Stakeholder perspectives on nature, people and sustainability at Mount Kilimanjaro

Effective approaches towards sustainability need to be informed by a diverse array of stakeholder perspectives. However, capturing these perspectives in a way that can be integrated with other forms of knowledge can represent a challenge. Here we present the first application of the conceptual framework of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) to a participatory assessment of local perspectives on nature, people and sustainability on Mount Kilimanjaro, Tanzania. This assessment was organized in the form of a participatory workshop with five different groups of stakeholders. Following this framework, we assembled information on the state of and trends in species diversity, Nature's Contributions to People (NCP), and on the main drivers of changes in species and habitats. Additionally, we gathered perspectives on the needs and opportunities for the sustainable management and conservation of natural resources from the individual to the international level. The various stakeholders agreed that both the condition and extent of the various habitats and NCP are declining. In line with available knowledge, the key direct drivers of change mentioned by the workshop participants were land use and climate change, whereas human population growth was singled out as the most important indirect driver. The most frequently suggested measures to address the observed decline in species diversity and its drivers were related to land and water management and to education and awareness raising. Yet, the stakeholder groups differed in the measures they suggested. The willingness of a diversity of knowledge holders to systematically engage in a structured discussion around all the elements of the IPBES framework provides support for its applicability in participatory workshops aimed at capturing nuanced and context-based perspectives on social–ecological systems from informed stakeholders. The application of the IPBES framework enabled the comparability needed for developing narratives of stakeholder visions that can help identify new pathways towards sustainability and guide planning while retaining the context-based nuances that remain unresolved with non-participatory methods

La gestión forestal de usos múltiples y una gobernanza participativa como alternativas a las actividades extractivas en Madre de Dios, Perú

Madre de Dios, “Capital de la Biodiversidad del Perú”, alberga una abundante diversidad biológica. La riqueza de los recursos naturales de la región aporta múltiples contribuciones a la sociedad, incluyendo la regulación del clima, productos forestales como la castaña y oportunidades para el ecoturismo. Aunque las actividades extractivas como la minería aurífera y la tala aportan una parte importante de los medios de vida en Madre de Dios, también comprometen el desarrollo sostenible de la región. Sin embargo, existen alternativas con enfoques integrados participativos y usos múltiples que pueden armonizar el bienestar humano y la conservación de la naturaleza

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56\u20131.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion