The CLIMPACTS synthesis report: An assessment of the effects of climate change and variation in New Zealand using the CLIMPACTS system

In the late 1980s, New Zealand undertook the first national assessment of climate change and its possible impacts on the country.The landmark report, reflecting the judgement of scores of national experts, called for greater efforts in building the national research capacity in order to better quantify the range of impacts that could occur in New Zealand from climate change and variability. In response, the collaborative CLIMPACTS Programme was established to provide this capacity. Ten years on from the first national assessment, the present synthesis offers some results from, as well as a demonstration of, the capacity developed by the CLIMPACTS Programme. The purpose of the present document is to provide a summary report from the CLIMPACTS Programme on climate change and its effects on New Zealand.The chapters and their contents are not comprehensive. Rather, they are focused on a specific set of questions, which conform to the particular expertise of the CLIMPACTS Programme members and which employ a limited set of the wide range of tools available within the CLIMPACTS Model. Other important areas such as forests, indigenous ecosystems and pests and diseases are not yet covered

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

New Zealand climate. I. Precipitation patterns

Temperature patterns are identified by similar methods to those used in Part I of this study. Correlation of station temperature anomalies with time series of circulation indices revealed that warm anomalies of temperature occur when airflow is northerly and cold anomalies occur when it is from the south. This method also shows that in zonal flow the windward side of the country is cooler than the leeward. Principal component analysis revealed three distinct patterns. The first occurs over the northern half of the North Island, the second over the southern half of the South Island and the third over the west of the South Island. All temperature patterns have warm anomalies when higher than normal pressure occurs to the southeast and cast of New Zealand. The warm synoptic anomaly is the more important mechanism. The results show that complex patterns of warming and cooling occur which show great detail in such a small spatial scale. Like precipitation, the spatial expression of temperature is much enhanced by the country's rugged topography. The results may present a unique opportunity for reconstructing pást climates because of New Zealand's sensitivity to small circulation changes