Good participatory practice for coronavirus disease 2019 (COVID-19) research: the case of a COVID-19 prevention study.

Background: The COPCOV study (chloroquine/ hydroxychloroquine prevention of coronavirus disease), which started recruitment in April 2020, is a multi-country double-blind, randomised, placebo-controlled trial which is being conducted in healthcare facilities involved in coronavirus disease 2019 (COVID-19) case management. COPCOV aims to recruit healthcare workers and other staff employed in facilities managing people with proven or suspected COVID-19. Methods: We conducted a series of engagement sessions, each involving a short presentation of the study, a section where attendees were asked to express if they would be interested in participating in such a study and which information they would need to change their view and an open Q&A section. Answers were transcribed and coded into themes by two independent investigators. Themes were derived from the data. The aims were to assess the feasibility of the study at the respective sites, to identify context-specific ethical issues, to understand concerns potential participants might have, to fine tune research procedures and to refine COPCOV information materials. They complemented other site-specific engagement, communication and public relation activities such as press releases and websites. Results: From 16 th March 2020 to 20 th January 2021, 12 engagement sessions were conducted in Thailand, Laos, Vietnam, Nepal and the UK involving 213 attendees in total. The sessions were designed to encourage potential participants and research professionals not directly involved in the project to interact with those who planned the study and those conducting it. Many attendees were keen to join the study while others had concerns. Questions raised revolved around the social value and study rationale; safety of trial medications and risk-benefit balance; study design and commitments. Conclusions: These sessions helped us refine information materials, identify misunderstandings about the study as well as complement site feasibility assessments. Our experience strongly supports the use of participatory practices prior to conducting clinical trials.

Modeling the future impacts of climate change on water availability in the Karnali River Basin of Nepal Himalaya.

It's unequivocal that the global climate is changing, including the rise in atmospheric temperature and variability in amount and pattern of precipitation, and the rate of temperature change in the Himalayan region is higher than the global average. Since precipitation and temperature are the major driving factors of water resources in the Himalayas both upstream and downstream regions, it is important to understand theimpacts of climate change in water resource availability in the future. In this study, we analyzed the historical hydro-climate data and developed a suitable ensemble of the Coordinated Regional Downscaling Experiment (CORDEX) climate models for the Karnali River Basin (KRB) in western Nepal and assessed the future water availability in different climate scenarios using a semi-distributed catchment scale hydrological model the Soil and Water Assessment Tool (SWAT). The climate data analysis shows that the atmospheric temperature is rising throughout the basin but there is high spatial variability in precipitation trend. The historical river discharge data analysis do not show any significant trend, however, there is some inter-annual variability. Future projection shows that the annual precipitation amount will increase compared to the baseline so does the river discharge. However, this increase is not uniform for all seasons. The post-monsoon season having the lowest observed precipitation will get lesser amount of precipitation in the future and the river discharge also follows the same trend. These anomalies play a crucial role in determining the future water availability for agriculture, hydropower, ecosystem functioning and its services availability to the people living in the KRB as well as in the downstream region.

Evaluating climatic and non-climatic stresses for declining surface water quality in Bagmati River of Nepal.

Both climatic and non-climatic factors affect surface water quality. Similar to its effect across various sectors and areas, climate change has potential to affect surface water quality directly and indirectly. On the one hand, the rise in temperature enhances the microbial activity and decomposition of organic matter in the river system and changes in rainfall alter discharge and water flow in the river ultimately affecting pollution dilution level. On the other hand, the disposal of organic waste and channelizing municipal sewage into the rivers seriously worsen water quality. This study attempts to relate hydro-climatology, water quality, and impact of climatic and non-climatic stresses in affecting river water quality in the upper Bagmati basin in Central Nepal. The results showed that the key water quality indicators such as dissolved oxygen and chemical oxygen demand are getting worse in recent years. No significant relationships were found between the key water quality indicators and changes in key climatic variables. However, the water quality indicators correlated with the increase in urban population and per capita waste production in the city. The findings of this study indicate that dealing with non-climatic stressors such as reducing direct disposal of sewerage and other wastes in the river rather than emphasizing on working with the effects from climate change would largely help to improve water quality in the river flowing from highly populated urban areas.