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Abstract The Intergovernmental Panel on Climate Change (IPCC) has been producing influential reports for over 35 years. As the IPCC’s Seventh Assessment Report (AR7) cycle begins, we offer our perspective as former members of the IPCC Technical Support Units from Working Groups I, II & III, and the Synthesis Report on lessons learned during the Sixth Assessment Report (AR6) cycle. We identify three broad issues that, if addressed, could reinforce and sustain the IPCC in continuing its mission to comprehensively assess the scientific understanding of human-induced climate change. These are the imperative to ensure balanced representation, the importance of author recognition, and the need for improved institutional memory. Our recommendations include addressing skill and training needs, tackling barriers to participation particularly for Global South authors, and ensuring all contributors receive appropriate recognition for their efforts. We focus, in particular, on feasible incremental changes that could be implemented during AR7 without major changes to the underlying procedures that require approval by the 195 member governments that make up the IPCC.

This study assessed the effects of COVID-19 on Ghana's WASH system. It focused on low-income households and WASH sector stakeholders using Ayawaso East Municipality as a case study to document lessons from the pandemic's impact on the WASH sector. We used the water and sanitation system approach to understand the effects of COVID-19 mitigation measures on the WASH system. Data were collected through surveys, stakeholder engagements, and document analysis. We found that the government's WASH response increased hygiene practices, solid and liquid waste generation, and water consumption. Sanitation service providers experienced reduced demands for their services, lost clients, and increased operational expenditure. The pandemic's impact is gendered, with women and girls experiencing a greater burden. We argue that responses to the pandemic highlight the need and opportunities for sustainable management of sanitation waste through integrated, circular economy business models, turning waste into valuable resources. Responses to COVID-19 in the WASH system are multisectoral because of its interconnected nature, highlighting the need to integrate sectors beyond water and sanitation. This requires improved institutional structures, policies, investment, and professionalising service providers. HIGHLIGHTS Government's WASH response to COVID-19 increased hygiene practices.; A holistic approach to managing all aspects of WASH is vital.; Effective COVID-19 responses require effective inter-agency cooperation.; Social inclusion and support to marginalised groups is critical to deal with a pandemic.; Investments along the whole service delivery chain are needed to improve wastewater management.;

Artificial intelligence is a strong focus of interest for global health development. Diagnostic endoscopy is an attractive substrate for artificial intelligence with a real potential to improve patient care through standardisation of endoscopic diagnosis and to serve as an adjunct to enhanced imaging diagnosis. The possibility to amass large data to refine algorithms makes adoption of artificial intelligence into global practice a potential reality. Initial studies in luminal endoscopy involve machine learning and are retrospective. Improvement in diagnostic performance is appreciable through the adoption of deep learning. Research foci in the upper gastrointestinal tract include the diagnosis of neoplasia, including Barrett’s, squamous cell and gastric where prospective and real-time artificial intelligence studies have been completed demonstrating a benefit of artificial intelligence–augmented endoscopy. Deep learning applied to small bowel capsule endoscopy also appears to enhance pathology detection and reduce capsule reading time. Prospective evaluation including the first randomised trial has been performed in the colon, demonstrating improved polyp and adenoma detection rates; however, these appear to be relevant to small polyps. There are potential additional roles of artificial intelligence relevant to improving the quality of endoscopic examinations, training and triaging of referrals. Further large-scale, multicentre and cross-platform validation studies are required for the robust incorporation of artificial intelligence–augmented diagnostic luminal endoscopy into our routine clinical practice.

Introduction. Training opportunities have decreased dramatically since the introduction of the European Working Time Directive (EWTD). In order to maximise training we introduced a rotation schedule in which registrars do not work night shifts and elective training opportunities are protected. We aimed to determine the safety and effectiveness of this EWTD compliant rotation schedule in achieving exposure of trainees to acute general surgical admissions and operations. Methods. A prospective study of consecutive emergency surgical admissions over a 6-month period. Exposure to acute admissions and operative procedures and patient outcomes during day and night shifts was compared. Results. There were 1156 emergency admissions covering a broad range of acute conditions. Significantly more patients were admitted during the day shift and almost all emergency procedures were performed during the day shift (2.1 versus 0.3, p < 0.001). A registrar was the primary operating surgeon in 49% of cases and was directly involved in over 65%. There were no significant differences between patients admitted during the day and night shifts in mortality rate, length of stay, admission to ICU, requirement for surgery, or readmission rates. Conclusion. A EWTD compliant rotation schedule that protects elective training opportunities is safe for patients and provides adequate exposure to training opportunities in emergency surgery.

The study examines the roles of the annual Durban Tourism Careers Expo and the Tourism Indaba in creating job opportunities for youths and developing entrepreneurial minds of emerging entrepreneurs. Informed by the Social Capital Theory of Career Success, the study explores how social structures create value and facilitate the actions of youths within the tourism industry for career opportunities and success. We employed a qualitative study with a purposively selected sample of 16 participants. Findings of the study show that the events create jobs for youths through internships and learnerships. In addition, they give youths exposure in the industry and encourage them to start their own businesses. Seasonal employment, limited township/community-based tourism and lack of start-up capital were challenges identified. We recommend further research concerning the dynamics of seasonal employment in the tourism industry as well as the extent to which township/community-based tourism is practised and its potential entrepreneurial opportunities for youths.