Demystifying agritourism development in Fiji: inclusive growth for smallholders

Agritourism has gained traction with a variety of stakeholders within the Pacific to supplement farm revenue, create linkages to tourism and ultimately contribute to sustainable economic development. This paper, with a focus on smallholders, examines the key constraints of agriculture, current agritourism products, policy development initiatives, and proposes an open framework for agritourism in Fiji. Among the key considerations are a careful examination of tourist preferences, the promotion of agritourism on working farms without displacing the key activity of food production, and redefining agritourism as a value for money experience rather than a niche market in the Pacific region

Induction of labour in pregnancies with fetal demise: a randomised control trial

Background: The present study aims at comparing efficacy and safety of two different regimens of induction of labour (IOL) in pregnancies with fetal demise. Settings and Design: A randomised controlled trial was conducted on 100 eligible pregnant women diagnosed with intrauterine fetal demise who were admitted in the labour ward of a tertiary care hospital. Methods: All participants were randomly divided into two groups in group A and group B. In Group A, IOL was done with transcervical foley’s catheter and vaginal misoprostol while in group B, mifepristone with vaginal misoprostol were used for IOL. During intrapartum period the mode of delivery, induction-delivery interval, total dose of induction agent used and amount of total blood loss were noted. Any side effect if present was also noted. Results: Comparing both the groups, Induction delivery interval was less in group A as compared to group B. Conclusions: Use of mifepristone with misoprostol as well as Foley’s with misoprostol were found to be equally safe and effective methods

Coinfections in Patients With Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Study

Background: The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection. Methods: We included adult (≥18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within ±2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality. Results: Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections: 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age \u3e50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections. Conclusions: Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Land use change detection in Solan Forest Division, Himachal Pradesh, India

Background Monitoring the changing pattern of vegetation across diverse landscapes through remote sensing is instrumental in understanding the interactions of human activities and the ecological environment. Land use pattern in the state of Himachal Pradesh in the Indian Western Himalayas has been undergoing rapid modifications due to changing cropping patterns, rising anthropogenic pressure on forests and government policies. We studied land use change in Solan Forest Division of Himachal Pradesh to assess species wise area changes in the forests of the region. Methods The supervised classification (Maximum likelihood) on two dates of IRS (LISS III) satellite data was performed to assess land use change over the period 1998–2010. Results Seven land use categories were identified namely, chir pine (Pinus roxburghii) forest, broadleaved forest, bamboo (Dendrocalamus strictus) forest, ban oak (Quercus leucotrichophora) forest, khair (Acacia catechu) forest, culturable blank and cultivation. The area under chir pine, cultivation and khair forests increased by 191 ha (4.55 %), 129 ha (13.81 %) and 77 ha (23.40 %), whereas the area under ban oak, broadleaved, culturable blank and bamboo decreased by 181 ha (16.58 %), 152 ha (6.30 %), 71 ha (2.72 %) and 7 ha (0.47 %), respectively. Conclusions The study revealed a decrease in the area under forest and culturable blank categories and a simultaneous increase in the area under cultivation primarily due to the large scale introduction of horticultural cash crops in the state. The composition of forests also exhibited some major changes, with an increase in the area of commercially important monoculture plantation species such as pine and khair, and a decline in the area of oak, broadleaved and bamboo which are facing a high anthropogenic pressure in meeting the livelihood demands of forest dependent communities. In time deforestation, forest degradation and ecological imbalances due to the changing forest species composition may inflict irreversible damages upon unstable and fragile mountain zones such as the Indian Himalayas. The associated common property externalities involved at local, regional and global scales, necessitate the monitoring of land use dynamics across forested landscapes in developing future strategies and policies concerning agricultural diversification, natural forest conservation and monoculture tree plantations

Exploring a market for agritourism in Fiji: tourists’ perspective

This research aimed to interpret motivations of tourists for agritourism in Fiji. Data was collected through a paper-based face to face survey. Structured questionnaires were administered to a convenience sample of tourists at the two international airports. Descriptive and factorial statistics reveal seven principal factors that motivate and influence visitor preferences for agritourism venues. Most tourists seemed interested in agritourism but presently were unaware of the existence of such venues in Fiji. Findings also suggest that tourists preferred a short stay at working farms offering value for money experience. In terms of importance, hospitality followed by entertainment, were the two main desired services for an agritourism venue. This research offers insights for dynamic product development for the Fijian and Pan-Pacific agritourism industry

Coastal resource management and tourism development in Fiji Islands: a conservation challenge

The tourism sector has been a key driver of socioeconomic progress in Fiji Islands since the 1980s, in comparison with other industries such as agriculture, fisheries, and forestry. Fiji currently plans to further expand its tourism industry into a 2 billion FJD sector, which places great pressure on the coastal environment and resources that attract more than 500,000 tourists per year. Unplanned tourism development has adverse impacts on the environment and dependent communities, which is often attributed to weak governance and poorly enforced regulations. In Fiji, the industry has been recognized as responsible for mangrove clearance and coastal degradation, both of which aggravate problems such as coastline erosion, vulnerability to natural disasters, fish stock declines, poor water quality, pollution, and biodiversity loss. Though the country has national legislations in place, as well as regional and international collaborations to manage its ocean resources, it lacks the capacity and resources to implement environment policy, planning, and regulation. There is a need to strengthen governance and community capacity to address problems of effective enforcement of legislation and ensure the conservation, management, and sustainable utilization of marine and coastal resources

A facile non-photocatalytic technique for hydrogen gas production by hydroelectric cell

Hydrogen gas is a zero-emission fuel for clean environment. In present work a novel environment friendly hydrogen producing technique based on nascently invented Hydroelectric cell has been reported. Hydroelectric cell is one of the unique non-polluting H-2 gas generation methods compared to photo-biosynthesis, photo-electro-catalysis and thermo-chemical etc. Spontaneous dissociation of water molecule by Hydroelectric cell (HEC) has led this study for effective production of hydrogen gas. Moreover, a nanoporous lithium substituted magnesium ferrite used in HEC dissociates water molecule to produce hydrogen without using any electrolyte and light. Ferrite pellet combined with zinc and silver electrodes known as hydroelectric cell produces zinc hydroxide and hydrogen gas as a result of redox reaction. Nanoporous and oxygen deficient ferrite pellet has been synthesised with optimized processing conditions. Maximum average nanopore size distribution has been obtained 3.8 nm by N-2 adsorption-desorption isotherm. Surface dangling bonds of unsaturated cations and oxygen vacancies in ferrite chemidissociate water molecule into hydroxide and hydronium ion. High purity hydrogen gas is produced continuously by applying different external voltage only on hydroelectric cell. Collected gas has been analysed by gas chromatography in comparison to pure reference hydrogen gas. This technique has produced hydrogen in large quantity 1.856 mmol/h compared to existing photocatalytic active ferrite methods. Hydrogen gas generation by HEC is an exclusively facile, low cost and novel technique