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As coastal communities across the Global South confront the multiple challenges of climate change, overfishing, poverty and other socio-environmental pressures, there is an increasing need to understand diverse coastal governance responses and livelihood trajectories from a comparative perspective. This paper presents a holistic investigation of the pressures coastal communities face in four countries and examines possible meeting points between bottom-up initiatives and top-down policies. We compare the experiences of eight fishing areas in Ghana, Tanzania, Thailand and the Philippines and ask how small-scale fishing communities perceive overfishing and other socio-environmental pressures; what factors determine the success and failure of coastal governance initiatives; and how different initiatives can be made congruent to improve coastal, rural development outcomes. Results from an extensive survey of 835 fisherfolk and semi-structured interviews with 196 key informants show that overfishing remains a significant driver of livelihood trajectories in the communities and that fisherfolk respond through informal mechanisms of collective action. Drawing from these diverse experiences, we propose viewing coastal livelihood trajectories through the integrated dimensions of socio-environmental relationships and coastal governance options and discuss implications that address institutional scalar flexibility, illegal fishing, and persistent marginalisation. • This article comprehensively compares rural fishing communities in four countries. • A mixed methods approach was employed; 835 surveys and 196 interviews. • While climate change impacts matter, overfishing remains the most pressing issue. • Coastal governance requires institutional flexibility and meso-level solutions. • Fishing communities in middle -income countries remain marginalised. [ABSTRACT FROM AUTHOR]

This article is concerned with the impact of environmental pressures on coastal livelihoods in the municipality of Ajuy, Iloilo Province, central Philippines. The empirical research focuses on three issues: artificial reefs submerged to increase fish stocks, the search for alternative livelihoods options after Typhoon Yolanda (international name Haiyan), and relocation schemes. While the majority of the surveyed households find it hard to make ends meet and persist in fishing they are reluctant to relocate. The results of this investigation highlight that working towards the twin-goals of reducing overfishing and higher standards of living requires a holistic multi-sectoral approach. Future livelihood projects in coastal areas should better address government – NGO coordination; not only in terms of financing and implementation, but also in terms of monitoring and controlling vulnerable marine resources in the longer term. The challenge for international NGOs is to find a compromise between short-term expectations regarding aid effectiveness in donor countries and long-term environmental and socio-economic problematiques in recipient countries. [ABSTRACT FROM AUTHOR]

Abstract Background In preterm infants with Respiratory Distress Syndrome (RDS), Less Invasive Surfactant Administration (LISA) has been established to reduce the need of mechanical ventilation and might improve survival rates without bronchopulmonary dysplasia. The aim of this study was to investigate whether NICU care has changed after introduction of less invasive surfactant administration (LISA), with regard to diagnostic and therapeutic procedures in the first week of life. Methods Infants with gestational age

Summary: The objectives of this study were to implement a uniform guideline for perioperative antibiotic prophylaxis (PAP) and to measure the impact on timing and costs of PAP. The effects of implementation of the new guideline describing the application of PAP were measured by comparing the choice of agents and their timing in a random sample of procedures before and after implementation. Before the intervention, 153 procedures from different specialties were observed; eight different antibiotics in different dosages were used and in 20% of the procedures, PAP was given after the incision. Two months after the intervention, 147 procedures were observed; three different antibiotics were given and all were used in the correct dosage. There was a significant reduction of administration of PAP after the incision from 20 to 7% (P =0.002). Besides the quality improvements, the modified PAP protocol resulted in a net annual savings of at least US$112,000. This study shows that the implementation of a uniform, simple and clear protocol for PAP is associated with improved dosing and timing. The costs of PAP were also reduced. [Copyright &y& Elsevier]

As part of fisheries governance initiatives, conservation has been deployed as an important management strategy in the rebuilding of depleted marine fish stock. However, a major challenge associated with conservation initiatives concerns the lack of participation and broader consultation of relevant local resource users, as well as restricted access to vital community resources. This study investigates the perception of the impacts of a newly introduced seasonal closure on the livelihoods and assets of small-scale coastal fisherfolk in Ghana, as well as the broader issue of local perception of conservation. Based on the conceptual integration of the sustainable livelihoods approach and political ecology insights, a mixed-methods approach was employed consisting of 400 fisherfolk households survey and 42 interviews with key stakeholders. The results reveal that the seasonal closure has led to four main challenges: restricted access to coastal waters, decreased financial capital, decreased fish trading activities and declining small-scale fisheries opportunities. The opinions on the closed season were mostly negative. This can be attributed to the fisherfolk's level of participation and perceived lack of influence in decision-making, the absence of alternative livelihoods and the questionable ecological effectiveness of the closed season. The implications of the findings relate to improving coastal governance and as well as the need to reduce illegal fishing practises. If fisherfolk in sub-Saharan Africa are not sufficiently heard and empowered, drastic measures such as closed seasons are not likely to be effective. The poverty–environment nexus and associated vicious circles cannot be effectively addressed without active local involvement. • Local support for conservation is associated with socio-economic impacts, stakeholder engagement and conservation outcomes. • Persistent illegal fishing activities are unsustainable and undermines the ecological effectiveness of the closed season. • Closed seasons require an effective governance system that incentivize local support for marine conservation. • Collaborative marine resource management is a viable strategy to balance the power dynamics and knowledge. [ABSTRACT FROM AUTHOR]