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

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

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

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

The contribution of locally managed marine areas to small-scale fisheries and food security: a Solomon Islands case study

Small-scale fisheries support the livelihoods and food security of millions of people worldwide, and if well managed can make significant contributions to socio-economic development. Coastal populations in developing countries can be highly reliant on coastal resources as small-scale fisheries provide an important source of income generation, are an important source of food, and in many areas often provide the primary source of dietary protein and micronutrients. However the sustainability of small-scale fisheries and the benefits they provide are under increasing pressure as populations grow, markets develop, technologies change and environments become degraded. Community-based and collaborative strategies (i.e., co-management) emerge as an important strategy to address challenges faced in managing small-scale fisheries. By engaging small-scale fishers in management, comanagement can more effectively sustain benefits provided by fisheries. In so doing, co-management can support the three pillars of food security i.e., by protecting resource availability and access, the role of fisheries in nutrition may be sustained or improved. The expansion of co-management initiatives is particularly apparent in the Indo-Pacific where centralised approaches have typically had low levels of success in managing subsistence and domestically-marketed fisheries. In this region co-management initiatives combine scientific information and conventional approaches to marine resource management, with local knowledge and institutions; a model referred to as locally managed marine areas (LMMAs). There are now hundreds of coastal communities with LMMAs in which a range of resource-use rules are developed and implemented at the community level, often with support from government or non-government organisations (NGOs). However, despite widespread arguments that such models of co-management can result in sustainable fisheries, empirical studies that systematically demonstrate benefits to fisheries and to food security are lacking. My thesis presents a case study of Solomon Islands to address the overarching question; do locally managed marine areas contribute to sustainable smallscale fisheries, and what are the implications for food security? I address this question by examining local fisheries governance arrangements and outcomes in Chapters 2, 3 and 4, and national level governance support structures and outcomes in Chapter 5. LMMA initiatives frequently promote the re-establishment or re-invention of customary periodically harvested marine closures as a measure to regulate marine resource use. Periodically-harvested closures are touted as being a successful, traditionally based measure for marine management, and often emerge as the principle management measure within LMMAs. Although periodically-harvested closures confer fisheries benefits for some taxa in western fisheries management contexts, there is little evidence that they are effective for the sustainable management of the many types of small-scale fisheries important in the Indo-Pacific. In Chapter 2 I systematically review cases from across the Indo-Pacific region to explore the opening and closure cycles, concurrent harvest control measures, and fisheries objectives, and outcomes of periodically-harvested closures as they are employed in practice. I find that harvesting and closure regimes are highly variable, with some areas remaining predominantly closed and subjected to irregular one day harvests, while others are harvested for periods extending to weeks or months. Periodically-harvested closures are commonly placed over reef habitats, and are most frequently employed to manage trochus fisheries. I found few reports of restrictions being placed on periodic harvests, and few reports of concurrently employed restrictions on marine resource use in the broader fisheries area. This review clearly illustrated that there has been a lack of systematic research exploring the fisheries outcomes and potential limitations of periodically-harvested closures. To address the knowledge gap identified in Chapter 2, I conducted an interdisciplinary study of periodically-harvested closures as a measure to control fishing effort, and to maintain and improve catch rates and yields. In Chapter 3 I aimed to determine whether fishing pressure (both in terms of effort and yield) was alleviated by implementing periodically-harvested closures, and whether resultant levels of harvesting were sustainable. I also aimed to understand how implementing periodically-harvested closures altered access to resources, and if their implementation resulted in displacement of fishing effort to other areas. In Chapter 3 I documented cycles of opening and closure applied in four periodically-harvested closures, decisions driving those cycles, access rights to closures through time and by different sectors of the local communities, and the broader management frameworks that influenced exploitation and management outcomes. I found duration and frequency of openings was highly variable, with open periods ranging from a single night to one month in duration, and occurring between one and 15 times per year. Fishing during openings was permitted for entire fishing communities in some cases, and only for specific rights-holding families in others. Decisions to harvest closures tended to be based on immediate social or economic needs. Harvesting during openings was restricted to a single taxon and single method in some cases, or unrestricted multi-species, multi-method harvesting in others. Periodically-harvested closures were the main form of management in use at all case study locations. In examining patterns of fishing pressure I found that fishing effort (mean fisher hours per day) during openings was relatively intense (between four and 60 times higher) compared to average daily effort on reefs continuously open to fishing. However over a full year, total effort and total harvested biomass from closures was low to moderate compared to open reefs. I found that effort was not significantly displaced onto open fishing grounds due to closures, likely because of the small size of closed areas relative to continuously open and accessible fishing grounds. In Chapter 4 I examined the characteristics of catch to test hypotheses that emerged from the review in Chapter 2 i.e., that in periodically-harvested closures (a) catch rates (catch per unit effort; CPUE) are higher, (b) short lived, fast growing, sedentary taxa are more abundant, and (c) finfish and invertebrates are larger, compared to harvests from reefs continuously open to fishing. I compared catch rates and catch composition from periodic harvests to harvests of continuously-open fishing grounds, and also examined changes in catch rates throughout the opening period to look for depletion effects. I found that CPUE was significantly higher from periodically-harvested closures for gleaning, but not for spear and line fishing. In one periodically-harvested closure where data were sufficient for analysis of catch rates throughout the periodic harvest, I did not find quantitative evidence of significant fisheries depletion indicated by declines in CPUE for line and spear fishing. However catch rates from gleaning for invertebrates declined throughout the periodic harvest; CPUE was significantly higher in the early stages of the periodic harvest compared with