Climate Change Projections for Walvis Bay: Adding value through downscaling [Annex 30]

Annex 30 from "Adaptation to Climate Change: Stakeholder engagement and understanding impacts - International Council for Local Environment Initiatives (ICLEI) (Section 21)" list of annexureThis project addresses knowledge, resource, capacity and networking gaps on the theme: 'Strengthening urban governments in planning adaptation.' The main objective of this project is to develop an adaptation framework for managing the increased risk to African local government and their communities due to climate change impact. The ultimate beneficiaries of this project will be African local governments and their communities. The guiding and well-tested ICLEI principle of locally designed and owned projects for the global common good, specifically in a developing world context, will be applied throughout project design, inception and delivery. Additionally, the research will test the theory that the most vulnerable living and working in different geographical, climatic and ecosystem zones will be impacted differently and as such, will require a different set of actions to be taken. Potential commonalities will be sought towards regional participatory learning and wider applicability. The five urban centres chosen for this study, based on selection criteria, include: Cape Town, South Africa, Dar es Salaam, Tanzania; Maputo, Mozambique; Windhoek, Namibia; and Port St. Louis, Mauritius. Through a participatory process, this project will carry out a desk-top study, long-term, multi-discipline, multi-sectoral stakeholder platforms in five Southern African cities comprising of academics, communities and the local government in order to facilitate knowledge-sharing, promote proactive climate adaptation and resource opportunities available for African cities, develop five tailor-made Adaptation Frameworks and explore regional applicability. A network of stakeholders within each urban centre will be established, feeding into a larger regional network of local authorities and partners in Sub-Saharan Africa, and globally through existing ICLEI global (e.g. the ICLEI Cities for Climate Protection programme), ICLEI Africa and UCLG-A members and networks, ensuring global best practice, roll-out, and long-term sustainability

Climate Change Projections for Port Louis: Adding value through downscaling [Annex 34]

Annex 34 from "Adaptation to Climate Change: Stakeholder engagement and understanding impacts - International Council for Local Environment Initiatives (ICLEI) (Section 21)" list of annexureThis project addresses knowledge, resource, capacity and networking gaps on the theme: 'Strengthening urban governments in planning adaptation.' The main objective of this project is to develop an adaptation framework for managing the increased risk to African local government and their communities due to climate change impact. The ultimate beneficiaries of this project will be African local governments and their communities. The guiding and well-tested ICLEI principle of locally designed and owned projects for the global common good, specifically in a developing world context, will be applied throughout project design, inception and delivery. Additionally, the research will test the theory that the most vulnerable living and working in different geographical, climatic and ecosystem zones will be impacted differently and as such, will require a different set of actions to be taken. Potential commonalities will be sought towards regional participatory learning and wider applicability. The five urban centres chosen for this study, based on selection criteria, include: Cape Town, South Africa, Dar es Salaam, Tanzania; Maputo, Mozambique; Windhoek, Namibia; and Port St. Louis, Mauritius. Through a participatory process, this project will carry out a desk-top study, long-term, multi-discipline, multi-sectoral stakeholder platforms in five Southern African cities comprising of academics, communities and the local government in order to facilitate knowledge-sharing, promote proactive climate adaptation and resource opportunities available for African cities, develop five tailor-made Adaptation Frameworks and explore regional applicability. A network of stakeholders within each urban centre will be established, feeding into a larger regional network of local authorities and partners in Sub-Saharan Africa, and globally through existing ICLEI global (e.g. the ICLEI Cities for Climate Protection programme), ICLEI Africa and UCLG-A members and networks, ensuring global best practice, roll-out, and long-term sustainability

Climate Change Projections for Dar es Salaam: Adding value through downscaling [Annex 32]

Annex 32 from "Adaptation to Climate Change: Stakeholder engagement and understanding impacts - International Council for Local Environment Initiatives (ICLEI) (Section 21)" list of annexureThis project addresses knowledge, resource, capacity and networking gaps on the theme: 'Strengthening urban governments in planning adaptation.' The main objective of this project is to develop an adaptation framework for managing the increased risk to African local government and their communities due to climate change impact. The ultimate beneficiaries of this project will be African local governments and their communities. The guiding and well-tested ICLEI principle of locally designed and owned projects for the global common good, specifically in a developing world context, will be applied throughout project design, inception and delivery. Additionally, the research will test the theory that the most vulnerable living and working in different geographical, climatic and ecosystem zones will be impacted differently and as such, will require a different set of actions to be taken. Potential commonalities will be sought towards regional participatory learning and wider applicability. The five urban centres chosen for this study, based on selection criteria, include: Cape Town, South Africa, Dar es Salaam, Tanzania; Maputo, Mozambique; Windhoek, Namibia; and Port St. Louis, Mauritius. Through a participatory process, this project will carry out a desk-top study, long-term, multi-discipline, multi-sectoral stakeholder platforms in five Southern African cities comprising of academics, communities and the local government in order to facilitate knowledge-sharing, promote proactive climate adaptation and resource opportunities available for African cities, develop five tailor-made Adaptation Frameworks and explore regional applicability. A network of stakeholders within each urban centre will be established, feeding into a larger regional network of local authorities and partners in Sub-Saharan Africa, and globally through existing ICLEI global (e.g. the ICLEI Cities for Climate Protection programme), ICLEI Africa and UCLG-A members and networks, ensuring global best practice, roll-out, and long-term sustainability

Climate Change Projections for Cape Town: Adding Value through Downscaling [Annex 31]

