Managing Fish or Governing Fisheries? An Historical Recount of Marine Resources Governance in the Context of Latin America – The Ecuadorian Case

The narratives and images about ocean and its resources governance, their use and value have deep roots in human history. Traditionally, the contemporary images of fish and fisheries have been shaped under the cultural construction of power, wealth and exclusion, and also as one of poverty and marginalization. This perception was formed on early notions of natural (marine) resources access and use that were born within the colonial machinery that ruled the world from the Middle Ages until late XVII. This research explores the historical overview of marine resources usage and governance in Latin America, from a ‘critical approach to development’ perspective, by following a narrative description based on a ‘three acts’ format. It illustrates how and to what extent politics, power and knowledge have deeply influenced policies and practices at exploring the marine and terrestrial resources and at managing fish and seafood, historically, and how the fisheries resources’ management practices are influenced by principles of appropriation, regulation and usage, put in place already in the XV century that were imposed at the conquering and colonization of the Americas, disregarded previous governance practices. This article argues that fisheries governance cannot be improved without some appreciation for the social, historical, geopolitical, and cultural significance of the fishing resources themselves, of the perceptions of them by humans, and of the interactions Global North-Global South. The analysis also opens the dialogue about what kind of ocean and governance “science” we want, to support decisions, policies and practices regarding fisheries governance. Final thoughts highlight a reflection about whose knowledge is created and used to support decision and policy making in Ecuador

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research