920 resultados para Medical climatology
Resumo:
Northern Hemisphere cyclone activity is assessed by applying an algorithm for the detection and tracking of synoptic scale cyclones to mean sea level pressure data. The method, originally developed for the Southern Hemisphere, is adapted for application in the Northern Hemisphere winter season. NCEP-Reanalysis data from 1958/59 to 1997/98 are used as input. The sensitivities of the results to particular parameters of the algorithm are discussed for both case studies and from a climatological point of view. Results show that the choice of settings is of major relevance especially for the tracking of smaller scale and fast moving systems. With an appropriate setting the algorithm is capable of automatically tracking different types of cyclones at the same time: Both fast moving and developing systems over the large ocean basins and smaller scale cyclones over the Mediterranean basin can be assessed. The climatology of cyclone variables, e.g., cyclone track density, cyclone counts, intensification rates, propagation speeds and areas of cyclogenesis and -lysis gives detailed information on typical cyclone life cycles for different regions. The lowering of the spatial and temporal resolution of the input data from full resolution T62/06h to T42/12h decreases the cyclone track density and cyclone counts. Reducing the temporal resolution alone contributes to a decline in the number of fast moving systems, which is relevant for the cyclone track density. Lowering spatial resolution alone mainly reduces the number of weak cyclones.
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The climatology of ozone produced by the Canadian Middle Atmosphere Model (CMAM) is presented. This three-dimensional global model incorporates the radiative feedbacks of ozone and water vapor calculated on-line with a photochemical module. This module includes a comprehensive gas-phase reaction set and a limited set of heterogeneous reactions to account for processes occurring on background sulphate aerosols. While transport is global, photochemistry is solved from about 400 hPa to the top of the model at ∼95 km. This approach provides a complete and comprehensive representation of transport, emission, and photochemistry of various constituents from the surface to the mesopause region. A comparison of model results with observations indicates that the ozone distribution and variability are in agreement with observations throughout most of the model domain. Column ozone annual variation is represented to within 5–10% of the observations except in the Southern Hemisphere for springtime high latitudes. The vertical ozone distribution is generally well represented by the model up to the mesopause region. Nevertheless, in the upper stratosphere, the model generally underestimates the amount of ozone as well as the latitudinal tilting of ozone isopleths at high latitude. Ozone variability is analyzed and compared with measurements. The comparison shows that the phase and amplitude of the seasonal variation as well as shorter timescale variations are well represented by the model at various latitudes and heights. Finally, the impact of incorporating ozone radiative feedback on the model climatology is isolated. It is found that the incorporation of ozone radiative feedback results in a cooling of ∼8 K in the summer stratopause region, which corrects a warm bias that results when climatological ozone is used.
Resumo:
The Canadian Middle Atmosphere Modelling (MAM) project is a collaboration between thé Atmospheric Environment Service (AES) of Environment Canada and several Canadian universities. Its goal is thé development of a comprehensive General Circulation Model of the troposphere-stratosphere-mesosphere System, starting from the AES/CCCma third-generation atmospheric General Circulation Model. This paper describes the basic features of the first-generation Canadian MAM and some aspects of its radiative-dynamical climatology. Standard first-order mean diagnostics are presented for monthly means and for the annual cycle of zonal-mean winds and temperatures. The mean meridional circulation is examined, and comparison is made between thé steady diabatic, downward controlled, and residual stream functions. It is found that downward control holds quite well in the monthly mean through most of the middle atmosphere, even during equinoctal periods. The relative roles of different drag processes in determining the mean downwelling over the wintertime polar middle stratosphere is examined, and the vertical structure of the drag is quantified.
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Introduction. Feature usage is a pre-requisite to realising the benefits of investments in feature rich systems. We propose that conceptualising the dependent variable 'system use' as 'level of use' and specifying it as a formative construct has greater value for measuring the post-adoption use of feature rich systems. We then validate the content of the construct as a first step in developing a research instrument to measure it. The context of our study is the post-adoption use of electronic medical records (EMR) by primary care physicians. Method. Initially, a literature review of the empirical context defines the scope based on prior studies. Having identified core features from the literature, they are further refined with the help of experts in a consensus seeking process that follows the Delphi technique. Results.The methodology was successfully applied to EMRs, which were selected as an example of feature rich systems. A review of EMR usage and regulatory standards provided the feature input for the first round of the Delphi process. A panel of experts then reached consensus after four rounds, identifying ten task-based features that would be indicators of level of use. Conclusions. To study why some users deploy more advanced features than others, theories of post-adoption require a rich formative dependent variable that measures level of use. We have demonstrated that a context sensitive literature review followed by refinement through a consensus seeking process is a suitable methodology to validate the content of this dependent variable. This is the first step of instrument development prior to statistical confirmation with a larger sample.
