The Splitting of the Stratospheric Polar Vortex in the Southern Hemisphere, September 2002: Dynamical Evolution

The polar vortex of the Southern Hemisphere (SH) split dramatically during September 2002. The large-scale dynamical effects were manifest throughout the stratosphere and upper troposphere, corresponding to two distinct cyclonic centers in the upper troposphere–stratosphere system. High-resolution (T511) ECMWF analyses, supplemented by analyses from the Met Office, are used to present a detailed dynamical analysis of the event. First, the anomalous evolution of the SH polar vortex is placed in the context of the evolution that is usually witnessed during spring. Then high-resolution fields of potential vorticity (PV) from ECMWF are used to reveal several dynamical features of the split. Vortex fragments are rapidly sheared out into sheets of high (modulus) PV, which subsequently roll up into distinct synoptic-scale vortices. It is proposed that the stratospheric circulation becomes hydrodynamically unstable through a significant depth of the troposphere–stratosphere system as the polar vortex elongates.

Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa

Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

Conservation of open solar magnetic flux and the floor in the heliospheric magnetic field

The near-Earth heliospheric magnetic field intensity, |B|, exhibits a strong solar cycle variation, but returns to the same ``floor'' value each solar minimum. The current minimum, however, has seen |B| drop below previous minima, bringing in to question the existence of a floor, or at the very least requiring a re-assessment of its value. In this study we assume heliospheric flux consists of a constant open flux component and a time-varying contribution from CMEs. In this scenario, the true floor is |B| with zero CME contribution. Using observed CME rates over the solar cycle, we estimate the ``no-CME'' |B| floor at ~4.0 +/- 0.3 nT, lower than previous floor estimates and below |B| observed this solar minimum. We speculate that the drop in |B| observed this minimum may be due to a persistently lower CME rate than the previous minimum, though there are large uncertainties in the supporting observational data.

Understanding electron heat flux signatures in the solar wind

Suprathermal electrons (E > 80 eV) carry heat flux away from the Sun. Processes controlling the heat flux are not well understood. To gain insight into these processes, we model heat flux as a linear dependence on two independent parameters: electron number flux and electron pitch angle anisotropy. Pitch angle anisotropy is further modeled as a linear dependence on two solar wind components: magnetic field strength and plasma density. These components show no correlation with number flux, reinforcing its independence from pitch angle anisotropy. Multiple linear regression applied to 2 years of Wind data shows good correspondence between modeled and observed heat flux and anisotropy. The results suggest that the interplay of solar wind parameters and electron number flux results in distinctive heat flux dropouts at heliospheric features like plasma sheets but that these parameters continuously modify heat flux. This is inconsistent with magnetic disconnection as the primary cause of heat flux dropouts. Analysis of fast and slow solar wind regimes separately shows that electron number flux and pitch angle anisotropy are equally correlated with heat flux in slow wind but that number flux is the dominant correlative in fast wind. Also, magnetic field strength correlates better with pitch angle anisotropy in slow wind than in fast wind. The energy dependence of the model fits suggests different scattering processes in fast and slow wind.

What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

Intermittent release of transients in the slow solar wind: 2. In situ evidence

In paper 1, we showed that the Heliospheric Imager (HI) instruments on the pair of NASA STEREO spacecraft can be used to image the streamer belt and, in particular, the variability of the slow solar wind which originates near helmet streamers. The observation of intense intermittent transient outflow by HI implies that the corresponding in situ observations of the slow solar wind and corotating interaction regions (CIRs) should contain many signatures of transients. In the present paper, we compare the HI observations with in situ measurements from the STEREO and ACE spacecraft. Analysis of the solar wind ion, magnetic field, and suprathermal electron flux measurements from the STEREO spacecraft reveals the presence of both closed and partially disconnected interplanetary magnetic field lines permeating the slow solar wind. We predict that one of the transients embedded within the second CIR (CIR‐D in paper 1) should impact the near‐Earth ACE spacecraft. ACE measurements confirm the presence of a transient at the time of CIR passage; the transient signature includes helical magnetic fields and bidirectional suprathermal electrons. On the same day, a strahl electron dropout is observed at STEREO‐B, correlated with the passage of a high plasma beta structure. Unlike ACE, STEREO‐B observes the transient a few hours ahead of the CIR. STEREO‐A, STEREO‐B, and ACE spacecraft observe very different slow solar wind properties ahead of and during the CIR analyzed in this paper, which we associate with the intermittent release of transients.