open reefs, but not in the later stages of the harvest. This evidence, alongside reports from fishers and declines in effort (particularly for gleaning), suggests there was substantial localised depletion of invertebrate stocks. Family level catch composition was similar to open reefs for two closures. The small amount of dissimilarity in catches was due to relatively higher abundances of families of high rebound potential i.e., Strombidae, Acanthuridae and Balistidae. Six out of the eight species analysed were larger when harvested from periodically-harvested closures than those harvested from open reefs, but only Lutjanus rufolineatus was significantly larger. Trochus (Trochus niloticus) was significantly smaller from closures than those harvested from open reefs, which may be due to the effect of prior harvests. To summarise the local fisheries governance arrangements and outcomes presented in Chapters 2, 3 and 4; periodically-harvested closures are a socially acceptable management measure, frequently implemented within co-management frameworks across the Indo-Pacific. My research indicates periodically-harvested closures can achieve at least short-term benefits by bolstering catch rates of invertebrates, and leading to catches with slightly larger fish in some species. However, harvesting during periodic harvests was intense, and there was evidence that this led to substantial localised depletion of invertebrate stocks. Further, as social and economic needs (rather than ecological knowledge and indicators) often drive decisions to open areas to harvest, the short-term fisheries benefits may be threatened by rising demand, and heavier and more frequent fishing events in the medium to long-term. There is a need for future studies to address long-term fisheries benefits of periodically-harvested closures. I found that periodically-harvested closures were the main form of management employed by communities with LMMAs. However, achieving nation-wide sustainable fisheries management will require marine resource governance to be comprehensive and widespread, requiring more than the currently localised and small scale advances. In response to this challenge, environmental governance is increasingly focused on connecting local management to higher scales of policy and planning. Governance networks are suggested as institutions that can foster cross-scale relations between actors for collective purposes. In Chapter 5 I present my analysis of a governance network explicitly established to strengthen and extend outcomes of local management efforts to hasten advancement towards national goals of widespread and effective fisheries governance. In Chapter 5 I used quantitative social network analysis to examine patterns of collaborative and knowledge-exchange relations amongst NGOs, government agencies and local communities involved in co-management of small-scale fisheries and coastal ecosystems in Solomon Islands. I examined network structure alongside qualitative data to understand the potential of the network to facilitate coordination and learning among management actors. I identified an active social network that transcends the formal membership of the governance network. Cross-scale analysis highlighted that network members were the only functional pathway for cross-scale knowledge-exchange and higher level representation of local issues. I found mid-scale managers (e.g., provincial governments) were poorly connected, yet were identified as the target actors in policies and planning for improving decentralised management. The governance network also provided the primary means for knowledge-exchange between agencies, and was important for multi-actor learning about best practice for co-management. Yet I identified geographic, logistical and institutional barriers and tradeoffs to multi-actor and cross-scale coordination and learning – and therefore significant obstacles to the ultimate objective of widespread and effective co-management. My thesis highlights that periodically-harvested closures are a prominent feature of the small-scale fisheries co-management model employed widely across the Indo-Pacific region. Within periodically-harvested closures fisheries can be maintained at proposed sustainable targets in coastal regions where fishing pressure and populations densities are relatively low. Catch rates for invertebrates and fish size are bolstered by periodically-harvested closures. However, I found that in these particular coastal regions only a small proportion of fishing grounds are influenced by any LMMA or national management measures at all. Long-term successful fishery management will require periodically-harvested closures to be embedded within functional co-management frameworks in which a diversity of context specific, socially acceptable and fisheries appropriate rules are implemented and adapted. This presents an ongoing challenge to community managers and their partner agencies. Cross-scale institutional and knowledge exchange linkages, via partnerships with NGOs or government agencies, can guide and bolster local management institutions to address this challenge in the face of increasing pressures. Cross-scale, cross-institutional relationships are supported by a formal governance network designed to promote learning and collaboration. However maintaining these relationships in a manner that ensures equitable representation, and realises objectives of effective and widespread management, will continue to be fraught with challenges. The success of co-management of small-scale fisheries has implications for three food security pillars; availability (i.e., sufficient amounts of food), access (i.e., ability to obtain sufficient food), and consumption (i.e., meeting nutritional needs). Small-scale fisheries provide the primary source of protein and are an important source of micronutrients to coastal populations, and across the Indo- Pacific alternatives are often limited. My thesis worked on the premise that the nutritional role fisheries plays would be threatened if availability and access were problematic, and that comanagement can play a role in supporting these pillars. My thesis suggests that periodicallyharvested closures can, in some cases, enhance availability of stocks, and act as a ‘bank in the water’ by stock piling resources for when needs are high. Yet the flexibility to harvest and lack of concurrent fisheries management measures may mean that modest gains in abundance or biomass are insufficient to meet future food needs and demands. The cases I examined showed that periodicallyharvested closures present only short-term access restrictions to relatively small areas, and therefore fishers suffer only a minor loss of access to fisheries resources. However, in one of four cases I found evidence of elite capture, where direct benefits from harvesting accrued mainly to the Chief and his family, whereas previously the reef had been accessible to all fishers in adjacent communities. As competition for resources intensifies, it is increasingly important to consider equitable access and distribution of benefits in co-management initiatives. Finally, projections suggest that with current consumption patterns, coastal fisheries will not meet the needs of populations in 2030, even if reefs are well managed. Nevertheless, improving management of small-scale fisheries can help to minimize this shortfall. While the 137 LMMAs established in Solomon Islands represent a substantial advance in managing coastal ecosystems and small-scale fisheries, these areas account for only a very small proportion of coastal waters, human populations and small-scale fishing activities; mechanisms to expand and improve management are critical

