Understanding the paradox of rising consumption of alternative medicine in Kenya

Kenya has been expanding provision of healthcare services, taking health facilities closer to the people. While this would be expected to reduce dependence on complementary/alternative medicine, the consumption has continued to rise. This raises the question of whether alternative medicine is replacing conventional medicine or the two are jointly used to deal with diseases. Thus, this study sought to establish the relationship of the two remedies in household choice of healthcare and explored the determinants of such choices. The study used bivariate probit analysis on cross-sectional data. The study found that consumption of conventional medicine and alternative medicine was indeed interdependent. The two were, on average, substitutes although some groups still consumed them jointly. Gender, education and age of the household head, price of conventional medicine, distance to conventional medicine facilities and social networks were found to influence the decisions. Male household heads, price of conventional medicine and distance to conventional medical facilities had a positive relationship with the probability of using alternative remedies. Education and age of household head, and social capital were associated with lower likelihood of choosing alternative remedies. The results of this study have important ramifications for medical researchers, health policy makers and health insurance providers. For medical researchers, joint use of alternative and conventional medicines makes it important to understand the interactions between the two so as to avoid adverse reactions that may endanger the lives of patients. For the health policy makers, because patients have different preferences for healthcare services, it is useful to provide alternative medicine and conventional medicine in a joint and integrated health system for patients’ freedom of choice, and for safety and efficacy of treatment. Health insurance providers, on their part, need to explore the possibilities and modalities for bringing users of alternative medicine, and joint users of alternative and conventional medicines under their cover.     

The impact of global change on economic values of water for Public Irrigation Schemes at the São Francisco River Basin in Brazil

Economic values of water for the main Public Irrigation Schemes in the sub-middle region of the São Francisco River Basin, in northeastern Brazil, are determined in this study using an integration of a global agro-economic land and water use (MAgPIE) with a local economic model (Positive Mathematical Programming). As in the latter, the water values depend on the crops grown, and as Brazilian agriculture is strongly influenced by the global market, we used a regionalized version of the global model adapted to the region in order to simulate the crop land use, which is in turn determined by changes in global demand, trade barriers, and climate. The allocation of sugarcane and fruit crops projected with climate change by the global model, showed an impact on the average yields and on the water costs in the main schemes resulting in changes in the water values locally. The economic values for all schemes in the baseline year were higher than the water prices established for agricultural use in the basin. In the future, these water values will be higher in all the schemes. The highest water values currently and in the future were identified in municipalities with a significant proportion of area growing irrigated sugarcane. Being aware of current water values of each user in a baseline year and in a projected future under global climate and socioeconomic changes, decision makers should improve water allocation policies at local scale, in order to avoid conflicts and unsustainable development in the future.     

Water management and aquatic ecosystem services of a tropical reservoir (Itaparica,São Francisco,Brazil)

Reservoirs have a wide variety of uses that have led to frequent conflicts over ecological conservation and contamination, especially as land management has intensified. Oligotrophication must be implemented in numerous tropical reservoirs that experience advanced eutrophication to maintain aquatic ecosystem functions. To quantify impacts on ecosystem functions and to develop an adaptive management policy, multiple studies have been conducted on the Itaparica Reservoir, São Francisco River, in the semi-arid north-eastern region of Brazil. Here, we add to that existing body of knowledge through investigating how nutrient accumulation is affected by water exchange between the main river flow and Icó-Mandantes Bay. Operational water-level fluctuations in the reservoir create large desiccated littoral areas that release high amounts of nutrients when they are rewetted. In particular, water-level variation promotes proliferation of Egeria densa, a noxious weed, thus elevating trophic levels of the Itaparica Reservoir and Icó-Mandantes Bay. Analysis with a P efficiency model determined 25 μg P L^?1 to be the critical concentration and further indicated that the critical load in both bodies of water have been exceeded. Moreover, intensive fish aquaculture using net cages has led to further overtaxing of the reservoir. We conclude that an effective ecological reservoir management policy must involve oligotrophication, harvesting of noxious water weeds for use as soil amendment in agriculture or biogas production, “blue” aquaculture, and limiting hydroelectric power production based on current water availability.     

Salinity evolution of the Tigris River

Major modifications regulating the Tigris River, originated in the 1940s and continuing to the present, have resulted in changes in salinity in the system over time and in different portions of the river course. The increase in salinity is due to decreases in stream discharge due to dams, water management structures such as the Lake Tharthar system, irrigation return flow, and soluble minerals in the basin. This research documents the increase and evaluates the causes of the salinity increase of the river from predevelopment to present using published and previously unavailable data. The predevelopment salinity was under 600 ppm, since 1984 has exceeded the 1000 ppm threshold recommended for drinking water downstream of Amara. A minimum instream flow for the river is calculated at Baghdad and Kut at 185 cubic meters per second (cms), approximately 15% of the mean historical flow of the river, but above the lowest minimum flow recorded at 140 cms. Recommended salinity management options discussed include (1) eliminating Lake Tharthar as a water storage facility, (2) managing saline inflows from tributaries, and (3) employing a minimum instream flow for the river.     

Freshwater stress on small island developing states: population projections and aridity changes at 1.5 and 2 °C

Small island developing states (SIDS) face multiple threats from anthropogenic climate change, including potential changes in freshwater resource availability. Due to a mismatch in spatial scale between SIDS landforms and the horizontal resolution of global climate models (GCMs), SIDS are mostly unaccounted for in GCMs that are used to make future projections of global climate change and its regional impacts. Specific approaches are required to address this gap between broad-scale model projections and regional, policy-relevant outcomes. Here, we apply a recently developed methodology that circumvents the GCM limitation of coarse resolution in order to project future changes in aridity on small islands. These climate projections are combined with independent population projections associated with shared socioeconomic pathways (SSPs) to evaluate overall changes in freshwater stress in SIDS at warming levels of 1.5 and 2 °C above pre-industrial levels. While we find that future population growth will dominate changes in projected freshwater stress especially toward the end of the century, projected changes in aridity are found to compound freshwater stress for the vast majority of SIDS. For several SIDS, particularly across the Caribbean region, a substantial fraction (~?25%) of the large overall freshwater stress projected under 2 °C at 2030 can be avoided by limiting global warming to 1.5 °C. Our findings add to a growing body of literature on the difference in climate impacts between 1.5 and 2 °C and underscore the need for regionally specific analysis.     

Reducing external costs of nitrogen pollution by relocation of pig production between regions in the European Union

This paper tests the hypothesis that relocation of pig production within the EU27 can reduce the external costs of nitrogen (N) pollution. The external cost of pollution by ammonia and nitrate from agriculture in the European Union (EU27) in 2008 was estimated at 61–215 billion € (0.5 to 1.8% of the GDP). Per capita it ranged from more than 1000 € in north-west EU27 to 50 € in Romania. The average contribution of pig production was 15%. Using provincial data (224 NUTS2 regions in EU27), the potential reduction of external N cost by relocation of pig production was estimated at 14 billion € (10% of the total). Regions most eligible for decreasing the pig stock were in western Germany, Flemish region, Denmark, the Netherlands and Bretagne, while Romania is most eligible for increasing pig production. Relocating 20 million pigs (13% of the total EU stock) decreased average external costs per capita from 900 to 785 € in the 13 NUTS2 regions where pigs were removed and increased from 69 to 107 € in 11 regions receiving pigs. A second alternative configuration of pig production was targeted at reducing exceedance of critical N deposition and closing regional nutrient cycles. This configuration relocates pigs within Germany and France, for example from Bretagne to Northern France and from Weser-Ems to Oberbayern. However, total external cost increases due to an increase of health impacts, unless when combined with implementation of best N management practices. Relocation of the pig industry in the EU27 will meet many socio-economic barriers and realisation requires new policy incentives.     

Assessing the implications of a 1.5 °C temperature limit for the Jamaican agriculture sector

Despite recent calls to limit future increases in the global average temperature to well below 2 °C, little is known about how different climatic thresholds will impact human society. Future warming trends have significant global food security implications, particularly for small island developing states (SIDS) that are recognized as being among the most vulnerable to global climate change. In the case of the Caribbean, any significant change in the region’s climate is likely to have significant adverse effects on the agriculture sector. This paper explores the potential biophysical impacts of a +?1.5 °C warming scenario on several economically important crops grown in the Caribbean island of Jamaica. Also, it explores differences to a >?2.0 °C warming scenario, which is more likely, if the current policy agreements cannot be complied with by the international community. We use the ECOCROP niche model to estimate how predicted changes in future climate could affect the growing conditions of several commonly cultivated crops from both future scenarios. We then discuss some key policy considerations for Jamaica’s agriculture sector, specifically related to the challenges posed to future adaptation pathways amidst growing climate uncertainty and complexity. Our model results show that even an increase less than +?1.5 °C is expected to have an overall negative impact on crop suitability and a general reduction in the range of crops available to Jamaican farmers. This observation is instructive as increases above the +?1.5 °C threshold would likely lead to even more irreversible and potentially catastrophic changes to the sustainability of Jamaica’s agriculture sector. The paper concludes by outlining some key considerations for future action, paying keen attention to the policy relevance of a +?1.5 °C temperature limit. Given little room for optimism with respect to the imminent changes that SIDS will need to confront in the near future, broad-based policy engagement by stakeholders in these geographies is paramount, irrespective of the climate warming scenario.     

Promoting e-mobility in India: challenges,framework, and future roadmap

The purpose of the research is to identify the critical challenges that are impeding the adoption of e-mobility in India. It also aims to give a roadmap how to address these challenges while taking into considerations concerns of all the relevant stakeholders. Based on an in-depth literature review, an exploratory research design is employed to delve deep into various aspects of e-mobility. This is followed by a three-phase Delphi technique to identify and rate the e-mobility challenges in the Indian context. The study successfully identifies four different categories of challenges and proposes integrative framework for e-mobility. Further, the research goes on to lay out the future roadmap for mass adoption of electric vehicles (EVs) in India. The research is novel in terms of presenting a holistic viewpoint on e-mobility in India. Its originality lies in identifying the major inhibitors obstructing EVs adoption in India and then suggesting the roadmap how to overcome these impediments for mass adoption of e-mobility.