73 resultados para Review of developments in health inequalities over the last 10 years

em CentAUR: Central Archive University of Reading - UK


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The mechanisms involved in Atlantic meridional overturning circulation (AMOC) decadal variability and predictability over the last 50 years are analysed in the IPSL–CM5A–LR model using historical and initialised simulations. The initialisation procedure only uses nudging towards sea surface temperature anomalies with a physically based restoring coefficient. When compared to two independent AMOC reconstructions, both the historical and nudged ensemble simulations exhibit skill at reproducing AMOC variations from 1977 onwards, and in particular two maxima occurring respectively around 1978 and 1997. We argue that one source of skill is related to the large Mount Agung volcanic eruption starting in 1963, which reset an internal 20-year variability cycle in the North Atlantic in the model. This cycle involves the East Greenland Current intensity, and advection of active tracers along the subpolar gyre, which leads to an AMOC maximum around 15 years after the Mount Agung eruption. The 1997 maximum occurs approximately 20 years after the former one. The nudged simulations better reproduce this second maximum than the historical simulations. This is due to the initialisation of a cooling of the convection sites in the 1980s under the effect of a persistent North Atlantic oscillation (NAO) positive phase, a feature not captured in the historical simulations. Hence we argue that the 20-year cycle excited by the 1963 Mount Agung eruption together with the NAO forcing both contributed to the 1990s AMOC maximum. These results support the existence of a 20-year cycle in the North Atlantic in the observations. Hindcasts following the CMIP5 protocol are launched from a nudged simulation every 5 years for the 1960–2005 period. They exhibit significant correlation skill score as compared to an independent reconstruction of the AMOC from 4-year lead-time average. This encouraging result is accompanied by increased correlation skills in reproducing the observed 2-m air temperature in the bordering regions of the North Atlantic as compared to non-initialized simulations. To a lesser extent, predicted precipitation tends to correlate with the nudged simulation in the tropical Atlantic. We argue that this skill is due to the initialisation and predictability of the AMOC in the present prediction system. The mechanisms evidenced here support the idea of volcanic eruptions as a pacemaker for internal variability of the AMOC. Together with the existence of a 20-year cycle in the North Atlantic they propose a novel and complementary explanation for the AMOC variations over the last 50 years.

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Low variability of crop production from year to year is desirable for many reasons, including reduced income risk and stability of supplies. Therefore, it is important to understand the nature of yield variability, whether it is changing through time, and how it varies between crops and regions. Previous studies have shown that national crop yield variability has changed in the past, with the direction and magnitude dependent on crop type and location. Whilst such studies acknowledge the importance of climate variability in determining yield variability, it has been assumed that its magnitude and its effect on crop production have not changed through time and, hence, that changes to yield variability have been due to non-climatic factors. We address this assumption by jointly examining yield and climate variability for three major crops (rice, wheat and maize) over the past 50 years. National yield time series and growing season temperature and precipitation were de-trended and related using multiple linear regression. Yield variability changed significantly in half of the crop–country combinations examined. For several crop–country combinations, changes in yield variability were related to changes in climate variability.

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Winter storms are among the most important natural hazards affecting Europe. We quantify changes in storm frequency and intensity over the North Atlantic and Europe under future climate scenarios in terms of return periods (RPs) considering uncertainties due to both sampling and methodology. RPs of North Atlantic storms' minimum central pressure (CP) and maximum vorticity (VOR) remain unchanged by 2100 for both the A1B and A2 scenarios compared to the present climate. Whereas shortened RPs for VOR of all intensities are detected for the area between British Isles/North-Sea/western Europe as early as 2040. However, the changes in storm VOR RP may be unrealistically large: a present day 50 (20) year event becomes approximately a 9 (5.5) year event in both A1B and A2 scenarios by 2100. The detected shortened RPs of storms implies a higher risk of occurrence of damaging wind events over Europe.

