Impacts of Climate Change on Stream Inflows into the Volta Lake

The study examined the impact of climate change on future water availability in the Volta Lake from climate downscaled data using ensemble projections of two Global Climate Models (MPEH5 and HADCM3) and two emission scenarios (A1B and A2) used in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. The SWAT hydrological model was calibrated and validated and then used with the downscaled climate change data to assess the impacts of climate change on the inflows to the Lake. Results from the impact assessment showed that future mean annual streamflow into the Volta Lake could increase by about 17 and 16 percent under the A1B and A2 scenarios, respectively. However, streamflow from Geoere, Boromo and Dapola in the Black Volta basin and Nawuni in the White Volta basin could decrease. The projected increase in total annual streamflow in the basin is consistent with the increase in annual rainfall in the basin under both the A1B and A2 scenarios of between 2.0 and 8.0 percent obtained in a separate climate downscaling study. Since streamflow in some of the sub-basins were found to decrease under the climate change scenarios investigated, integrated and prudent management of the basin's water resources would be necessary to ensure sustainability in water use

Environmental sanitation and urban agriculture in Ghana

Environmental sanitation and urban agriculture in Ghan

Designing a combined Liothyronine (LT3), L-thyroxine (LT4) trial in symptomatic hypothyroid subjects on LT4 – the importance of patient selection, choice of LT3 and trial design

Approximately 10%–15% of subjects with hypothyroidism on L-thyroxine (LT4) alone have persistent symptoms affecting their quality of life (QoL). Although the cause is unclear, there is evidence that “tissue T3 lack” may be responsible. If so, combining liothyronine (LT3) with LT4 would be helpful. However, randomized controlled trials (RCT), have not established greater efficacy for the LT3 + LT4 combination in these subjects than for LT4 alone. While the trial design may have been responsible, the use of unphysiological, short-acting LT3 preparations and non-thyroid-specific patient-reported outcome measures (PROMs) may have contributed. We recommend attention to the following aspects of trial design for future RCTs of LT3 + LT4 compared to LT4 alone: (a) Subject selection—(i) measurable symptoms (disadvantages should be recognized); (ii) using a validated thyroid specific PROM such as ThyPRO39 or the Composite scale derived from it; (iii) those taking over 1.2 μg/day or 100 μg/day (for pragmatic reasons) of LT4 defining a population likely without intrinsic thyroid activity who depend on exogenous LT4; (iv) recruiting a preponderance of subjects with autoimmune thyroiditis increasing generalisability; and (v) those with a high symptom load with a greater response to combination therapy e.g. those with the deiodinase 2 polymorphism. (b) The use of physiological LT3 preparations producing pharmacokinetic similarities to T3 profiles in unaffected subjects: two long-acting LT3 preparations are currently available and must be tested in phase 2b/3 RCTs. (c) The superiority of a crossover design in limiting numbers and costs while maintaining statistical power and ensuring that all subjects experienced the investigative medication

African farmer-led irrigation development: re-framing agricultural policy and investment?

The past decade has witnessed an intensifying focus on the development of irrigation in sub-Saharan Africa. It follows a 20-year hiatus in the wake of disappointing irrigation performance during the 1970s and 1980s. Persistent low productivity in African agriculture and vulnerability of African food supplies to increasing instability in international commodity markets are driving pan-African agricultural investment initiatives, such as the Comprehensive Africa Agricultural Development Programme (CAADP), that identify as a priority the improvement in reliability of water control for agriculture. The paper argues that, for such initiatives to be effective, there needs to be a re-appraisal of current dynamics of irrigation development in sub-Saharan Africa, particularly with respect to the role of small-scale producers’ initiatives in expanding irrigation. The paper reviews the principal forms such initiatives take and argues that official narratives and statistics on African irrigation often underestimate the extent of such activities. The paper identifies five key characteristics which, it argues, contradict widely held assumptions that inform irrigation policy in Africa. The paper concludes by offering a definition of ‘farmer-led irrigation’ that embraces a range of interaction between producers and commercial, government and non-government agencies, and identifies priority areas for research on the growth potential and impact of such interactions and strategies for their future development

A nationwide study of adults admitted to hospital with diabetic ketoacidosis or hyperosmolar hyperglycaemic state and COVID‐19

AimsTo investigate characteristics of people hospitalized with coronavirus-disease-2019 (COVID-19) and diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS), and to identify risk factors for mortality and intensive care admission.Materials and methodsRetrospective cohort study with anonymized data from the Association of British Clinical Diabetologists nationwide audit of hospital admissions with COVID-19 and diabetes, from start of pandemic to November 2021. The primary outcome was inpatient mortality. DKA and HHS were adjudicated against national criteria. Age-adjusted odds ratios were calculated using logistic regression.ResultsIn total, 85 confirmed DKA cases, and 20 HHS, occurred among 4073 people (211 type 1 diabetes, 3748 type 2 diabetes, 114 unknown type) hospitalized with COVID-19. Mean (SD) age was 60 (18.2) years in DKA and 74 (11.8) years in HHS (p < .001). A higher proportion of patients with HHS than with DKA were of non-White ethnicity (71.4% vs 39.0% p = .038). Mortality in DKA was 36.8% (n = 57) and 3.8% (n = 26) in type 2 and type 1 diabetes respectively. Among people with type 2 diabetes and DKA, mortality was lower in insulin users compared with non-users [21.4% vs. 52.2%; age-adjusted odds ratio 0.13 (95% CI 0.03-0.60)]. Crude mortality was lower in DKA than HHS (25.9% vs. 65.0%, p = .001) and in statin users versus non-users (36.4% vs. 100%; p = .035) but these were not statistically significant after age adjustment.ConclusionsHospitalization with COVID-19 and adjudicated DKA is four times more common than HHS but both associate with substantial mortality. There is a strong association of previous insulin therapy with survival in type 2 diabetes-associated DKA

Modelling potential areas of groundwater development for agriculture in northern Ghana using GIS/RS

Groundwater development potential in northern Ghana (108 671 km2) has been assessed by combining spatial layers for five critical factors?recharge rate, regolith thickness, transmissivity, borehole success rate and static water level?through a multi-criteria analysis approach to rank development potential from the viewpoint of groundwater availability and accessibility at a resolution of 1 km2. The results indicate a high potential for development in the study area, as about 70% of the area was found to have high to moderate groundwater availability, while 83% has high to medium groundwater accessibility. Comparing the two main hydrogeological environments, the Precambrian Basement rocks (PCB) area was found to generally have a higher groundwater development potential than the Voltaian Sedimentary rocks (VSB). More detailed investigation revealed that the VSB can produce a small proportion of exceptionally high-yielding boreholes that can support large-scale irrigation. A test of the reliability of results showed that generally, the majority of high- and low-yielding boreholes fall in areas predicted by the model as having high and low groundwater availability, respectively

Irrigated urban vegetable production in Ghana: characteristics, benefits and risk mitigation

This chapter serves as an introduction to the book and provides brief information about urbanization in West Africa, and in Ghana in particular, the general role of urban agriculture and the common use of polluted irrigation water. It describes our focus on irrigated smallholder vegetable production and our understanding of the terms ‘urban‘, ‘peri-urban’ and ‘wastewater’. The chapter reflects on some of the key challenges of the farming system, its dynamic and resilience. It also gives an overview on the structure of the book, the origins of the data and the main objective of this publication