A typology of natural resource use for livelihood impact assessments in Nusa Tenggara Barat Province, Indonesia

The vulnerability of less developed regions is exacerbated by a lack of information to inform appropriate adaptation planning. We addressed this challenge in the islands of Lombok and Sumbawa (Nusa Tenggara Barat Province, Indonesia) by combining multiple sources of knowledge to develop a typology of natural resource use by communities of the province. This enabled an assessment of future impacts of drivers of change such as population growth and climate change. The typology was developed by cluster analysis of an inventory of the use of ecosystem goods and services (EGS) by the 105 rural subdistricts in the province. The data were largely elicited from expert knowledge, augmented by a rapid rural appraisal of communities' marine resource use in Sumbawa. Exploratory analysis of existing secondary data on livelihoods and land use provided context and skeleton data, which were developed further by experts. Overall, 82 EGS were identified from nine terrestrial, coastal, marine and freshwater habitats. EGS included livestock, cropping, forestry, wildlife hunting, fishing, aquaculture, mining, water (for drinking and agriculture) and tourism. The typology comprised seven types that captured 42% of the variation in the data matrix. The types were moderately spatially aggregated and showed some congruence with administrative (district) boundaries. We discuss the implications of the results for planning livelihood adaptation strategies, and out-scaling these among subdistricts of matching types

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Assessing the adequacy of current fisheries management under changing climate:a southern synopsis

Climate change is likely to have a significant impact on both target and non-target marine stocks worldwide, with the concomitant need for management strategies capable of sustaining fishing in future. We use several southern hemisphere fisheries to highlight the likely impacts of climate change at a range of levels, from individual to population responses, as well as ecosystem ramifications. Examples span polar (Antarctic krill fishery), temperate (west coast pelagic fishery, abalone and rock lobster), and tropical (Torres Strait rock lobster) commercially important fisheries. Responses of these fisheries to either past observed environmental changes or projected future changes are used to deduce some anticipated implications of climate change for fisheries management, including economic impacts and governance considerations. We evaluate the effectiveness of current single-species assessment models, management strategy evaluation approaches and multispecies assessment models as future management tools to cope with likely climaterelated changes. Non-spatial stock assessment models will have limited ability to separate fishery effects from the impacts of climate change. Anthropogenic climate change is occurring at a time-scale relevant to current fisheries management strategic planning and testing. Adaptive management frameworks (with their feedback loops) are ideal for detecting and adapting to changes in target stock

Workshop on the ecosystem and fisheries of the Coral Sea: an Australian perspective on research and management

This report summarizes a workshop on the Coral Sea to determine key research findings and identify the research gaps needed to support sustainable management of a proposed Coral Sea Marine Reserve. Key research questions included determining the connectivity of apex predators with the broader southwest Pacific Ocean, and assessing the regions’ biodiversity in relation to seabed topography and oceanographic processes. The workshop concluded noting the importance of engaging surrounding countries in maintaining the sustainability and uniqueness of the Coral Sea

The Coral Sea: physical environment, ecosystem status and biodiversity assets

The Coral Sea, located at the southwestern rim of the Pacific Ocean, is the only tropical marginal sea where human impacts remain relatively minor. Patterns and processes identified within the region have global relevance as a baseline for understanding impacts in more disturbed tropical locations. Despite 70 years of documented research, the Coral Sea has been relatively neglected, with a slower rate of increase in publications over the past 20 years than total marine research globally. We review current knowledge of the Coral Sea to provide an overview of regional geology, oceanography, ecology and fisheries. Interactions between physical features and biological assemblages influence ecological processes and the direction and strength of connectivity among Coral Sea ecosystems. To inform management effectively, we will need to fill some major knowledge gaps, including geographic gaps in sampling and a lack of integration of research themes, which hinder the understanding of most ecosystem processes