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A Hale cycle, one complete magnetic cycle of the Sun, spans two complete Schwabe cycles (also referred to as sunspot and, more generally, solar cycles). The approximately 22-year Hale cycle is seen in magnetic polarities of both sunspots and polar fields, as well as in the intensity of galactic cosmic rays reaching Earth, with odd- and even-numbered solar cycles displaying qualitatively different waveforms. Correct numbering of solar cycles also underpins empirical cycle-to-cycle relations which are used as first-order tests of stellar dynamo models. There has been much debate about whether the unusually long solar cycle 4 (SC4), spanning- 1784–1799, was actually two shorter solar cycles combined as a result of poor data coverage in the original Wolf sunspot number record. Indeed, the group sunspot number does show a small increase around 1794–1799 and there is evidence of an increase in the mean latitude of sunspots at this time, suggesting the existence of a cycle ‘‘4b’’. In this study, we use cosmogenic radionuclide data and associated reconstructions of the heliospheric magnetic field (HMF) to show that the Hale cycle has persisted over the last 300 years and that data prior to 1800 are more consistent with cycle 4 being a single long cycle (the ‘‘no SC4b’’ scenario). We also investigate the effect of cycle 4b on the HMF using an open solar flux (OSF) continuity model, in which the OSF source term is related to sunspot number and the OSF loss term is determined by the heliospheric current sheet tilt, assumed to be a simple function of solar cycle phase. The results are surprising; Without SC4b, the HMF shows two distinct peaks in the 1784–1799 interval, while the addition of SC4b removes the secondary peak, as the OSF loss term acts in opposition to the later rise in sunspot number. The timing and magnitude of the main SC4 HMF peak is also significantly changed by the addition of SC4b. These results are compared with the cosmogenic isotope reconstructions of HMF and historical aurora records. These data marginally favour the existence of SC4b (the ‘‘SC4b’’ scenario), though the result is less certain than that based on the persistence of the Hale cycle. Thus while the current uncertainties in the observations preclude any definitive conclusions, the data favour the ‘‘no SC4b’’ scenario. Future improvements to cosmogenic isotope reconstructions of the HMF, through either improved modelling or additional ice cores from well-separated geographic locations, may enable questions of the existence of SC4b and the phase of Hale cycle prior to the Maunder minimum to be settled conclusively.

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An improved understanding of present-day climate variability and change relies on high-quality data sets from the past 2 millennia. Global efforts to model regional climate modes are in the process of being validated against, and integrated with, records of past vegetation change. For South America, however, the full potential of vegetation records for evaluating and improving climate models has hitherto not been sufficiently acknowledged due to an absence of information on the spatial and temporal coverage of study sites. This paper therefore serves as a guide to high-quality pollen records that capture environmental variability during the last 2 millennia. We identify 60 vegetation (pollen) records from across South America which satisfy geochronological requirements set out for climate modelling, and we discuss their sensitivity to the spatial signature of climate modes throughout the continent. Diverse patterns of vegetation response to climate change are observed, with more similar patterns of change in the lowlands and varying intensity and direction of responses in the highlands. Pollen records display local-scale responses to climate modes; thus, it is necessary to understand how vegetation–climate interactions might diverge under variable settings. We provide a qualitative translation from pollen metrics to climate variables. Additionally, pollen is an excellent indicator of human impact through time. We discuss evidence for human land use in pollen records and provide an overview considered useful for archaeological hypothesis testing and important in distinguishing natural from anthropogenically driven vegetation change. We stress the need for the palynological community to be more familiar with climate variability patterns to correctly attribute the potential causes of observed vegetation dynamics. This manuscript forms part of the wider LOng-Term multi-proxy climate REconstructions and Dynamics in South America – 2k initiative that provides the ideal framework for the integration of the various palaeoclimatic subdisciplines and palaeo-science, thereby jump-starting and fostering multidisciplinary research into environmental change on centennial and millennial timescales.

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This study assesses the current state of adult skeletal age-at-death estimation in biological anthropology through analysis of data published in recent research articles from three major anthropological and archaeological journals (2004–2009). The most commonly used adult ageing methods, age of ‘adulthood’, age ranges and the maximum age reported for ‘mature’ adults were compared. The results showed a wide range of variability in the age at which individuals were determined to be adult (from 14 to 25 years), uneven age ranges, a lack of standardisation in the use of descriptive age categories and the inappropriate application of some ageing methods for the sample being examined. Such discrepancies make comparisons between skeletal samples difficult, while the inappropriate use of some techniques make the resultant age estimations unreliable. At a time when national and even global comparisons of past health are becoming prominent, standardisation in the terminology and age categories used to define adults within each sample is fundamental. It is hoped that this research will prompt discussions in the osteological community (both nationally and internationally) about what defines an ‘adult’, how to standardise the age ranges that we use and how individuals should be assigned to each age category. Skeletal markers have been proposed to help physically identify ‘adult’ individuals.

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To gain a new perspective on the interaction of the Atlantic Ocean and the atmosphere, the relationship between the atmospheric and oceanic meridional energy transports is studied in a version of HadCM3, the U.K. Hadley Centre's coupled climate model. The correlation structure of the energy transports in the atmosphere and Atlantic Ocean as a function of latitude, and the cross correlation between the two systems are analyzed. The processes that give rise to the correlations are then elucidated using regression analyses. In northern midlatitudes, the interannual variability of the Atlantic Ocean energy transport is dominated by Ekman processes. Anticorrelated zonal winds in the subtropics and midlatitudes, particularly associated with the North Atlantic Oscillation (NAO), drive anticorrelated meridional Ekman transports. Variability in the atmospheric energy transport is associated with changes in the stationary waves, but is only weakly related to the NAO. Nevertheless, atmospheric driving of the oceanic Ekman transports is responsible for a bipolar pattern in the correlation between the atmosphere and Atlantic Ocean energy transports. In the Tropics, the interannual variability of the Atlantic Ocean energy transport is dominated by an adjustment of the tropical ocean to coastal upwelling induced along the Venezuelan coast by a strengthening of the easterly trade winds. Variability in the atmospheric energy transport is associated with a cross-equatorial meridional overturning circulation that is only weakly associated with variability in the trade winds along the Venezuelan coast. In consequence, there is only very limited correlation between the atmosphere and Atlantic Ocean energy transports in the Tropics of HadCM3

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Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values-liberty and equity-can be evaluated and assessed.