The contribution of locally managed marine areas to small-scale fisheries and food security: a Solomon Islands case study

Small-scale fisheries support the livelihoods and food security of millions of people worldwide, and if well managed can make significant contributions to socio-economic development. Coastal populations in developing countries can be highly reliant on coastal resources as small-scale fisheries provide an important source of income generation, are an important source of food, and in many areas often provide the primary source of dietary protein and micronutrients. However the sustainability of small-scale fisheries and the benefits they provide are under increasing pressure as populations grow, markets develop, technologies change and environments become degraded. Community-based and collaborative strategies (i.e., co-management) emerge as an important strategy to address challenges faced in managing small-scale fisheries. By engaging small-scale fishers in management, comanagement can more effectively sustain benefits provided by fisheries. In so doing, co-management can support the three pillars of food security i.e., by protecting resource availability and access, the role of fisheries in nutrition may be sustained or improved.\ud \ud The expansion of co-management initiatives is particularly apparent in the Indo-Pacific where centralised approaches have typically had low levels of success in managing subsistence and domestically-marketed fisheries. In this region co-management initiatives combine scientific information and conventional approaches to marine resource management, with local knowledge and institutions; a model referred to as locally managed marine areas (LMMAs). There are now hundreds of coastal communities with LMMAs in which a range of resource-use rules are developed and implemented at the community level, often with support from government or non-government organisations (NGOs). However, despite widespread arguments that such models of co-management can result in sustainable fisheries, empirical studies that systematically demonstrate benefits to fisheries and to food security are lacking. My thesis presents a case study of Solomon Islands to address the overarching question; do locally managed marine areas contribute to sustainable smallscale fisheries, and what are the implications for food security? I address this question by examining local fisheries governance arrangements and outcomes in Chapters 2, 3 and 4, and national level governance support structures and outcomes in Chapter 5.\ud \ud LMMA initiatives frequently promote the re-establishment or re-invention of customary periodically harvested marine closures as a measure to regulate marine resource use. Periodically-harvested closures are touted as being a successful, traditionally based measure for marine management, and often emerge as the principle management measure within LMMAs. Although periodically-harvested closures confer fisheries benefits for some taxa in western fisheries management contexts, there is little evidence that they are effective for the sustainable management of the many types of small-scale fisheries important in the Indo-Pacific. In Chapter 2 I systematically review cases from across the Indo-Pacific region to explore the opening and closure cycles, concurrent harvest control measures, and fisheries objectives, and outcomes of periodically-harvested closures as they are employed in practice. I find that harvesting and closure regimes are highly variable, with some areas remaining predominantly closed and subjected to irregular one day harvests, while others are harvested for periods extending to weeks or months. Periodically-harvested closures are commonly placed over reef habitats, and are most frequently employed to manage trochus fisheries. I found few reports of restrictions being placed on periodic harvests, and few reports of concurrently employed restrictions on marine resource use in the broader fisheries area. This review clearly illustrated that there has been a lack of systematic research exploring the fisheries outcomes and potential limitations of periodically-harvested closures.\ud \ud To address the knowledge gap identified in Chapter 2, I conducted an interdisciplinary study of periodically-harvested closures as a measure to control fishing effort, and to maintain and improve catch rates and yields. In Chapter 3 I aimed to determine whether fishing pressure (both in terms of effort and yield) was alleviated by implementing periodically-harvested closures, and whether resultant levels of harvesting were sustainable. I also aimed to understand how implementing periodically-harvested closures altered access to resources, and if their implementation resulted in displacement of fishing effort to other areas. In Chapter 3 I documented cycles of opening and closure applied in four periodically-harvested closures, decisions driving those cycles, access rights to closures through time and by different sectors of the local communities, and the broader management frameworks that influenced exploitation and