Pacific sea surface temperature associations with southwestern United States summer rainfall and atmospheric circulation

Pacific sea surface temperatures (SSTs) are examined for their associations with (1) summer rainfall, and (2) the latitude location of the mid-tropospheric subtropical high pressure ridge (STR) in the southwestern United States during 1945 to 1986. Extreme northward (southward) displacements of STR are associated with wet (dry) summers over Arizona and an enhanced (weakened) gradient of SST off the California and Baja coasts. These tend to follow winters marked by positive (negative) phases of the PNA, Pacific/North America, teleconnection pattern. Recent decadal variations of Arizona summer rainfall (1950s wet; 1970s dry) appear similarly related to southwestern United States synoptic circulation and eastern Pacific SSTs.

El Niño-Southern Oscillation (ENSO) phenomena and forest fires in the southwestern United States

Fire statistics (area burned) and fire-scar chronologies from tree rings show reduced fire activity during El Niño-Southern Oscillation (ENSO) in forests of Arizona and New Mexico. This relationship probably stems from increased fuel moisture after a wet winter and spring, but also could involve climatic controls on lightning activity at the onset of the monsoon season.

Inter-regional correlation in tree-growth variations in the western United States, 1513-1964, at ENSO, sunspot, and longer frequency bands

Cross-spectral analysis of regional tree-ring data suggests the spatial pattern of correlation between moisture variations in the Sierra Nevada of central California and in other parts of the western United States is frequency dependent. Short wavelengths (2.8 to 10.7 years), perhaps associated with El Niño/Southern Oscillation, are strongly coherent both to the north (Oregon) and to the south (Southern California). Longer wavelengths (45 to 75 years) are strongly coherent only to the north. Frequency bands corresponding to annual sunspot series were associated with relatively weak patterns of spatial correlation.

Anomalous atmospheric circulation and large winter floods in six subregions of the southwestern United States

EXTRACT (SEE PDF FOR FULL ABSTRACT): We examined atmospheric circulation conditions conducive to occurrence of winter floods that exceed the 10-year peak discharge on rivers in six hydroclimatic subregions in Arizona, southern Utah, Nevada, and California. ... This relationship between flooding and broad-scale atmospheric patterns in the modern record will aid in paleoclimatic interpretations of paleoflood records over the last few thousand years.

A numerical simulation of cool/wet and warm/wet episodes in the western United States

Wintertime precipitation in the mountains of the western United States during a warm or cool period has a pronounced influence on streamflow. During a warm year, streamflow at intermediate elevations responds more immediately to precipitation events; during a cold year, much of the discharge is delayed until the snow melts in spring and summer. Previous efforts at studying these extremes have been hampered by a limited number and length of observational analyses. In this study, we augment this limited observational record by analyzing a simplified general circulation model.

ENSO influences on atmospheric circulation and precipitation in the western United States

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.

Recent winters in the western United States and relationship to ENSO patterns [abstract]

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.

Decadal hydroclimatic variability in the western coastal United States: temporal and spatial variations in precipitation, streamflow, and lake level

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.

Tree-ring reconstructions of winter climate and circulation indices for the southwestern United States

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.

Changes to the North Atlantic subtropical high and its role in the intensification of summer rainfall variability in the southeastern United States

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.

Characteristics of primary care office visits to nurse practitioners, physician assistants and physicians in United States Veterans Health Administration facilities, 2005 to 2010: a retrospective cross-sectional analysis.

UNLABELLED: BACKGROUND: Primary care, an essential determinant of health system equity, efficiency, and effectiveness, is threatened by inadequate supply and distribution of the provider workforce. The Veterans Health Administration (VHA) has been a frontrunner in the use of nurse practitioners (NPs) and physician assistants (PAs). Evaluation of the roles and impact of NPs and PAs in the VHA is critical to ensuring optimal care for veterans and may inform best practices for use of PAs and NPs in other settings around the world. The purpose of this study was to characterize the use of NPs and PAs in VHA primary care and to examine whether their patients and patient care activities were, on average, less medically complex than those of physicians. METHODS: This is a retrospective cross-sectional analysis of administrative data from VHA primary care encounters between 2005 and 2010. Patient and patient encounter characteristics were compared across provider types (PA, NP, and physician). RESULTS: NPs and PAs attend about 30% of all VHA primary care encounters. NPs, PAs, and physicians fill similar roles in VHA primary care, but patients of PAs and NPs are slightly less complex than those of physicians, and PAs attend a higher proportion of visits for the purpose of determining eligibility for benefits. CONCLUSIONS: This study demonstrates that a highly successful nationwide primary care system relies on NPs and PAs to provide over one quarter of primary care visits, and that these visits are similar to those of physicians with regard to patient and encounter characteristics. These findings can inform health workforce solutions to physician shortages in the USA and around the world. Future research should compare the quality and costs associated with various combinations of providers and allocations of patient care work, and should elucidate the approaches that maximize quality and efficiency.