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This study investigates the potential contribution of observed changes in lower stratospheric water vapour to stratospheric temperature variations over the past three decades using a comprehensive global climate model (GCM). Three case studies are considered. In the first, the net increase in stratospheric water vapour (SWV) from 1980–2010 (derived from the Boulder frost-point hygrometer record using the gross assumption that this is globally representative) is estimated to have cooled the lower stratosphere by up to ∼0.2 K decade−1 in the global and annual mean; this is ∼40% of the observed cooling trend over this period. In the Arctic winter stratosphere there is a dynamical response to the increase in SWV, with enhanced polar cooling of 0.6 K decade−1 at 50 hPa and warming of 0.5 K decade−1 at 1 hPa. In the second case study, the observed decrease in tropical lower stratospheric water vapour after the year 2000 (imposed in the GCM as a simplified representation of the observed changes derived from satellite data) is estimated to have caused a relative increase in tropical lower stratospheric temperatures by ∼0.3 K at 50 hPa. In the third case study, the wintertime dehydration in the Antarctic stratospheric polar vortex (again using a simplified representation of the changes seen in a satellite dataset) is estimated to cause a relative warming of the Southern Hemisphere polar stratosphere by up to 1 K at 100 hPa from July–October. This is accompanied by a weakening of the westerly winds on the poleward flank of the stratospheric jet by up to 1.5 m s−1 in the GCM. The results show that, if the measurements are representative of global variations, SWV should be considered as important a driver of transient and long-term variations in lower stratospheric temperature over the past 30 years as increases in long-lived greenhouse gases and stratospheric ozone depletion.

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Capturing the sensory perception and preferences of older adults, whether healthy or with particular disease states, poses major methodological challenges for the sensory community. Currently a vastly under researched area, it is at the same time a vital area of research as alterations in sensory perception can affect daily dietary food choices, intake, health and wellbeing. Tailored sensory methods are needed that take into account the challenges of working with such populations including poor access leading to low patient numbers (study power), cognitive abilities, use of medications, clinical treatments and context (hospitals and care homes). The objective of this paper was to review current analytical and affective sensory methodologies used with different cohorts of healthy and frail older adults, with focus on food preference and liking. We particularly drew attention to studies concerning general ageing as well as to those considering age-related diseases that have an emphasis on malnutrition and weight loss. Pubmed and Web of Science databases were searched to 2014 for relevant articles in English. From this search 75 papers concerning sensory acuity, 41 regarding perceived intensity and 73 relating to hedonic measures were reviewed. Simpler testing methods, such as directional forced choice tests and paired preference tests need to be further explored to determine whether they lead to more reliable results and better inter-cohort comparisons. Finally, sensory quality and related quality of life for older adults suffering from dementia must be included and not ignored in our future actions.

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The Middle East and Southwest Asia comprise a region that is water-stressed, societally vulnerable, and prone to severe droughts. Large-scale climate variability, particularly La Niña, appears to play an important role in region-wide drought, including the two most severe of the last fifty years—1999-2001 and 2007-2008—with implications for drought forecasting. Important dynamical factors include orography, thermodynamic influence on vertical motion, storm track changes, and moisture transport. Vegetation in the region is strongly impacted by drought and may provide an important feedback mechanism. In future projections, drying of the eastern Mediterranean is a robust feature, as are temperature increases throughout the region, which will affect evaporation and the timing and intensity of snowmelt. Vegetation feedbacks may become more important in a warming climate. There are a wide range of outstanding issues for understanding, monitoring, and predicting drought in the region, including: dynamics of the regional storm track, the relative importance of the range of dynamical mechanisms related to drought, regional coherence of drought, the relationship between synoptic-scale mechanisms and drought, predictability of vegetation and crop yields, stability of remote influences, data uncertainty, and the role of temperature. Development of a regional framework for cooperative work and dissemination of information and existing forecasts would speed understanding and make better use of available information.

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We present the results of a study of solar wind velocity and magnetic field correlation lengths over the last 35 years. The correlation length of the magnetic field magnitude λ | B| increases on average by a factor of two at solar maxima compared to solar minima. The correlation lengths of the components of the magnetic field λ_{B_{XYZ}} and of the velocity λ_{V_{YZ}} do not show this change and have similar values, indicating a continual turbulent correlation length of around 1.4×106 km. We conclude that a linear relation between λ | B|, VB 2, and Kp suggests that the former is related to the total magnetic energy in the solar wind and an estimate of the average size of geoeffective structures, which is, in turn, proportional to VB 2. By looking at the distribution of daily correlation lengths we show that the solar minimum values of λ | B| correspond to the turbulent outer scale. A tail of larger λ | B| values is present at solar maximum causing the increase in mean value.