management outcomes. I found duration and frequency of openings was highly variable, with open periods ranging from a single night to one month in duration, and occurring between one and 15 times per year. Fishing during openings was permitted for entire fishing communities in some cases, and only for specific rights-holding families in others. Decisions to harvest closures tended to be based on immediate social or economic needs. Harvesting during openings was restricted to a single taxon and single method in some cases, or unrestricted multi-species, multi-method harvesting in others. Periodically-harvested closures were the main form of management in use at all case study locations. In examining patterns of fishing pressure I found that fishing effort (mean fisher hours per day) during openings was relatively intense (between four and 60 times higher) compared to average daily effort on reefs continuously open to fishing. However over a full year, total effort and total harvested biomass from closures was low to moderate compared to open reefs. I found that effort was not significantly displaced onto open fishing grounds due to closures, likely because of the small size of closed areas relative to continuously open and accessible fishing grounds.\ud \ud In Chapter 4 I examined the characteristics of catch to test hypotheses that emerged from the review in Chapter 2 i.e., that in periodically-harvested closures (a) catch rates (catch per unit effort; CPUE) are higher, (b) short lived, fast growing, sedentary taxa are more abundant, and (c) finfish and invertebrates are larger, compared to harvests from reefs continuously open to fishing. I compared catch rates and catch composition from periodic harvests to harvests of continuously-open fishing grounds, and also examined changes in catch rates throughout the opening period to look for depletion effects. I found that CPUE was significantly higher from periodically-harvested closures for gleaning, but not for spear and line fishing. In one periodically-harvested closure where data were sufficient for analysis of catch rates throughout the periodic harvest, I did not find quantitative evidence of significant fisheries depletion indicated by declines in CPUE for line and spear fishing. However catch rates from gleaning for invertebrates declined throughout the periodic harvest; CPUE was significantly higher in the early stages of the periodic harvest compared with open reefs, but not in the later stages of the harvest. This evidence, alongside reports from fishers and declines in effort (particularly for gleaning), suggests there was substantial localised depletion of invertebrate stocks. Family level catch composition was similar to open reefs for two closures. The small amount of dissimilarity in catches was due to relatively higher abundances of families of high rebound potential i.e., Strombidae, Acanthuridae and Balistidae. Six out of the eight species analysed were larger when harvested from periodically-harvested closures than those harvested from open reefs, but only Lutjanus rufolineatus was significantly larger. Trochus (Trochus niloticus) was significantly smaller from closures than those harvested from open reefs, which may be due to the effect of prior harvests.\ud \ud To summarise the local fisheries governance arrangements and outcomes presented in Chapters 2, 3 and 4; periodically-harvested closures are a socially acceptable management measure, frequently implemented within co-management frameworks across the Indo-Pacific. My research indicates periodically-harvested closures can achieve at least short-term benefits by bolstering catch rates of invertebrates, and leading to catches with slightly larger fish in some species. However, harvesting during periodic harvests was intense, and there was evidence that this led to substantial localised depletion of invertebrate stocks. Further, as social and economic needs (rather than ecological knowledge and indicators) often drive decisions to open areas to harvest, the short-term fisheries benefits may be threatened by rising demand, and heavier and more frequent fishing events in the medium to long-term. There is a need for future studies to address long-term fisheries benefits of periodically-harvested closures. I found that periodically-harvested closures were the main form of management employed by communities with LMMAs. However, achieving nation-wide sustainable fisheries management will require marine resource governance to be comprehensive and widespread, requiring more than the currently localised and small scale advances. In response to this challenge, environmental governance is increasingly focused on connecting local management to higher scales of policy and planning. Governance networks are suggested as institutions that can foster cross-scale relations between actors for collective purposes.\ud \ud In Chapter 5 I present my analysis of a governance network explicitly established to strengthen and extend outcomes of local management efforts to hasten advancement towards national goals of widespread and effective fisheries governance.