Spatio-temporal characterization of drought variability in data-scarce regions using global precipitation data: a case study in Cauto river basin, Cuba.

Drought is considered the most severe water-related disaster in the Cauto river basin, which is the longest river and the main agricultural producer in Cuba. Better understanding of drought characteristics is crucial to drought management. Given the sparsity of ground-based precipitation observations in the Cauto, this study aims at using gridded global precipitation to analyze the spatio-temporal variations of drought in this river basin. Firstly, the monthly Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS) was calibrated with the gauged precipitation using the Thiessen polygon-based method and linear least squares regression equations. Then, the gridded standardized precipitation index (SPI) with time scales of 3, 6, 9 months and drought characteristics, namely, drought frequency, duration and intensity were calculated using the calibrated CHIRPS. Finally, the spatio-temporal analysis was performed to investigate the variations of drought in the Cauto river basin in time and space. The obtained results show that the calibrated CHIRPS is highly consistent with the gauged observations and is capable of determining the magnitude, time, and spatial extent of drought events in the Cauto river basin. The trend analysis by the Mann-Kendall test reveals that although the trend is not statistically significant, the SPI tends to decrease with time in the dry season, which indicates the more severe drought. The spatial analysis indicates that the lower altitude area of the Cauto river basin is suffered from longer drought duration and higher drought intensity than the upper one. This study expresses the importance of open global precipitation data sources in monitoring and quantifying drought characteristics in data-scarce regions.

Dual Sensory Impairment: Impact of Central Vision Loss and Hearing Loss on Visual and Auditory Localization.

Purpose: In the United States, AMD is a leading cause of low vision that leads to central vision loss and has a high co-occurrence with hearing loss. The impact of central vision loss on the daily functioning of older individuals cannot be fully addressed without considering their hearing status. We investigated the impact of combined central vision loss and hearing loss on spatial localization, an ability critical for social interactions and navigation. Methods: Sixteen older adults with central vision loss primarily due to AMD, with or without co-occurring hearing loss, completed a spatial perimetry task in which they verbally reported the directions of visual or auditory targets. Auditory testing was done with eyes open in a dimly lit room or with a blindfold. Twenty-three normally sighted, age-matched, and hearing-matched control subjects also completed the task. Results: Subjects with central vision loss missed visual targets more often. They showed increased deviations in visual biases from control subjects as the scotoma size increased. However, these deficits did not generalize to sound localization. As hearing loss became more severe, the sound localization variability increased, and this relationship was not altered by coexisting central vision loss. For both control and central vision loss subjects, sound localization was less reliable when subjects wore blindfolds, possibly due to the absence of visual contextual cues. Conclusions: Although central vision loss impairs visual localization, it does not impair sound localization and does not prevent vision from providing useful contextual cues for sound localization.

Visual and Auditory Spatial Localization in Younger and Older Adults.

Visual and auditory localization abilities are crucial in real-life tasks such as navigation and social interaction. Aging is frequently accompanied by vision and hearing loss, affecting spatial localization. The purpose of the current study is to elucidate the effect of typical aging on spatial localization and to establish a baseline for older individuals with pathological sensory impairment. Using a verbal report paradigm, we investigated how typical aging affects visual and auditory localization performance, the reliance on vision during sound localization, and sensory integration strategies when localizing audiovisual targets. Fifteen younger adults (N = 15, mean age = 26 years) and thirteen older adults (N = 13, mean age = 68 years) participated in this study, all with age-adjusted normal vision and hearing based on clinical standards. There were significant localization differences between younger and older adults, with the older group missing peripheral visual stimuli at significantly higher rates, localizing central stimuli as more peripheral, and being less precise in localizing sounds from central locations when compared to younger subjects. Both groups localized auditory targets better when the test space was visible compared to auditory localization when blindfolded. The two groups also exhibited similar patterns of audiovisual integration, showing optimal integration in central locations that was consistent with a Maximum-Likelihood Estimation model, but non-optimal integration in peripheral locations. These findings suggest that, despite the age-related changes in auditory and visual localization, the interactions between vision and hearing are largely preserved in older individuals without pathological sensory impairments.

Retrospective analysis of patterns of opioid overdose and interventions delivered at a tertiary hospital emergency department: impact of COVID-19.

BACKGROUND: Opioid-related overdoses cause substantial numbers of preventable deaths. Naloxone is an opioid antagonist available in take-home naloxone (THN) kits as a lifesaving measure for opioid overdose. As the emergency department (ED) is a primary point of contact for patients with high-risk opioid use, evidence-based recommendations from the Society of Hospital Pharmacists of Australia THN practice guidelines include the provision of THN, accompanied by psychosocial interventions. However, implementation of these guidelines in practice is unknown. This study investigated ED opioid-related overdose presentations, concordance of post-overdose interventions with the THN practice guidelines, and the impact, if any, of the SARS-CoV-2 (COVID-19) pandemic on case presentations. METHODS: A single-centre retrospective audit was conducted at a major tertiary hospital of patients presenting with overdoses involving opioids and non-opioids between March to August 2019 and March to August 2020. Patient presentations and interventions delivered by the paramedics, ED and upon discharge from the ED were collated from medical records and analysed using descriptive statistics, chi square and independent T-tests. RESULTS: The majority (66.2%) of patients presented to hospital with mixed drug overdoses involving opioids and non-opioids. Pharmaceutical opioids were implicated in a greater proportion (72.1%) of overdoses than illicit opioids. Fewer patients presented in March to August 2020 as compared with 2019 (26 vs. 42), and mixed drug overdoses were more frequent in 2020 than 2019 (80.8% vs. 57.1%). Referral to outpatient psychology (22.0%) and drug and alcohol services (20.3%) were amongst the most common post-discharge interventions. Naloxone was provided to 28 patients (41.2%) by the paramedics and/or ED. No patients received THN upon discharge. CONCLUSIONS: This study highlights opportunities to improve ED provision of THN and other interventions post-opioid overdose. Large-scale multi-centre studies are required to ascertain the capacity of EDs to provide THN and the impact of COVID-19 on opioid overdose presentations.