Annex 31 from "Adaptation to Climate Change: Stakeholder engagement and understanding impacts - International Council for Local Environment Initiatives (ICLEI) (Section 21)" list of annexureThis project addresses knowledge, resource, capacity and networking gaps on the theme: 'Strengthening urban governments in planning adaptation.' The main objective of this project is to develop an adaptation framework for managing the increased risk to African local government and their communities due to climate change impact. The ultimate beneficiaries of this project will be African local governments and their communities. The guiding and well-tested ICLEI principle of locally designed and owned projects for the global common good, specifically in a developing world context, will be applied throughout project design, inception and delivery. Additionally, the research will test the theory that the most vulnerable living and working in different geographical, climatic and ecosystem zones will be impacted differently and as such, will require a different set of actions to be taken. Potential commonalities will be sought towards regional participatory learning and wider applicability. The five urban centres chosen for this study, based on selection criteria, include: Cape Town, South Africa, Dar es Salaam, Tanzania; Maputo, Mozambique; Windhoek, Namibia; and Port St. Louis, Mauritius. Through a participatory process, this project will carry out a desk-top study, long-term, multi-discipline, multi-sectoral stakeholder platforms in five Southern African cities comprising of academics, communities and the local government in order to facilitate knowledge-sharing, promote proactive climate adaptation and resource opportunities available for African cities, develop five tailor-made Adaptation Frameworks and explore regional applicability. A network of stakeholders within each urban centre will be established, feeding into a larger regional network of local authorities and partners in Sub-Saharan Africa, and globally through existing ICLEI global (e.g. the ICLEI Cities for Climate Protection programme), ICLEI Africa and UCLG-A members and networks, ensuring global best practice, roll-out, and long-term sustainability

Local climate forcing and eco-climatic complexes in the wooded savannah of Western Nigeria

Local perturbations such as terrain, land cover, and land-water boundary often exert a strong influence on the local climate and create eco-climatic structures or complexes that can support the natural resource capita on which livelihoods depend. This research focuses on the eco-climatic complexes that produce the natural resource capita which supports livelihood systems across the wooded savannah of western Nigeria. Downscaled climate data can be integrated and analyzed with the drivers of the local climate system, enabling their spatial pattern of influence and impact on the local climate system to be deciphered and quantified so that it becomes useful

Evaluation and projections of extreme precipitation over southern Africa from two CORDEX models

The study focus on the analysis of extreme precipitation events of the present and future climate over southern Africa. Parametric and non-parametric approaches are used to identify and analyse these extreme events in data from the Coordinated Regional Climate Downscaling Experiment (CORDEX) models. The performance of the global climate model (GCM) forced regional climate model (RCM) simulations shows that the models are able to capture the observed climatological spatial patterns of the extreme precipitation. It is also shown that the downscaling of the present climate are able to add value to the performance of GCMs over some areas and depending on the metric used. The added value over GCMs justify the additional computational effort of RCM simulation for the generation relevant climate information for regional application. In the climate projections for the end of twenty-first Century (2069-2098) relative to the reference period (1976-2005), annual total precipitation is projected to decrease while the maximum number of consecutive dry days increases. Maximum 5-day precipitation amounts and 95th percentile of precipitation are also projected to increase significantly in the tropical and sub-tropical regions of southern Africa and decrease in the extra-tropical region. There are indications that rainfall intensity is likely to increase. This does not equate to an increase in total rainfall, but suggests that when it does rain, the intensity is likely to be greater. These changes are magnified under the RCP8.5 when compared with the RCP4.5 and are consistent with previous studies based on GCMs over the region.Water Research Commission-Project K5-2240.http://link.springer.com/journal/105842017-04-30hb2016Geography, Geoinformatics and Meteorolog

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Predicting plant diversity patterns in Madagascar : understanding the effects of climate and land cover change in a biodiversity hotspot

Climate and land cover change are driving a major reorganization of terrestrial biotic communities in tropical ecosystems. In an effort to understand how biodiversity patterns in the tropics will respond to individual and combined effects of these two drivers of environmental change, we use species distribution models (SDMs) calibrated for recent climate and land cover variables and projected to future scenarios to predict changes in diversity patterns in Madagascar. We collected occurrence records for 828 plant genera and 2186 plant species. We developed three scenarios, (i.e., climate only, land cover only and combined climate-land cover) based on recent and future climate and land cover variables. We used this modelling framework to investigate how the impacts of changes to climate and land cover influenced biodiversity across ecoregions and elevation bands. There were large-scale climate- and land cover-driven changes in plant biodiversity across Madagascar, including both losses and gains in diversity. The sharpest declines in biodiversity were projected for the eastern escarpment and high elevation ecosystems. Sharp declines in diversity were driven by the combined climate-land cover scenarios; however, there were subtle, region-specific differences in model outputs for each scenario, where certain regions experienced relatively higher species loss under climate or land cover only models. We strongly caution that predicted future gains in plant diversity will depend on the development and maintenance of dispersal pathways that connect current and future suitable habitats. The forecast for Madagascar's plant diversity in the face of future environmental change is worrying: regional diversity will continue to decrease in response to the combined effects of climate and land cover change, with habitats such as ericoid thickets and eastern lowland and sub-humid forests particularly vulnerable into the future

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

BACKGROUND: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors. METHOD: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. RESULTS: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs. CONCLUSIONS: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety

The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning.

BACKGROUND: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). METHOD: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. RESULTS: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. DISCUSSION: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training