\ud \ud In Chapter 5 I used quantitative social network analysis to examine patterns of collaborative and knowledge-exchange relations amongst NGOs, government agencies and local communities involved in co-management of small-scale fisheries and coastal ecosystems in Solomon Islands. I examined network structure alongside qualitative data to understand the potential of the network to facilitate coordination and learning among management actors. I identified an active social network that transcends the formal membership of the governance network. Cross-scale analysis highlighted that network members were the only functional pathway for cross-scale knowledge-exchange and higher level representation of local issues. I found mid-scale managers (e.g., provincial governments) were poorly connected, yet were identified as the target actors in policies and planning for improving decentralised management. The governance network also provided the primary means for knowledge-exchange between agencies, and was important for multi-actor learning about best practice for co-management. Yet I identified geographic, logistical and institutional barriers and tradeoffs to multi-actor and cross-scale coordination and learning – and therefore significant obstacles to the ultimate objective of widespread and effective co-management.\ud \ud My thesis highlights that periodically-harvested closures are a prominent feature of the small-scale fisheries co-management model employed widely across the Indo-Pacific region. Within periodically-harvested closures fisheries can be maintained at proposed sustainable targets in coastal regions where fishing pressure and populations densities are relatively low. Catch rates for invertebrates and fish size are bolstered by periodically-harvested closures. However, I found that in these particular coastal regions only a small proportion of fishing grounds are influenced by any LMMA or national management measures at all. Long-term successful fishery management will require periodically-harvested closures to be embedded within functional co-management frameworks in which a diversity of context specific, socially acceptable and fisheries appropriate rules are implemented and adapted. This presents an ongoing challenge to community managers and their partner agencies. Cross-scale institutional and knowledge exchange linkages, via partnerships with NGOs or government agencies, can guide and bolster local management institutions to address this challenge in the face of increasing pressures. Cross-scale, cross-institutional relationships are supported by a formal governance network designed to promote learning and collaboration. However maintaining these relationships in a manner that ensures equitable representation, and realises objectives of effective and widespread management, will continue to be fraught with challenges. The success of co-management of small-scale fisheries has implications for three food security pillars; availability (i.e., sufficient amounts of food), access (i.e., ability to obtain sufficient food), and consumption (i.e., meeting nutritional needs). Small-scale fisheries provide the primary source of protein and are an important source of micronutrients to coastal populations, and across the Indo- Pacific alternatives are often limited. My thesis worked on the premise that the nutritional role fisheries plays would be threatened if availability and access were problematic, and that comanagement can play a role in supporting these pillars. My thesis suggests that periodicallyharvested closures can, in some cases, enhance availability of stocks, and act as a ‘bank in the water’ by stock piling resources for when needs are high. Yet the flexibility to harvest and lack of concurrent fisheries management measures may mean that modest gains in abundance or biomass are insufficient to meet future food needs and demands. The cases I examined showed that periodicallyharvested closures present only short-term access restrictions to relatively small areas, and therefore fishers suffer only a minor loss of access to fisheries resources. However, in one of four cases I found evidence of elite capture, where direct benefits from harvesting accrued mainly to the Chief and his family, whereas previously the reef had been accessible to all fishers in adjacent communities. As competition for resources intensifies, it is increasingly important to consider equitable access and distribution of benefits in co-management initiatives. Finally, projections suggest that with current consumption patterns, coastal fisheries will not meet the needs of populations in 2030, even if reefs are well managed. Nevertheless, improving management of small-scale fisheries can help to minimize this shortfall. While the 137 LMMAs established in Solomon Islands represent a substantial advance in managing coastal ecosystems and small-scale fisheries, these areas account for only a very small proportion of coastal waters, human populations and small-scale fishing activities; mechanisms to expand and improve management are critical

