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Centralization of fisheries management within large-scale, colonial governing bodies can remove access and management rights of Indigenous communities and deplete marine resources through a mismatch in bioecological and managerial scales. Management of pāua (blackfoot abalone, Haliotis iris) in Aotearoa New Zealand exemplifies this transition from small-scale fisheries management by tangata whenua (local Indigenous people with historical claim to the land, Māori) to central government regulation and subsequent overexploitation. Comanagement strategies have the potential to address degradation of biological and cultural diversity by returning management to local scales and authority to local people. New Zealand's customary fisheries management legislation aims to facilitate such a devolution of management back to tangata whenua through the establishment of Taiāpure Local Fisheries and Mātaitai Reserves. However, local management systems can remain constrained by the wider governance structures that encompass them. These constraints are discussed in relation to a management proposal for pāua harvesting made by the East Otago Taiāpure Management Committee. The proposal aimed to return fishing practices to a customary method, providing greater protection for declining pāua populations while allowing a small harvest to continue. After a long and protracted application process, central government did not support the proposed regulation. This opposition demonstrated many of the constraints that local management committees face as they endeavor to operate within the confines of broader legal frameworks: conflicting worldviews, inequitable power sharing, perceived inferiority of Indigenous customs, requirements for conventional science, and navigation of bureaucratic processes. Insights are also drawn from another small-scale abalone fishery (ormer, Haliotis tuberculata) in the Channel Islands, for which the desired regulation has been in place for over three decades.

For the past 40 years, the dominant ‘policy’ on cooking energy in the Global South has been to improve the combustion efficiency of biomass fuels. This was said to alleviate the burdens of biomass cooking for three billion people by mitigating emissions, reducing deforestation, alleviating expenditure and collection times on fuels and increasing health outcomes. By 2015, international agencies were openly saying it was a failing policy. The dispersal of improved cookstoves was not keeping up with population growth, increasing urbanisation was leading to denser emissions and evidence suggested health effects of improved stoves were not as expected. A call was made for a new strategy, something other than ‘business as usual’. Conventional wisdom suggests that access to electricity is poor in Sub-Saharan Africa (SSA), that it is too expensive and that weak grids prevent even connected households from cooking. Could a new strategy be built around access to electricity (and gas)? Could bringing modern energy for cooking to the forefront kill two birds with one stone? In 2019, UK Aid announced a multi-million-pound programme on ‘Modern Energy Cooking Services’ (MECS), specifically designed to explore alternative approaches to address cooking energy concerns in the Global South. This paper outlines the rationale behind such a move, and how it will work with existing economies and policies to catalyse a global transition.

Induction of a clinical complete response with chemoradiotherapy, followed by observation via a watch-and-wait approach, has emerged as a management option for patients with rectal cancer. We aimed to address the shortage of evidence regarding the safety of the watch-and-wait approach by comparing oncological outcomes between patients managed by watch and wait who achieved a clinical complete response and those who had surgical resection (standard care). Oncological Outcomes after Clinical Complete Response in Patients with Rectal Cancer (OnCoRe) was a propensity-score matched cohort analysis study, that included patients of all ages diagnosed with rectal adenocarcinoma without distant metastases who had received preoperative chemoradiotherapy (45 Gy in 25 daily fractions with concurrent fluoropyrimidine-based chemotherapy) at a tertiary cancer centre in Manchester, UK, between Jan 14, 2011, and April 15, 2013. Patients who had a clinical complete response were offered management with the watch-and-wait approach, and patients who did not have a complete clinical response were offered surgical resection if eligible. We also included patients with a clinical complete response managed by watch and wait between March 10, 2005, and Jan 21, 2015, across three neighbouring UK regional cancer centres, whose details were obtained through a registry. For comparative analyses, we derived one-to-one paired cohorts of watch and wait versus surgical resection using propensity-score matching (including T stage, age, and performance status). The primary endpoint was non-regrowth disease-free survival from the date that chemoradiotherapy was started, and secondary endpoints were overall survival, and colostomy-free survival. We used a conservative p value of less than 0·01 to indicate statistical significance in the comparative analyses. 259 patients were included in our Manchester tertiary cancer centre cohort, 228 of whom underwent surgical resection at referring hospitals and 31 of whom had a clinical complete response, managed by watch and wait. A further 98 patients were added to the watch-and-wait group via the registry. Of the 129 patients managed by watch and wait (median follow-up 33 months [IQR 19–43]), 44 (34%) had local regrowths (3-year actuarial rate 38% [95% CI 30–48]); 36 (88%) of 41 patients with non-metastatic local regrowths were salvaged. In the matched analyses (109 patients in each treatment group), no differences in 3-year non-regrowth disease-free survival were noted between watch and wait and surgical resection (88% [95% CI 75–94] with watch and wait vs 78% [63–87] with surgical resection; time-varying p=0·043). Similarly, no difference in 3-year overall survival was noted (96% [88–98] vs 87% [77–93]; time-varying p=0·024). By contrast, patients managed by watch and wait had significantly better 3-year colostomy-free survival than did those who had surgical resection (74% [95% CI 64–82] vs 47% [37–57]; hazard ratio 0·445 [95% CI 0·31–0·63; p<0·0001), with a 26% (95% CI 13–39) absolute difference in patients who avoided permanent colostomy at 3 years between treatment groups. A substantial proportion of patients with rectal cancer managed by watch and wait avoided major surgery and averted permanent colostomy without loss of oncological safety at 3 years. These findings should inform decision making at the outset of chemoradiotherapy. Bowel Disease Research Foundation.

