Climate risk, vulnerability and resilience: Supporting livelihood of smallholders in semiarid India

Using panel data from 256 smallholder households from 2006 to 2014 in three semiarid regions India, this study develops a framework for quantifying vulnerability and resilience by accounting for a smallholder household’s ability to adapt and respond to climatic risk. Findings indicate that although smallholders with smaller landholdings are more vulnerable to climatic risk (drought, in our case), they are also more resilient than their counterparts. Results reveal that cropping intensity and crop risk increase the vulnerability of smallholders to climatic risk, but large farms are less vulnerable. Diversification in on-farm enterprises, like livestock units, and off-farm income sources, play significant roles in increasing smallholder households’ resilience to climatic risk. Other drivers of resiliency include the choice of cash and risky crops, borrowing capacity, liquid investments, and the ability to regain yields

Identifying Low Emissions Development Pathways – Synergies and Trade-offs: A Case Study of Mahbubnagar District, Telangana, India

This case study examines the opportunities for obtaining synergies between agricultural productivity, whole-farm profitability and greenhouse gas (GHG) mitigation and highlights where trade-offs exist. We explore how agricultural practices and systems can be designed and managed to balance the synergies and trade-offs for small-holder farmers in semi-arid India. We used data on farm-household characteristics and agricultural practices from 100 farm-households of Telangana state, India. Quantifying synergies and trade-offs between profitability, adaptation and mitigation we employed simulation modelling- crop, livestock and whole-farm simulation models, and Cool Farm Tool to estimate net GHG emissions. Our analysis reveals that specific plot-level crop management strategies and farm-level enterprise interventions can increase profitability as well as benefit climate change mitigation. It depict how farming systems can be managed to achieve synergies between profitability and mitigation outcomes and where, if any trade-offs exist. Combinations of reduced tillage, retaining crop-residue, improved nitrogen management, utilizing organic manure, improved livestock feeding practices, introducing agro-forestry could contribute to GHG abatement and improved profitability at our study site. Such multi-model systems analysis using participatory design and tools could help practitioners and policymakers to identify and promote use of management practices that can help achieve multiple objectives and guide investments towards synergistic climate smart agriculture strategies. Our study contributes empirical evidence to the debate surrounding integrated approaches to sustainable development goals and adaptation and mitigation objectives

Technology, infrastructure and enterprise trade-off: Strengthening smallholder farming systems in Tamil Nadu State of India for sustainable income and food security

The complexities of smallholder farming systems pose a challenge in demonstrating the potential benefits or risks of new technologies and policies. Using Integrated Analysis Tool, a rule-based dynamic simulation model, this study tried to improve the performance of major farming systems in the Tamil Nadu State of India. Amongst the four major farming systems viz. Black gram-based (BFS), Paddy-based (PFS), and Integrated Farming Systems (IFS) in Villupuram district and Dryland Farming System (DFS) in Virudhunagar district, IFS was found to be the most profitable and resilient based on their performance simulated for a 3-year rotation. Setting IFS as a benchmark, potential interventions were evaluated under other farming systems to improve their relative performance. The analysis allowed understanding the interactions in smallholder farming systems and the potential impact of interventions in a whole farm way considering the cash flows, cost intensity, and input-output trade-offs. While multi-bloom technology in black gram increased the net profit of BFS without much stress on input and labour, area expansion under rainfed groundnut incurred high expenditure. Trading-off paddy with maize and groundnut significantly increased the net profit of PFS but replacing sugarcane with tapioca and turmeric was not remunerative. Improved livestock management practices have substantially increased the net profit of DFS wherein crop yield could not be enhanced substantially without the prospects of good irrigation infrastructure. The irrigation endowed PFS has achieved 90% performance, whereas the water-starved BFS and DFS could achieve only 65% performance of IFS. We conclude that agricultural policy must not only focus on potential interventions that are profitable but also consider what is acceptable to the farmer, considering synergies and trade-offs between competing resources at the farm level

A Multi-Model Systems Approach for Identifying Low Emissions Development Pathways– Analyzing Synergies and Trade-offs in Semiarid Agriculture in India

Food security in the face of changing climate has pushed governments and development actors to focus efforts on improving adaptation, however, going forward besides adaptation, mitigation efforts to reduce GHG emissions are of global significance and calls for triple-win solutions with positive contributions to productivity, adaptation and mitigation. An emerging paradigm for promoting mitigation in agriculture is the Low-Emissions Development (LED) strategies. LED acknowledge broader sustainable development goals and identify mitigation practices compatible with these goals. This case study examines the opportunities for obtaining synergies between agricultural productivity, whole-farm profitability and GHG mitigation and highlights where trade-offs exist and explores how agricultural practices and systems can be designed and managed to balance the synergies and trade-offs for small-holder farmers in semi-arid India. We used data from 100 farm-households of Telangana state, India on farm-household characteristics and agricultural practices. Quantifying synergies and trade-offs between profitability, adaptation and mitigation we employed simulation modelling- crop, livestock and whole-farm simulation models, and Cool Farm Tool to estimate net GHG emissions. Our analysis reveals that specific plot-level crop management strategies and farm-level enterprise interventions can increase profitability as well as benefit climate change mitigation. It depict how farming systems can be managed to achieve synergies between profitability and mitigation outcomes and where, if any trade-offs exist. Combinations of reduced tillage, retaining crop-residue, improved nitrogen management, utilizing organic manure, improved livestock feeding practices, introducing agro-forestry could contribute to GHG abatement and improved profitability at our study site. Such multi-model systems analysis using participatory design and tools could help practitioners and policymakers to identify and promote use of management practices that can help achieve multiple objectives and guide investments towards synergistic climate smart agriculture strategies. Our study contributes empirical evidence to the debate surrounding integrated approaches to sustainable development goals and adaptation and mitigation objectives

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

Dichotomous outcomes and drivers of drought resilience mechanisms of smallholder farmers in semiarid India

Frequent droughts affect agriculture and livelihoods of millions of farm households in Semiarid India. Here we attempt to answer the question why some farm households are able to better cope with drought and bounce back quickly as compared to many others. The analysis considered 256 households-data from 2006 to 2014 from three semi-arid regions in India. Households were categorized using crop income and composite crop productivity index of pre-drought and post-drought years. The principal component analysis was applied to construct a composite vulnerability and resilience index. Study analyzes determinants of drought-impacts and risk choices through rigorous statistical process. It is revealed that cultivated area was more impacted then crop yields; adopting cash crops was an important driver of household’s resilience. Crop income drives not only high drought impacts but also the ability of households to bounce back. Higher operated-area, off-farm and livestock income in pre-drought years and cash crop area and cropping intensity post-drought enabled households to stay highly resilient. We conclude that drought impacts and resilience ability of different farm households in a region is not uniform. There is need to consider this heterogeneity to devise robust policy to derive effective resilience enhancing strategies targeting vulnerable households

Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome

Aim Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries. Method Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk-adjusted models for mortality, length of stay, readmissions and reoperations. Results In all, 52544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk-adjusted models, the 30-day mortality rate for colorectal surgery was 3.95% (95% CI 0.86-7.54), the 30-day readmission rate was 11.05% (5.67-17.61), the 28-day reoperation rate was 6.13% (3.68-9.66) and the mean length of stay was 14 (7.65-46.76) days. Conclusion The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarkin