Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and long wave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change

Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and long wave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change

Anticipatory Resilience Bringing Back the Future into Urban Planning and Knowledge Systems

Anticipatory thinking is a critical component in urban planning practices and knowledge systems in an era of unpredictability and conflicting expectations of the future. This chapter introduces “anticipatory resilience” as a futures-oriented knowledge system that intentionally addresses uncertain climate conditions and explores alternative, desirable future states. It suggests a portfolio of tools suitable for building long-term foresight capacity in urban planning. Examples of knowledge systems interventions are presented to explore the trade-offs, constraints, possibilities, and desires of diverse future scenarios co-generated in settings with people that hold different perspectives, knowledge, and expectations

Assessing Future Resilience, Equity, and Sustainability in Scenario Planning

In the absence of strong international agreements, many municipal governments are leading efforts to build resilience to climate change in general and to extreme weather events in particular. However, it is notoriously difficult to guide and activate processes of change in complex adaptive systems such as cities. Participatory scenario planning with city professionals and members of civil society provides an opportunity to coproduce positive visions of the future. Yet, not all visions are created equal. In this chapter, we introduce the Resilience, Equity, and Sustainability Qualitative (RESQ) assessment tool that we have applied to compare positive scenario visions for cities in the USA and Latin America. We use the tool to examine the visions of the two desert cities in the Urban Resilience to Extreme Events Sustainability Research Network (UREx SRN), which are Hermosillo (Mexico) and Phoenix (United States)

Triage conducted by lay-staff and emergency training reduces paediatric mortality in the emergency department of a rural hospital in Northern Mozambique

Introduction The majority of emergency paediatric death in African countries occur within the first 24 h of admission. A coloured triage system is widely implemented in high-income countries and the emergency triage and assessment treatment (ETAT) is recommended by the World Health Organization, but not put into practice in Mozambique. We implemented a three-colour triage system in a rural district hospital with lay-staff workers conducting the first triage. Methods A retrospective, before and after, mortality analysis was performed using routine patient files from the district hospital between 2014 and 2017. The triage system was implemented in August 2016. Inclusion criteria were children under 15 years of age that entered the emergency centre. Primary outcome was child mortality rate. Secondary outcomes included the percentage agreement between the clinical and non-clinical staff and the duration from triage to first treatment. We used a negative binomial model in STATA 15 to compare mortality rates, and Kappa statistics to estimate the agreement between clinical and non-clinical staff. Results 4176 admissions were included. The mortality rate ratio (MMR) was 45% lower after the start of the intervention (2016; MRR = 0.55; 0.38, 0.81; p = 0.002), compared to before. To estimate the agreement between non-clinical and clinical staff, 548 (of the 671) patient files were included. The agreement was estimated at 88.7% (Kappa = 0.644; p < 0.001). The median waiting time decreased with urgency of the triage: 2 h33 for ‘green’/least serious (IQR 1 h58-3 h30), 21 min for yellow/serious (IQR 0 h10-0 h58) and nine minutes for ‘red’/urgent (IQR 2–40 min). Conclusion In a rural setting with nurse-led clinical care and non-clinician staff working at the triage reception, implementation of a three-coloured triage system was feasible. Triage and ETAT training was associated with a decrease of 45% of paediatric deaths. The impact on mortality, low cost, and ease of the implementation supports scaling this intervention in similar settings

Estimation of potential evapotranspiration from extraterrestrial radiation, air temperature and humidity to assess future climate change effects on the vegetation of the Northern Great Plains, USA

The potential evapotranspiration (PET) that would occur with unlimited plant access to water is a central driver of simulated plant growth in many ecological models. PET is influenced by solar and longwave radiation, temperature, wind speed, and humidity, but it is often modeled as a function of temperature alone. This approach can cause biases in projections of future climate impacts in part because it confounds the effects of warming due to increased greenhouse gases with that which would be caused by increased radiation from the sun. We developed an algorithm for linking PET to extraterrestrial solar radiation (incoming top-of atmosphere solar radiation), as well as temperature and atmospheric water vapor pressure, and incorporated this algorithm into the dynamic global vegetation model MC1. We tested the new algorithm for the Northern Great Plains, USA, whose remaining grasslands are threatened by continuing woody encroachment. Both the new and the standard temperature-dependent MC1 algorithm adequately simulated current PET, as compared to the more rigorous PenPan model of Rotstayn et al. (2006). However, compared to the standard algorithm, the new algorithm projected a much more gradual increase in PET over the 21st century for three contrasting future climates. This difference led to lower simulated drought effects and hence greater woody encroachment with the new algorithm, illustrating the importance of more rigorous calculations of PET in ecological models dealing with climate change.Keywords: Potential evapotranspiration, Great Plains USA, Climate change, Vegetation dynamics, MC

Beyond bouncing back? Comparing and contesting urban resilience frames in US and Latin American contexts

Urban resilience has gained considerable popularity in planning and policy to address cities’ capacity to cope with climate change. While many studies discuss the different ways that academics define resilience, little attention has been given to how resilience is conceptualized across different urban contexts and among the actors that engage in building resilience ‘on the ground’. Given the implications that resilience frames can have for the solutions that are pursued (and who benefits from them), it is important to examine how transformative definitions of urban resilience are in practice. In this paper, we use data from a survey of nine US and Latin American and Caribbean cities to explore how the concept is framed across multiple governance sectors, including governmental, non-governmental, business, research, and hybrid organizations. We examine these framings in light of recent conceptual developments and tensions found in the literature. The results highlight that, in general across the nine cities, framings converge with definitions of resilience as the ability to resist, cope with, or bounce back to previous conditions, whereas sustainability, equity, and social-ecological-technological systems (SETS) perspectives are rarely associated with resilience. There are noticeable differences across cities and governance actors that point to geographic and political variation in the way resilience is conceptualized. We unpack these differences and discuss their implications for resilience research and practice moving forward. We argue that if resilience is going to remain a major goal for city policies into the future, it needs to be conceived in a more transformative, anticipatory, and equitable way, and acknowledge interconnected SETS

Characterizing the double-sided cascade of care for adolescents living with HIV transitioning to adulthood across Southern Africa

INTRODUCTION: As adolescents and young people living with HIV (AYLH) age, they face a "transition cascade," a series of steps associated with transitions in their care as they become responsible for their own healthcare. In high-income countries, this usually includes transfer from predominantly paediatric/adolescent to adult clinics. In sub-Saharan Africa, paediatric HIV care is mostly provided in decentralized, non-specialist primary care clinics, where "transition" may not necessarily include transfer of care but entails becoming more autonomous for one's HIV care. Using different age thresholds as proxies for when "transition" to autonomy might occur, we evaluated pre- and post-transition outcomes among AYLH. METHODS: We included AYLH aged <16 years at enrolment, receiving antiretroviral therapy (ART) within International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) sites (2004 to 2017) with no history of transferring care. Using the ages of 16, 18, 20 and 22 years as proxies for "transition to autonomy," we compared the outcomes: no gap in care (≥2 clinic visits) and viral suppression (HIV-RNA <400 copies/mL) in the 12 months before and after each age threshold. Using log-binomial regression, we examined factors associated with no gap in care (retention) in the 12 months post-transition. RESULTS: A total of 5516 AYLH from 16 sites were included at "transition" age 16 (transition-16y), 3864 at 18 (transition-18y), 1463 at 20 (transition-20y) and 440 at 22 years (transition-22y). At transition-18y, in the 12 months pre- and post-transition, 83% versus 74% of AYLH had no gap in care (difference 9.3 (95% confidence interval (CI) 7.8 to 10.9)); while 65% versus 62% were virally suppressed (difference 2.7 (-1.0 to 6.5%)). The strongest predictor of being retained post-transition was having no gap in the preceding year, across all transition age thresholds (transition-16y: adjusted risk ratio (aRR) 1.72; 95% CI (1.60 to 1.86); transition-18y: aRR 1.76 (1.61 to 1.92); transition-20y: aRR 1.75 (1.53 to 2.01); transition-22y: aRR 1.47; (1.21 to 1.78)). CONCLUSIONS: AYLH with gaps in care need targeted support to prevent non-retention as they take on greater responsibility for their healthcare. Interventions to increase virologic suppression rates are necessary for all AYLH ageing to adulthood

Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study.

OBJECTIVES: To examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART). SETTING: Sixteen government-funded health facilities in the rural Bikita district of Zimbabwe. DESIGN: Cross-sectional study. PARTICIPANTS: HIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months. OUTCOME MEASURES: The primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence. RESULTS: Out of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40-49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50-59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70). CONCLUSIONS: A substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe. TRIAL REGISTRATION NUMBER: NCT03704805