Strategies for meeting Sustainable Development Goal 7 of providing access to electricity for all recognize the important role that off-grid solutions will need to play. Mini-grids will from part of this response, yet little data exists on household demand from these customers. Predicting demand accurately is a crucial part of planning financially viable mini-grid systems, so it is important to understand demand as fully as possible. This paper draws on metered data from two solar PV diesel hybrid mini-grid sites in Tanzania. It presents an analysis of load profiles from the different sites and categorizes households by demand characteristics. The paper then combines load profile data with household demographic and electrical asset ownership data to explore factors behind distinct load profile patterns of use. It concludes that load profiles are determined by a complex mix of appliance ownership, occupancy, and socio-economic status.

Transitioning to clean cooking fuels is not only part of achieving SDG7 but also makes a significant contribution to mitigating climate change by reducing carbon emissions. Research projects and pilots across a number of countries in Africa and South Asia have been exploring the suitability and energy performance of different cooking appliances and fuels. The paper presents the first statistical analysis across these multiple datasets to determine the range of energy required to cook dishes using different technologies and fuels. The paper draws out distinctions between African and Asian dishes, notably the impact of energy-intensive dishes prepared mostly in Africa. The paper demonstrates that the standard efficiency-based approaches to comparing the performance of stoves are not appropriate to modern electric cooking devices, so a novel alternative approach based on specific energy consumption and termed energy ratios is developed. Charcoal stoves are shown to use 15 times as much energy as electric pressure cookers (EPCs) to cook African dishes, and a detailed review of how the EPC works explains why this should be. Energy ratios provide a basis for estimating carbon emission reductions associated with transitioning to modern cooking fuels and also for estimating household cooking costs. Fuel and electricity prices from studies show that the cost of cooking with an EPC can be only 20% of the cost of cooking with charcoal, which highlights the potential for modern, energy-efficient electric cooking devices to defy the conventional wisdom of the energy ladder.

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We analyzed pregnancy outcomes of women who became pregnant during the study. Among 740 women, 97 (13.1%) became pregnant. Of 102 pregnancies (in 97 participants), 30 (29.4%) participants were exposed to study drugs. Fetal loss was reported for 3/13 (23.1%) in the control regimen, 1/9 (11.1%) in the rifapentine/moxifloxacin regimen, and 1/8 (12.5%) in the rifapentine regimen. Among 21 live births in exposed pregnancies (7 in each arm), 1 infant with a congenital anomaly was reported in a participant on the rifapentine regimen. Among women receiving a short rifapentine/moxifloxacin regimen for tuberculosis who became pregnant, we observed no elevated rates of fetal losses or congenital anomalies.

Context Conservation requires aligning the spatial, temporal, and functional scales of environmental management with those of interlinked ecological processes. Objectives To assist Indigenous Ngāi Tahu and government-mandated authorities in the management of black swans ( kakī anau , Cygnus atratus) in the South Island of Aotearoa New Zealand, we investigated the effects of land cover on space use by swans and identified scale mismatches in contemporary gamebird and wetland management. Methods We GPS-tracked 48 swans over one year and compared home range sizes with spatial scales of gamebird management. We also examined relative preferences of swans for different land-cover types to understand the potential for human-wildlife conflict, an influential component of gamebird and wetland management. Results Home ranges were typically located within a single waterbody or catchment, whereas gamebird management units each comprised numerous catchments. Within home ranges, swan location records coincided with aquatic vegetation, sandy shorelines, and flooded deciduous hardwoods. Contrary to common perceptions among farmers (primarily European New Zealanders) of swans as widespread pests, swans significantly avoided pasture, except near some shorelines and nesting colonies where wetlands have been converted to pasture. Conclusions Regional-scale waterfowl management that does not account for habitat selection within home ranges (a spatial scale mismatch) could obscure patterns and determinants of population changes. Moreover, management geared towards suppressing waterfowl numbers in the interests of agricultural land uses that have encroached upon wetlands (a functional scale mismatch) could further degrade waterfowl populations. Mitigating these scale mismatches requires equitable governance arrangements that recognize Indigenous Peoples’ rights and values associated with the environment.

A previous study demonstrated noninferior efficacy of 4-month rifapentine/moxifloxacin regimen for tuberculosis (TB) treatment compared with the standard regimen. We explored results among study participants with diabetes. Among 2,516 randomized participants, 181 (7.2%) had diabetes. Of 166 participants with diabetes in the microbiologically eligible analysis group, 26.3% (15/57) had unfavorable outcomes in the control regimen, 13.8% (8/58) in the rifapentine/moxifloxacin regimen, and 29.4% (15/51) in the rifapentine regimen. The difference in proportion of unfavorable outcomes between the control and rifapentine/moxifloxacin arms in the microbiologically eligible analysis group was -12.5% (95% CI -27.0% to 1.9%); the difference between the control and rifapentine arms was 3.1% (95% CI -13.8% to 20.0%). Safety outcomes were similar in the rifapentine/moxifloxacin regimen and control arms. Among participants with TB and diabetes, the rifapentine/moxifloxacin arm had fewest unfavorable outcomes and was safe. Our findings indicate that the rifapentine/moxifloxacin regimen can be used in persons with TB and diabetes.

Scientific support invited by Indigenous peoples and local communities (IPLC) to assist with customary environmental management can improve conservation and community livelihoods. For example, demographic models can help to understand how alternative wildlife management strategies affect population dynamics and harvest sustainability. We developed a demographic model to assist Ngāi Tahu, the southern-most Māori tribe in Aotearoa/New Zealand, in customary management of a culturally important population of Black Swans (kakī anau, Cygnus atratus). We used recent demographic data, including results of an experimental egg harvest study, to inform tangata tiaki (Ngāi Tahu environmental guardians) about how customary egg harvest and background pressure from sport hunting of swans aged ≥ 1 year differentially affect population growth. We also assessed how sport hunting of swans affects the sustainability of customary egg harvest. Estimated population growth (1.018 or presently growing 1.8% annually; 95% CI: 0.808–1.241) was most sensitive to changes in adult and subadult survival, followed by juvenile (first-year) survival, breeding propensity, and nest hatching success. Uncertainty in population growth was almost entirely attributable to uncertainty in swan survival rates after hatching. Sustainable population-level rates of egg harvest varied from none to more than half of all eggs, depending on small changes in adult and subadult survival. Population sensitivity to adult and subadult survival suggests that limiting and monitoring their mortality are crucial to population and egg harvest sustainability, whereas contemporary government-mandated species management, through Fish and Game New Zealand, allows adult and subadult mortality from sport hunting, with little record of offtake. Recognizing the rights and interests of Ngāi Tahu, and monitoring swan mortality more closely, could improve Ngāi Tahu abilities to practice customary harvest, enhance population and environmental monitoring, and, when appropriate, control swan numbers in a culturally appropriate and less wasteful way. The model we present could aid decision making and communication between Ngāi Tahu and New Zealand’s Crown government within a potential future co-management arrangement. Demographic models can be useful tools for supporting customary environmental management, but developing, maintaining, and implementing these tools requires support for adaptive policies and management arrangements that recognize IPLC rights to the environment and decision making.

This paper assesses the relationship between the proportion of the population with primary reliance on different types of fuels for cooking (national averages) and a number of key wellbeing indices. The study uses a data set created from a combination of the Gallup World Poll database and the World Health Organisation (WHO) Household Energy Database. The Gallup database comprises multinational survey data and contains wellbeing indices (Personal Health, Social Life, Civic Engagement, Life Evaluation, Negative Experience, etc.). The WHO database gives the proportion of a population with primary reliance on different types of cooking fuels. In order to understand the relative importance of the choice of cooking fuels in terms of wellbeing, regression modelling is used to control for the effects of demographic variables (income per capita, age, education level, employment, etc.), available in the Gallup database, on the wellbeing indices. The regression analysis results show that clean cooking fuels are strongly influential in health-related indices. By adding access to electricity as an additional predictor variable, the analysis highlights the potential for integrating eCooking into national electrification plans as part of sustainable energy transitions, given that health outcomes appear to be as closely linked to the choice of cooking fuels as to access to electricity.