Water sourced from Asian mountains is vital to the survival of an estimated 1.4 billion people, but current and anticipated changes in snow, ice cover, and precipitation patterns may threaten these supplies and, in turn, the food security of tens of millions of people. Despite the severity of this developing environmental hazard, the relative importance of each component of the water cycle still needs more detailed study so that those communities who will experience the greatest extremes in supply can be identified. Specifically, data showing how the contribution of meltwater varies with increasing distance downstream are lacking for many mountain catchments, although the use of stable isotope tracers provides some hope in this regard. Imprinted on regional-scale hydroclimatological controls of water availability are local-scale cultural beliefs and practices that have evolved over centuries, which determine who is able to access water supplies, for how long, and for what purpose. Building the resilience of human populations and the environment to future changes in water supply therefore depends on effective interdisciplinary team working to develop an understanding of the complex interactions between physical, socioeconomic, cultural, and historical factors, and that can only be properly realized if local communities are considered as an integral part of the research team. Developing simple and practical methods for water management, storage, and societal adaptation that are appropriate to the socioeconomic and political conditions of mountain-dwelling communities will only be sustainable if they are built on this integrated knowledge base.

Sharing water resources in the Indus Basin, split between India and Pakistan and 1947, helped sour relations between these hostile neighbours until the signing of the Indus Waters Treaty in 1960. This article explores a radical early intervention into the dispute. David E Lilienthal, an American development expert, published a plan for trans-border cooperative development in 1951. He used a discourse of technocratic internationalism to privilege shared expertise over political difference. His proposal, I argue, tried to align politics in the Indus Basin with a constructed notion of the basin itself as a "natural" entity, contrasted with the political boundaries that divided India from Pakistan. I show how Lilienthal's appeal to engineers to effect a "scale jump", shifting the waters dispute from a nationalist to an internationalist plane, reinforced an existing reliance in South Asia on technocratic water management. While subsequent negotiations dropped his proposal for cooperative development, his novel use of the idea of engineering to produce the basin as a depoliticised space helped to frame the terms of the debate. The paper is based on material from diplomatic archives in the United States and the United Kingdom.

Post-ICU Syndromes (PICS) remain a devastating problem for intensive care unit (ICU) survivors. It is currently unknown if de novo initiation of an antidepressant medication during ICU stay decreases the prevalence of post-ICU depression. We performed a retrospective, pilot study evaluating patients who had not previously been on an antidepressant medication and who were started on an antidepressant while in the trauma surgical, cardiothoracic, or medical intensive care unit (ICU). The PHQ-2 depression scale was used to ascertain the presence of depression after ICU discharge and compared this to historical controls. Of 2,988 patients admitted to the ICU, 69 patients had de novo initiation of an antidepressant medication and 27 patients were alive and available for study inclusion. We found the prevalence of depression in these patients to be 26%, which is not statistically different than the prevalence of post-ICU depression in historical controls [95% CI (27.6%, 51.6%)]. De novo initiation of an antidepressant medication did not substantially decrease the prevalence of post-ICU depression in this retrospective, pilot study.

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The idea of ‘developing’ Sind has been a lynchpin of government action and rhetoric in the province during the twentieth century. The central symbols of this ‘development’ were three barrage dams, completed between 1932 and 1962. Because of the barrages’ huge economic and ideological significance, the ceremonies connected with the construction and opening of these barrages provide a unique opportunity to examine the public presentation of state authority by the colonial and postcolonial governments. This paper investigates the way that ideas of ‘development’ and ‘modernity’ appeared in discourses connected with these ceremonies, in order to demonstrate that the idea of imposing ‘progress’ on a province considered ‘backward’ by the state administrators survived longer than the British regime which had introduced it. The paper begins with the historical links between water-provision and governance in Sind, before examining the way that immediate political concerns of the sitting governments were addressed in connection with the projects, demonstrating the ways in which very similar projects were cast as symbols of different political priorities. The last part of the paper draws out deeper similarities between the logic of these political expressions, in order to demonstrate the powerful continuity in ideologies of ‘progress’ throughout mid-twentieth century Sind.