From Absences to Emergences::Foregrounding traditional and Indigenous climate change adaptation knowledges and practices from Fiji, Vietnam and the Philippines

The differential impacts of climate change have highlighted the need to implement fit-for-purpose interventions that are reflective of the needs of vulnerable communities. However, adaptation projects tend to favour technocratic, market-driven, and Eurocentric approaches that inadvertently disregard the place-based and contextual adaptation strategies of many communities in the Global South. The paper aims to decolonise climate change adaptation guided by the critical tenets of ‘Decolonising Climate Adaptation Scholarship’ (DCAS). It presents empirical case studies from Fiji, Vietnam, and the Philippines and reveals the different ways that Indigenous and local knowledge (ILK) and strategies are devalued and suppressed by modernist and developmentalist approaches to climate adaptation. The paper then foregrounds some of the adaptive techniques that resist and remain, or have been re-worked in hybrid ways with ILK. Ultimately, this paper combats the delegitimisation of ILK by mainstream climate change adaptation scholarship and highlights the need for awareness and openness to other forms of knowing and being

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection