Climate variability of the mid- and high-latitudes of the Southern Hemisphere in ensemble simulations from 1500 to 2000 AD

To increase the sparse knowledge of long-term Southern Hemisphere (SH) climate variability, we assess an ensemble of 4 transient simulations over the last 500 yr performed with a state-of-the-art atmosphere ocean general circulation model. The model is forced with reconstructions of solar irradiance, greenhouse gas (GHG) and volcanic aerosol concentrations. A 1990 control simulation shows that the model is able to represent the Southern Annular Mode (SAM), and to some extent the South Pacific Dipole (SPD) and the Zonal Wave 3 (ZW3). During the past 500 yr we find that SPD and ZW3 variability remain stable, whereas SAM shows a significant shift towards its positive state during the 20th century. Regional temperatures over South America are strongly influenced by changing both GHG concentrations and volcanic eruptions, whereas precipitation shows no significant response to the varying external forcing. For temperature this stands in contrast to proxy records, suggesting that SH climate is dominated by internal variability rather than external forcing. The underlying dynamics of the temperature changes generally point to a combination of several modes, thus, hampering the possibilities of regional reconstructing the modes from proxy records. The linear imprint of the external forcing is as expected, i.e. a warming for increase in the combined solar and GHG forcing and a cooling after volcanic eruptions. Dynamically, only the increase in SAM with increased combined forcing is simulated.

Multi-proxy summer and winter precipitation reconstruction for southern Africa over the last 200 years

This study presents the first consolidation of palaeoclimate proxy records from multiple archives to develop statistical rainfall reconstructions for southern Africa covering the last two centuries. State-of-the-art ensemble reconstructions reveal multi-decadal rainfall variability in the summer and winter rainfall zones. A decrease in precipitation amount over time is identified in the summer rainfall zone. No significant change in precipitation amount occurred in the winter rainfall zone, but rainfall variability has increased over time. Generally synchronous rainfall fluctuations between the two zones are identified on decadal scales, with common wet (dry) periods reconstructed around 1890 (1930). A strong relationship between seasonal rainfall and sea surface temperatures (SSTs) in the surrounding oceans is confirmed. Coherence among decadal-scale fluctuations of southern African rainfall, regional SST, SSTs in the Pacific Ocean and rainfall in south-eastern Australia suggest SST-rainfall teleconnections across the southern hemisphere. Temporal breakdowns of the SST-rainfall relationship in the southern African regions and the connection between the two rainfall zones are observed, for example during the 1950s. Our results confirm the complex interplay between large-scale teleconnections, regional SSTs and local effects in modulating multi-decadal southern African rainfall variability over long timescales.

Summer temperature in the eastern part of southern South America: its variability in the twentieth century and a teleconnection with Oceania

The 1907–2001 summer-to-summer surface air temperature variability in the eastern part of southern South America (SSA, partly including Patagonia) is analysed. Based on records from instruments located next to the Atlantic Ocean (36°S–55°S), we define indices for the interannual and interdecadal timescales. The main interdecadal mode reflects the late-1970s cold-to-warm climate shift in the region and a warm-to-cold transition during early 1930s. Although it has been in phase with the Pacific Decadal Oscillation (PDO) index since the 1960s, they diverged in the preceding decades. The main interannual variability index exhibits high spectral power at ~3.4 years and is representative of temperature variability in a broad area in the southern half of the continent. Eleven-years running correlation coefficients between this index and December-to-February (DJF) Niño3.4 show significant decadal fluctuations, out-of-phase with the running correlation with a DJF index of the Southern Annular Mode. The main interannual variability index is associated with a barotropic wavetrain-like pattern extending over the South Pacific from Oceania to SSA. During warm (cold) summers in SSA, significant anticyclonic (cyclonic) anomalies tend to predominate over eastern Australia, to the north of the Ross Sea, and to the east of SSA, whereas anomalous cyclonic (anticyclonic) circulation is observed over New Zealand and west of SSA. This teleconnection links warm (cold) SSA anomalies with dry (wet) summers in eastern Australia. The covariability seems to be influenced by the characteristics of tropical forcing; indeed, a disruption has been observed since late 1970s, presumably due to the PDO warm phase.

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration

INTRODUCTION HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. METHODS Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services - nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) - were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services. CONCLUSIONS This study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

Southern Hemisphere high-resolution palaeoclimate records of the last 2000 years

This study presents a comprehensive assessment of high-resolution Southern Hemisphere (SH) paleoarchives covering the last 2000 years. We identified 174 monthly to annually resolved climate proxy (tree ring, coral, ice core, documentary, speleothem and sedimentary) records from the Hemisphere. We assess the interannual and decadal sensitivity of each proxy record to large-scale circulation indices from the Pacific, Indian and Southern Ocean regions over the twentieth century. We then analyse the potential of this newly expanded palaeoclimate network to collectively represent predictands (sea surface temperature, sea level pressure, surface air temperature and precipitation) commonly used in climate reconstructions. The key dynamical centres-of-action of the equatorial Indo-Pacific are well captured by the palaeoclimate network, indicating that there is considerable reconstruction potential in this region, particularly in the post AD 1600 period when a number of long coral records are available. Current spatiotemporal gaps in data coverage and regions where significant potential for future proxy collection exists are discussed. We then highlight the need for new and extended records from key dynamical regions of the Southern Hemisphere. Although large-scale climate field reconstructions for the SH are in their infancy, we report that excellent progress in the development of regional proxies now makes plausible estimates of continental- to hemispheric-scale climate variations possible.