971 resultados para United States. Army. Base hospital no. 1, Vichy, France.
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EXTRACT (SEE PDF FOR FULL ABSTRACT): The influence of ENSO on atmospheric circulation and precipitation over the western United States is presented from two perspectives. First, ENSO-associated circulation patterns over the North Pacific/North America sector were identified using an REOF (rotated empirical orthogonal function) analysis of the 700-mb height field and compositing these for extreme phases of the Southern Oscillation Index. ... Second, we examine the variability of precipitation during the warm and cool phases of ENSO for different locations in the western United States.
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We describe a 2.5-degree gridpoint atmospheric hydrology/climatology of precipitable water, precipitation, atmospheric moisture convergence, and a residual evaporation or evapotranspiration for the coterminous United States. We also describe a large-scale surface hydrology/climatology of a residual soil moisture, streamflow divergence, or runoff, as well as precipitation and evaporation. Annual and seasonal means and interrelationships among various components of the hydrologic cycles are discussed.
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The western United States is characterized by heterogeneous patterns of seasonal precipitation regimes due to the hierarchy of climatic controls that operate at different spatial scales. A climatology of intermonthly precipitation changes, using data from more than 4,000 stations including high-elevation sites, illustrate how different climatic controls explain the spatial distribution of the seasonal precipitation maximum. These results indicate that smaller-scale climatic controls must be considered along with larger-scale ones to explain patterns of spatial climate heterogeneity over mountainous areas. The results also offer important implications for scholars interested in assessing spatial climatic variations of the western United States at different timescales.
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EXTRACT (SEE PDF FOR FULL ABSTRACT): We argue that the most important climatically-driven terrestrial ecosystem changes are concentrated in annual- to decadal-scale episodic events. These rapid ecosystem responses to climate change are manifested as regionally synchronized disturbance events (eg, floods, fires, and insect outbreaks) and increased drought-caused plant mortality rates.
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EXTRACT (SEE PDF FOR FULL ABSTRACT): In the mountainous western United States, winter weather has consequences for the entire year, especially with respect to the use of water. For most of the past 6-8 years, drought has been a persistent feature of the climate.
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Major controls on river salinity (total dissolved solids) in the western United States are climate, geology, and human activity. Climate, in general, influences soil-river salinity via salt-balance variations. When climate becomes wetter, river discharge increases and soil-river salinity decreases; when climate becomes drier river discharge decreases and soil-river salinity increases. This study characterizes the river salinity response to discharge using statistical-dynamic methods. An exploratory analysis of river salinity, using early 1900s water quality surveys in the western United States, shows much river salinity variability is in response to storm and annual discharge. Presumably this is because river discharge is largely supported by surface flow.
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EXTRACT (SEE PDF FOR FULL ABSTRACT): As part of a study of climatic influences on landslide initiation, a statistical analysis of long-term (>40 years) records of daily rainfall from 24 Pacific coastal stations, from San Diego to Cape Flattery, disclosed an unexpected result - the square root of the daily rainfall closely approximates a normal distribution function. ... This paper illustrates the use of the square-root-normal distribution to analyze variations in precipitation along the mainland United States Pacific Coast with examples of orographic enhancement, rain shadows, and increase in precipitation frequency with geographic latitude.
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EXTRACT (SEE PDF FOR FULL ABSTRACT): We have analyzed streamflow variations recorded at 15 USGS gauging stations in California during the past 90 years or so. The anomalies (departures from the 1960-1990 mean discharge) of streamflow on annual-to-decadal time scales are strongly correlated with precipitation anomalies in each drainage basin. ... Although causes of the decadal climate (precipitation) variability are not known with certainty, the use of streamflow records may help us understand the relative strengths of moisture sources and shift of the jet stream in atmospheric circulation.
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A key to understanding the causes for climate variability lies in understanding how atmospheric circulation influences regional climate. The goal of this research is to investigate the long-term relationships between atmospheric circulation and winter climate in the southwestern United States. Patterns of atmospheric circulation are described by circulation indices, and winter climate is defined as number of days with precipitation and mean maximum temperature for the winter wet season, November through March. Records of both circulation indices and climate variables were reconstructed with tree-ring chronologies for the period 1702-1983. The years of the highest and lowest values of circulation indices and climate variables were compared in order to investigate possible spatial and temporal relationships between extremes in circulation and climate.
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The variability of summer precipitation in the southeastern United States is examined in this study using 60-yr (1948-2007) rainfall data. The Southeast summer rainfalls exhibited higher interannual variability with more intense summer droughts and anomalous wetness in the recent 30 years (1978-2007) than in the prior 30 years (1948-77). Such intensification of summer rainfall variability was consistent with a decrease of light (0.1-1 mm day-1) and medium (1-10 mm day-1) rainfall events during extremely dry summers and an increase of heavy (.10 mm day-1) rainfall events in extremely wet summers. Changes in rainfall variability were also accompanied by a southward shift of the region of maximum zonal wind variability at the jet stream level in the latter period. The covariability between the Southeast summer precipitation and sea surface temperatures (SSTs) is also analyzed using the singular value decomposition (SVD) method. It is shown that the increase of Southeast summer precipitation variability is primarily associated with a higher SST variability across the equatorial Atlantic and also SST warming in the Atlantic. © 2010 American Meteorological Society.
Variation in use of surveillance colonoscopy among colorectal cancer survivors in the United States.
