Knowledge Priorities on Climate Change and Water in the Upper Indus Basin: A Horizon Scanning Exercise to Identify the Top 100 Research Questions in Social and Natural Sciences

River systems originating from the Upper Indus Basin (UIB) are dominated by runoff from snow and glacier melt and summer monsoonal rainfall. These water resources are highly stressed as huge populations of people living in this region depend on them, including for agriculture, domestic use, and energy production. Projections suggest that the UIB region will be affected by considerable (yet poorly quantified) changes to the seasonality and composition of runoff in the future, which are likely to have considerable impacts on these supplies. Given how directly and indirectly communities and ecosystems are dependent on these resources and the growing pressure on them due to ever-increasing demands, the impacts of climate change pose considerable adaptation challenges. The strong linkages between hydroclimate, cryosphere, water resources, and human activities within the UIB suggest that a multi- and inter-disciplinary research approach integrating the social and natural/environmental sciences is critical for successful adaptation to ongoing and future hydrological and climate change. Here we use a horizon scanning technique to identify the Top 100 questions related to the most pressing knowledge gaps and research priorities in social and natural sciences on climate change and water in the UIB. These questions are on the margins of current thinking and investigation and are clustered into 14 themes, covering three overarching topics of ‘governance, policy, and sustainable solutions’, ‘socioeconomic processes and livelihoods’, and ‘integrated Earth System processes’. Raising awareness of these cutting-edge knowledge gaps and opportunities will hopefully encourage researchers, funding bodies, practitioners, and policy makers to address them

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Climate change impact on groundwater-based livelihood in Soan River Basin of Pakistan (South Asia) based on the perception of local farmers

Abstract Based on the perceptions of the local farmers, this study aims to assess the effects of socioeconomic factors and climatic change on the groundwater livelihood system, with a particular focus on in situ Persian wheels/dug wells. Farmers’ perceptions of climate change and how it is affecting their way of life in the Soan River Basin have also been evaluated to determine the most appropriate adaptive interventions. Information and literature about dug wells was unavailable, which stressed the need to carry out this survey. A structured close-ended questionnaire was designed and administered with as much quantitative data as possible. Random sampling opted for a 5 km buffer zone across the Soan River and its tributaries. Union councils having more than 50% of their area lying in the buffer zone were surveyed, and data was collected. Fifty UCs fell within this criterion, and six dug wells from each Union Council were surveyed. The results of our survey collecting local farmer’s perceptions determined that about 70% of respondents agreed about climate change in the Soan Basin of Pakistan, and 62% of farmers reported that climate change severely impacted their livelihood by affecting agricultural productivity and water availability. Ninety-two percent reported summer becoming hot, 72% highlighted that winters are becoming less cold, and 96% reported that average annual rainfall has decreased compared to 10 years before. About 72% of respondents indicated that available water in their dug wells had decreased, and 80% of respondents explained that their crop yield had decreased compared to 10 years before. Sixty percent preferred drip and 35% sprinkler irrigation as efficient water management practices to cope with water shortages. Ninety-five percent of farmers were ready to use solar pumps for irrigation to tame high pumping costs. The study recommends integrating solar pumping with drip and sprinkler irrigation systems to enhance farmers’ cropped area and productivity. These vulnerable farmers can enhance their resilience and profitability by adopting high-value agriculture (tunnel farming, off-season vegetables, etc.) instead of conventional crops