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A method of classifying the upper tropospheric/lower stratospheric (UTLS) jets has been developed that allows satellite and aircraft trace gas data and meteorological fields to be efficiently mapped in a jet coordinate view. A detailed characterization of multiple tropopauses accompanies the jet characterization. Jet climatologies show the well-known high altitude subtropical and lower altitude polar jets in the upper troposphere, as well as a pattern of concentric polar and subtropical jets in the Southern Hemisphere, and shifts of the primary jet to high latitudes associated with blocking ridges in Northern Hemisphere winter. The jet-coordinate view segregates air masses differently than the commonly-used equivalent latitude (EqL) coordinate throughout the lowermost stratosphere and in the upper troposphere. Mapping O3 data from the Aura Microwave Limb Sounder (MLS) satellite and the Winter Storms aircraft datasets in jet coordinates thus emphasizes different aspects of the circulation compared to an EqL-coordinate framework: the jet coordinate reorders the data geometrically, thus highlighting the strong PV, tropopause height and trace gas gradients across the subtropical jet, whereas EqL is a dynamical coordinate that may blur these spatial relationships but provides information on irreversible transport. The jet coordinate view identifies the concentration of stratospheric ozone well below the tropopause in the region poleward of and below the jet core, as well as other transport features associated with the upper tropospheric jets. Using the jet information in EqL coordinates allows us to study trace gas distributions in regions of weak versus strong jets, and demonstrates weaker transport barriers in regions with less jet influence. MLS and Atmospheric Chemistry Experiment-Fourier Transform Spectrometer trace gas fields for spring 2008 in jet coordinates show very strong, closely correlated, PV, tropopause height and trace gas gradients across the jet, and evidence of intrusions of stratospheric air below the tropopause below and poleward of the subtropical jet; these features are consistent between instruments and among multiple trace gases. Our characterization of the jets is facilitating studies that will improve our understanding of upper tropospheric trace gas evolution.
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The results of coupled high resolution global models (CGCMs) over South America are discussed. HiGEM1.2 and HadGEM1.2 simulations, with horizontal resolution of ~90 and 135 km, respectively, are compared. Precipitation estimations from CMAP (Climate Prediction Center—Merged Analysis of Precipitation), CPC (Climate Prediction Center) and GPCP (Global Precipitation Climatology Project) are used for validation. HiGEM1.2 and HadGEM1.2 simulated seasonal mean precipitation spatial patterns similar to the CMAP. The positioning and migration of the Intertropical Convergence Zone and of the Pacific and Atlantic subtropical highs are correctly simulated by the models. In HiGEM1.2 and HadGEM1.2, the intensity and locations of the South Atlantic Convergence Zone are in agreement with the observed dataset. The simulated annual cycles are in phase with estimations of rainfall for most of the six regions considered. An important result is that HiGEM1.2 and HadGEM1.2 eliminate a common problem of coarse resolution CGCMs, which is the simulation of a semiannual cycle of precipitation due to the semiannual solar forcing. Comparatively, the use of high resolution in HiGEM1.2 reduces the dry biases in the central part of Brazil during austral winter and spring and in most part of the year over an oceanic box in eastern Uruguay.
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A global climatology (1979–2012) from the Modern-Era Retrospective Analysis for Research and Applications (MERRA) shows distributions and seasonal evolution of upper tropospheric jets and their relationships to the stratospheric subvortex and multiple tropopauses. The overall climatological patterns of upper tropospheric jets confirm those seen in previous studies, indicating accurate representation of jet stream dynamics in MERRA. The analysis shows a Northern Hemisphere (NH) upper tropospheric jet stretching nearly zonally from the mid-Atlantic across Africa and Asia. In winter–spring, this jet splits over the eastern Pacific, merges again over eastern North America, and then shifts poleward over the North Atlantic. The jets associated with tropical circulations are also captured, with upper tropospheric westerlies demarking cyclonic flow downstream from the Australian and Asian monsoon anticyclones and associated easterly jets. Multiple tropopauses associated with the thermal tropopause “break” commonly extend poleward from the subtropical upper tropospheric jet. In Southern Hemisphere (SH) summer, the tropopause break, along with a poleward-stretching secondary tropopause, often occurs across the tropical westerly jet downstream of the Australian monsoon region. SH high-latitude multiple tropopauses, nearly ubiquitous in June–July, are associated with the unique polar winter thermal structure. High-latitude multiple tropopauses in NH fall–winter are, however, sometimes associated with poleward-shifted upper tropospheric jets. The SH subvortex jet extends down near the level of the subtropical jet core in winter and spring. Most SH subvortex jets merge with an upper tropospheric jet between May and December; although much less persistent than in the SH, merged NH subvortex jets are common between November and April.