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BACKGROUND: Clinical practice guidelines recommend colonoscopies at regular intervals for colorectal cancer (CRC) survivors. Using data from a large, multi-regional, population-based cohort, we describe the rate of surveillance colonoscopy and its association with geographic, sociodemographic, clinical, and health services characteristics. METHODS: We studied CRC survivors enrolled in the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Eligible survivors were diagnosed between 2003 and 2005, had curative surgery for CRC, and were alive without recurrences 14 months after surgery with curative intent. Data came from patient interviews and medical record abstraction. We used a multivariate logit model to identify predictors of colonoscopy use. RESULTS: Despite guidelines recommending surveillance, only 49% of the 1423 eligible survivors received a colonoscopy within 14 months after surgery. We observed large regional differences (38% to 57%) across regions. Survivors who received screening colonoscopy were more likely to: have colon cancer than rectal cancer (OR = 1.41, 95% CI: 1.05-1.90); have visited a primary care physician (OR = 1.44, 95% CI: 1.14-1.82); and received adjuvant chemotherapy (OR = 1.75, 95% CI: 1.27-2.41). Compared to survivors with no comorbidities, survivors with moderate or severe comorbidities were less likely to receive surveillance colonoscopy (OR = 0.69, 95% CI: 0.49-0.98 and OR = 0.44, 95% CI: 0.29-0.66, respectively). CONCLUSIONS: Despite guidelines, more than half of CRC survivors did not receive surveillance colonoscopy within 14 months of surgery, with substantial variation by site of care. The association of primary care visits and adjuvant chemotherapy use suggests that access to care following surgery affects cancer surveillance.
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The health of clergy is important, and clergy may find health programming tailored to them more effective. Little is known about existing clergy health programs. We contacted Protestant denominational headquarters and searched academic databases and the Internet. We identified 56 clergy health programs and categorized them into prevention and personal enrichment; counseling; marriage and family enrichment; peer support; congregational health; congregational effectiveness; denominational enrichment; insurance/strategic pension plans; and referral-based programs. Only 13 of the programs engaged in outcomes evaluation. Using the Socioecological Framework, we found that many programs support individual-level and institutional-level changes, but few programs support congregational-level changes. Outcome evaluation strategies and a central repository for information on clergy health programs are needed. © 2011 Springer Science+Business Media, LLC.
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PURPOSE/BACKGROUND: Dynamic balance is an important component of motor skill development. Poor dynamic balance has previously been associated with sport related injury. However, the vast majority of dynamic balance studies as they relate to sport injury have occurred in developed North American or European countries. Thus, the purpose of this study was to compare dynamic balance in adolescent male soccer players from Rwanda to a matched group from the United States. METHODS: Twenty-six adolescent male soccer players from Rwanda and 26 age- and gender-matched control subjects from the United States were screened using the Lower Quarter Y Balance Test during their pre-participation physical. Reach asymmetry (cm) between limbs was examined for all reach directions. In addition, reach distance in each direction (normalized to limb length, %LL) and the composite reach score (also normalized to %LL) were examined. Dependent samples t-tests were performed with significant differences identified at p<0.05. RESULTS: Twenty-six male soccer players from Rwanda (R) were matched to twenty-six male soccer players from the United States (US). The Rwandan soccer players performed better in the anterior (R: 83.9 ± 3.2 %LL; US: 76.5 ± 6.6 %LL, p<0.01), posterolateral (R: 114.4 ± 8.3 %LL ; US: 106.5 ± 8.2 %LL, p<0.01) and composite (R: 105.6 ± 1.3 %LL; US: 97.8 ± 6.2 %LL, p<0.01) reach scores. No significant differences between groups were observed for reach asymmetry. CONCLUSIONS: Adolescent soccer players from Rwanda exhibit superior performance on a standardized dynamic balance test as comparison to similar athletes from the United States. The examination of movement abilities of athletes from countries of various origins may allow for a greater understanding of the range of true normative values for dynamic balance. LEVELS OF EVIDENCE: 3b.
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Given the increases in spatial resolution and other improvements in climate modeling capabilities over the last decade since the CMIP3 simulations were completed, CMIP5 provides a unique opportunity to assess scientific understanding of climate variability and change over a range of historical and future conditions. With participation from over 20 modeling groups and more than 40 global models, CMIP5 represents the latest and most ambitious coordinated international climate model intercomparison exercise to date. Observations dating back to 1900 show that the temperatures in the twenty-first century have the largest spatial extent of record breaking and much above normal mean monthly maximum and minimum temperatures. The 20-yr return value of the annual maximum or minimum daily temperature is one measure of changes in rare temperature extremes.
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This study investigates the changes of the North Atlantic subtropical high (NASH) and its impact on summer precipitation over the southeastern (SE) United States using the 850-hPa geopotential height field in the National Centers forEnvironmental Prediction (NCEP) reanalysis, the 40-yr European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERA-40), long-term rainfall data, and Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report (AR4) model simulations during the past six decades (1948-2007). The results show that the NASH in the last 30 yr has become more intense, and its western ridge has displaced westward with an enhanced meridional movement compared to the previous 30 yr. When the NASH moved closer to the continental United States in the three most recent decades, the effect of the NASH on the interannual variation of SE U.S. precipitation is enhanced through the ridge's north-south movement. The study's attribution analysis suggested that the changes of the NASH are mainly due to anthropogenic warming. In the twenty-first century with an increase of the atmospheric CO2 concentration, the center of the NASH would be intensified and the western ridge of the NASH would shift farther westward. These changes would increase the likelihood of both strong anomalously wet and dry summers over the SEUnited States in the future, as suggested by the IPCC AR4 models. © 2011 American Meteorological Society.