Thermodynamic and dynamic contributions to future changes in regional precipitation variance: focus on the Southeastern United States

© 2014, Springer-Verlag Berlin Heidelberg.The frequency and severity of extreme events are tightly associated with the variance of precipitation. As climate warms, the acceleration in hydrological cycle is likely to enhance the variance of precipitation across the globe. However, due to the lack of an effective analysis method, the mechanisms responsible for the changes of precipitation variance are poorly understood, especially on regional scales. Our study fills this gap by formulating a variance partition algorithm, which explicitly quantifies the contributions of atmospheric thermodynamics (specific humidity) and dynamics (wind) to the changes in regional-scale precipitation variance. Taking Southeastern (SE) United States (US) summer precipitation as an example, the algorithm is applied to the simulations of current and future climate by phase 5 of Coupled Model Intercomparison Project (CMIP5) models. The analysis suggests that compared to observations, most CMIP5 models (~60 %) tend to underestimate the summer precipitation variance over the SE US during the 1950–1999, primarily due to the errors in the modeled dynamic processes (i.e. large-scale circulation). Among the 18 CMIP5 models analyzed in this study, six of them reasonably simulate SE US summer precipitation variance in the twentieth century and the underlying physical processes; these models are thus applied for mechanistic study of future changes in SE US summer precipitation variance. In the future, the six models collectively project an intensification of SE US summer precipitation variance, resulting from the combined effects of atmospheric thermodynamics and dynamics. Between them, the latter plays a more important role. Specifically, thermodynamics results in more frequent and intensified wet summers, but does not contribute to the projected increase in the frequency and intensity of dry summers. In contrast, atmospheric dynamics explains the projected enhancement in both wet and dry summers, indicating its importance in understanding future climate change over the SE US. The results suggest that the intensified SE US summer precipitation variance is not a purely thermodynamic response to greenhouse gases forcing, and cannot be explained without the contribution of atmospheric dynamics. Our analysis provides important insights to understand the mechanisms of SE US summer precipitation variance change. The algorithm formulated in this study can be easily applied to other regions and seasons to systematically explore the mechanisms responsible for the changes in precipitation extremes in a warming climate.

Perceived cannabis use norms and cannabis use among adolescents in the United States.

Due to changes in cannabis policies, concerns about cannabis use (CU) in adolescents have increased. The population of nonwhite groups is growing quickly in the United States. We examined perceived CU norms and their association with CU and CU disorder (CUD) for White, Black, Hispanic, Native-American, Asian-American, Native Hawaiian/Pacific Islander (NH/PI), and mixed-race adolescents. Data were from adolescents (12-17 years) in the 2004-2012 National Surveys on Drug Use and Health (N = 163,837). Substance use and CUD were assessed by computer-assisted, self-interviewing methods. Blacks, Hispanics, Native-Americans, and mixed-race adolescents had greater odds of past-year CU and CUD than Whites. Among past-year cannabis users (CUs), Hispanics and Native-Americans had greater odds of having a CUD than Whites. Asian-Americans had the highest prevalence of perceived parental or close friends' CU disapproval. Native-Americans and mixed-race adolescents had lower odds than Whites of perceiving CU disapproval from parents or close friends. In adjusted analyses, adolescent's disapproval of CU, as well as perceived disapproval by parents or close friends, were associated with a decreased odds of CU in each racial/ethnic group, except for NHs/PIs. Adolescent's disapproval of CU was associated with a decreased odds of CUD among CUs for Whites (personal, parental, and close friends' disapproval), Hispanics (personal, parental, and close friends' disapproval), and mixed-race adolescents (personal, close friends' disapproval). Racial/ethnic differences in adolescent CU prevalence were somewhat consistent with adolescents' reports of CU norm patterns. Longitudinal research on CU health effects should oversample nonwhite adolescents to assure an adequate sample for analysis and reporting.