Social dimensions of local fisheries co-management in the Coral Triangle

The challenge to manage coastal resources within Asia-Pacific's Coral Triangle has gained global attention. Co-management is promoted as a key strategy to address this challenge. Contemporary community-based co-management often leads to 'hybridization' between local (customary) practices, and science-based management and conservation. However, the form of this hybrid has rarely been critically analysed. This paper presents examples of co-management practices in eastern Indonesia and Solomon Islands, focusing in particular on area closures. In contrast to the temporary closures used before the influx of sustainability discourses, contemporary closures are periodically-harvested but predominantly closed, reflecting attempts to reduce fishing effort and enhance ecological sustainability. When areas are opened, harvests are relatively short and largely triggered by the social and economic needs of particular individuals or whole communities. In all cases, engagement with environmental management interventions has led to more formalized access and use arrangements. The harvesting and management practices observed are influenced by these relatively recent interventions designed to promote sustainability, but also by religious institutions, increasing resource demand, and modernization. This study unpacks some of the contemporary influences, particularly environmental sustainability initiatives, on local management practices, and provides insights for co-management in practice

Finfish and trochus lengths.

<p>Average lengths of finfish and trochus harvested from open reefs (white bars) and periodically-harvested closures (black bars). Error bars indicate standard error. * indicates a significant difference between length of fish or trochus caught from periodically-harvested closures compared with open reefs.</p

Map of study sites.

<p>The regions of Solomon Islands in which the two community clusters and four periodically-harvested closures were situated.</p

Catch rates from periodically-harvested closures and open reefs, by fishing method.

<p>Catch rates (untransformed CPUE) from commonly used methods of harvesting in periodically-harvested closures (closed symbols) and continuously open reefs (open symbols). Error bars indicate 95% confidence intervals. * indicates a significant difference at α = 0.05.</p