept in either a standard (in order to remain lean) or low activity, obesogenic environment. R mothers gained less weight and produced smaller offspring. As adults, obese offspring were heavier and fatter with reduced glucose tolerance, irrespective of maternal diet. Molecular markers of stress and autophagy in liver and adipose tissue were increased with obesity, with gene expression of hepatic Grp78 and of omental Atf6, Grp78 and Edem1 only being increased in R offspring. In conclusion, the adverse effect of juvenile onset obesity on insulin responsive tissues can be amplified by previous exposure to a suboptimal nutritional environment in utero, thereby contributing to earlier onset of insulin resistance

Mapping the nexus of transitional justice and peacebuilding

This paper explores the convergences and divergence between transitional justice and peace-building, by considering some of the recent developments in scholarship and practice. We examine the notion of ‘peace’ in transitional justice and the idea of ‘justice’ in peacebuilding. We highlight that transitional justice and peacebuilding often engage with similar or related ideas, though the scholarship on in each field has developed, largely, in parallel to each other, and of-ten without any significant engagement between the fields of inquiry. We also note that both fields share other commonalities, insofar as they often neglect questions of capital (political, social, economic) and at times, gender. We suggest that trying to locate the nexus in the first place draws attention to where peace and justice have actually got to be produced in order for there not to be conflict and violence. This in turn demonstrates that locally, ‘peace’ and ‘justice’ do not always look like the ‘peace’ and ‘justice’ drawn up by international donors and peace-builders; and, despite the ‘turn to the local’ in international relations, it is surprising just how many local and everyday dynamics are (dis)missed as sources of peace and justice, or potential avenues of addressing the past

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Traditional Owners and Sea Country in the Southern Great Barrier Reef – Which Way Forward?

[Extract] For over 20 years, Traditional Owners (TOs) from across the Great Barrier Reef (GBR) have been coming together to explore and call for a collective approach to achieving their aspirations for ownership, access to, and involvement in the management of sea country. Over these years, people have made real progress in securing improved recognition of their rights and developing local capacities to govern and manage their sea country. Despite these wins, and good engagement by Commonwealth and State governments on occasions, there has been no lasting, continuously improving GBR-wide approach to engaging TOs.\ud \ud With the future health of the GBR under threat, the current Reef 2050 Long Term Sustainability Plan (Reef 2050) recognises the significance of Traditional Owner rights and interests in the management of sea country and the Marine Park. There are considered and significant Indigenous implementation actions embedded right across Reef 2050. Implementation, however, lies ahead. Given the long history of Traditional Owner attempts to influence sea country management across the GBR, they consider that, without strong partnerships, there could be a real risk of implementation failure. At this point, the mechanisms for cohesive and coordinated implementation of the Reef 2050 do not yet fundamentally engage Traditional Owners as real partners in the long-term management of sea country, consistent with international guidelines for their engagement in protected area management, which emphasise the required for prior informed consent and ongoing equity