Variability and trends in stratospheric NO2 in Antarctic summer, and implications for stratospheric NOy

NO2 measurements during 1990–2007, obtained from a zenith-sky spectrometer in the Antarctic, are analysed to determine the long-term changes in NO2. An atmospheric photochemical box model and a radiative transfer model are used to improve the accuracy of determination of the vertical columns from the slant column measurements, and to deduce the amount of NOy from NO2. We find that the NO2 and NOy columns in midsummer have large inter-annual variability superimposed on a broad maximum in 2000, with little or no overall trend over the full time period. These changes are robust to a variety of alternative settings when determining vertical columns from slant columns or determining NOy from NO2. They may signify similar changes in speed of the Brewer-Dobson circulation but with opposite sign, i.e. a broad minimum around 2000. Multiple regressions show significant correlation with solar and quasi-biennial-oscillation indices, and weak correlation with El Nino, but no significant overall trend, corresponding to an increase in Brewer-Dobson circulation of 1.4±3.5%/decade. There remains an unexplained cycle of amplitude and period at least 15% and 17 years, with minimum speed in about 2000.

Health care rights and NHS rationing: turning theory into practice

How should we understand the nature of patients’ right in public health care systems? Are health care rights different to rights under a private contract for car insurance? This article distinguishes between public and private rights and the relevance of community interests and notions of social solidarity. It discusses the distinction between political and civil rights, and social and economic rights and the inherently political and redistributive nature of the latter. Nevertheless, social and economic rights certainly give rise to “rights” enforceable by the courts. In the UK (as in many other jurisdictions), the courts have favoured a “procedural” approach to the question, in which the courts closely scrutinise decisions and demand high standards of rationality from decision-makers. However, although this is the general rule, the article also discusses a number of exceptional cases where “substantive” remedies are available which guarantee patients access to the care they need.

Variability and trends in England and Wales precipitation

The England and Wales precipitation (EWP) dataset is a homogeneous time series of daily accumulations from 1931 to 2014, composed from rain gauge observations spanning the region. The daily regional-average precipitation statistics are shown to be well described by a Weibull distribution, which is used to define extremes in terms of percentiles. Computed trends in annual and seasonal precipitation are sensitive to the period chosen, due to large variability on interannual and decadal timescales. Atmospheric circulation patterns associated with seasonal precipitation variability are identified. These patterns project onto known leading modes of variability, all of which involve displacements of the jet stream and storm-track over the eastern Atlantic. The intensity of daily precipitation for each calendar season is investigated by partitioning all observations into eight intensity categories contributing equally to the total precipitation in the dataset. Contrary to previous results based on shorter periods, no significant trends of the most intense categories are found between 1931 and 2014. The regional-average precipitation is found to share statistical properties common to the majority of individual stations across England and Wales used in previous studies. Statistics of the EWP data are examined for multi-day accumulations up to 10 days, which are more relevant for river flooding. Four recent years (2000, 2007, 2008 and 2012) have a greater number of extreme events in the 3-and 5-day accumulations than any previous year in the record. It is the duration of precipitation events in these years that is remarkable, rather than the magnitude of the daily accumulations.

Variability and trends in Laptev Sea ice outflow between 1992-2011

Variability and trends in seasonal and interannual ice area export out of the Laptev Sea between 1992 and 2011 are investigated using satellite-based sea ice drift and concentration data. We found an average total winter (Octo- ber to May) ice area transport across the northern and east- ern Laptev Sea boundaries (NB and EB) of 3.48 × 10 5 km 2 . The average transport across the NB (2.87 × 10 5 km 2 ) is thereby higher than across the EB (0.61 × 10 5 km 2 ), with a less pronounced seasonal cycle. The total Laptev Sea ice area flux significantly increased over the last decades (0.85 × 10 5 km 2 decade − 1 , p> 0 . 95), dominated by increas- ing export through the EB (0.55 × 10 5 km 2 decade − 1 , p> 0 . 90), while the increase in export across the NB is smaller (0.3 × 10 5 km 2 decade − 1 ) and statistically not significant. The strong coupling between across-boundary SLP gradient and ice drift velocity indicates that monthly variations in ice area flux are primarily controlled by changes in geostrophic wind velocities, although the Laptev Sea ice circulation shows no clear relationship with large-scale atmospheric in- dices. Also there is no evidence of increasing wind velocities that could explain the overall positive trends in ice export. The increased transport rates are rather the consequence of a changing ice cover such as thinning and/or a decrease in con- centration. The use of a back-propagation method revealed that most of the ice that is incorporated into the Transpolar Drift is formed during freeze-up and originates from the cen- tral and western part of the Laptev Sea, while the exchange with the East Siberian Sea is dominated by ice coming from the central and southeastern Laptev Sea. Furthermore, our re- sults imply that years of high ice export in late winter (Febru- ary to May) have a thinning effect on the ice cover, which in turn preconditions the occurence of negative sea ice extent anomalies in summer.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Humoral and cellular immune response generated by different vaccine programs before and after Salmonella Enteritidis challenge in chickens

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Health-related behavior and quality of life among the elderly: a population-based study

OBJETIVO: Analisar a associação de comportamentos saudáveis com a qualidade de vida relacionada à saúde em idosos. MÉTODOS: Estudo transversal de base populacional que envolveu 1.958 idosos residentes em quatro áreas do estado de São Paulo, em 2001/2002. A qualidade de vida foi aferida com o uso do instrumento Medical Outcomes Study SF-36-Item Short Form Health Survey. As oito escalas e os dois componentes do instrumento constituíram as variáveis dependentes e as independentes foram atividade física, freqüência semanal de ingestão de bebida alcoólica e hábito de fumar. Modelos de regressão linear múltipla foram usados para controlar o efeito de sexo, idade, escolaridade, trabalho, área de residência e número de doenças crônicas. RESULTADOS: Atividade física foi positivamente associada com as oito escalas do SF-36. As maiores associações foram encontradas em aspectos físicos (β = 11,9), capacidade funcional (β = 11,3) e no componente físico. Idosos que ingeriam bebida alcoólica pelo menos uma vez por semana apresentaram melhor qualidade de vida do que os que não ingeriam. Comparados com os que nunca fumaram, os fumantes tiveram pior qualidade de vida no componente mental (β = -2,4). CONCLUSÕES: Os resultados apresentam que praticar atividade física, consumir bebida alcoólica moderadamente e não fumar são fatores positivamente associados a uma melhor qualidade de vida em idosos.