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African societies are dependent on rainfall for agricultural and other water-dependent activities, yet rainfall is extremely variable in both space and time and reoccurring water shocks, such as drought, can have considerable social and economic impacts. To help improve our knowledge of the rainfall climate, we have constructed a 30-year (1983–2012), temporally consistent rainfall dataset for Africa known as TARCAT (TAMSAT African Rainfall Climatology And Time-series) using archived Meteosat thermal infra-red (TIR) imagery, calibrated against rain gauge records collated from numerous African agencies. TARCAT has been produced at 10-day (dekad) scale at a spatial resolution of 0.0375°. An intercomparison of TARCAT from 1983 to 2010 with six long-term precipitation datasets indicates that TARCAT replicates the spatial and seasonal rainfall patterns and interannual variability well, with correlation coefficients of 0.85 and 0.70 with the Climate Research Unit (CRU) and Global Precipitation Climatology Centre (GPCC) gridded-gauge analyses respectively in the interannual variability of the Africa-wide mean monthly rainfall. The design of the algorithm for drought monitoring leads to TARCAT underestimating the Africa-wide mean annual rainfall on average by −0.37 mm day−1 (21%) compared to other datasets. As the TARCAT rainfall estimates are historically calibrated across large climatically homogeneous regions, the data can provide users with robust estimates of climate related risk, even in regions where gauge records are inconsistent in time.
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Diatom, geochemical and isotopic data provide a record of environmental change in Laguna La Gaiba, lowland Bolivia (17°450S, 57°350W), over the last ca. 25 000 years. High-resolution diatom analysis around the Last Glacial–Interglacial Transition provides new insights into this period of change. The full and late glacial lake was generally quite shallow, but with evidence of periodic flooding. At about 13 100 cal a BP, just before the start of the Younger Dryas chronozone, the diatoms indicate shallower water conditions, but there is a marked change at about 12 200 cal a BP indicating the onset of a period of high variability, with rising water levels punctuated by periodic drying. From ca. 11 800 to 10 000 cal a BP, stable, deeper water conditions persisted. There is evidence for drying in the early to middle Holocene, but not as pronounced as that reported from elsewhere in the southern hemisphere tropics of South America. This was followed by the onset of wetter conditions in the late Holocene consistent with insolation forcing. Conditions very similar to present were established about 2100 cal a BP. A complex response to both insolation forcing and millennial-scale events originating in the North Atlantic is noted.
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Knowledge recommendation has become a promising method in supporting the clinicians decisions and improving the quality of medical services in the constantly changing clinical environment. However, current medical knowledge management systems cannot understand users requirements accurately and realize personalized recommendation. Therefore this paper proposes an ontological approach based on semiotic principles to personalized medical knowledge recommendations. In particular, healthcare domain knowledge is conceptualized and an ontology-based user profile is built. Furthermore, the personalized recommendation mechanism is illustrated.
Resumo:
Knowledge management has become a promising method in supporting the clinicians′ decisions and improving the quality of medical services in the constantly changing clinical environment. However, current medical knowledge management systems cannot understand users′ requirements accurately and realize personalized matching. Therefore this paper proposes an ontological approach based on semiotic principles to personalized medical knowledge matching. In particular, healthcare domain knowledge is conceptualized and an ontology-based user profile is built. Furthmore, the personalized matching mechanism and algorithm are illustrated.
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Biological models of an apoptotic process are studied using models describing a system of differential equations derived from reaction kinetics information. The mathematical model is re-formulated in a state-space robust control theory framework where parametric and dynamic uncertainty can be modelled to account for variations naturally occurring in biological processes. We propose to handle the nonlinearities using neural networks.
Resumo:
Objectives Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. Methods Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. Key findings In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. Conclusion The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.