Regional differences in the response of rainfall to convectively coupled Kelvin waves over tropical Africa

The representation of convection remains one of the most important sources of bias in global models and evaluation methods are needed that show that models provide the correct mean state and variability; both for the correct reasons. Here we develop a novel approach for evaluating rainfall variability due to CCKWs in this region. A phase cycle was defined for the CCKW cycle in OLR and used to composite rainfall anomalies. We characterize the observed (TRMM) rainfall response to CCKWs over tropical Africa in April and evaluate the performance of regional climate model (RCM) simulations: a parameterized convection simulation (P25) and the first pan-Africa convection permitting simulation (CP4). TRMM mean rainfall is enhanced and suppressed by CCKW activity and the occurrence of extreme rainfall and dry days is coupled with CCKW activity. Focusing on regional differences, we show for the first time that: there is a dipole between West Africa and the Gulf of Guinea involving onshore/offshore shifts in rainfall; and the transition to enhanced rainfall over west equatorial Africa occurs one phase before the transition over east equatorial Africa. The global model used to drive the RCMs simulated CCKWs with mean amplitudes of 75%-82% of observations. The RCMs simulated coherent responses to the CCKWs and captured the large-scale spatial patterns and phase relationships in rainfall although the simulated rainfall response is weaker than observations and there are regional biases which are bigger away from the equator. P25 produced a closer match to TRMM mean rainfall anomalies than CP4 although the response in dry days was more closely simulated by CP4

Prayer, personality and happiness: a study among undergraduate students in Wales

In order to examine the association between prayer and happiness, a sample of 131 undergraduate students attending a university in Wales completed three measures: the Oxford Happiness Questionnaire, the abbreviated Eysenck Personality Questionnaire Revised, and prayer frequency assessed on a 5-point scale. The data demonstrated a significant positive correlation between prayer frequency and happiness before controlling for individual differences in personality. After controlling for personality, however, this apparent association vanished

Psychological type and prayer preferences: a study among Anglican clergy in the United Kingdom

This study applies the framework of Jungian psychological type theory to define eight aspects of prayer preference, namely: introverted prayer, extraverted prayer, sensing prayer, intuitive prayer, feeling prayer, thinking prayer, judging prayer, and perceiving prayer. On the basis of data provided by 1,476 newly ordained Anglican clergy from England, Ireland, Scotland, and Wales, eight 7-item scales were developed to access these aspects of prayer preferences. Significant correlations were found between each prayer preference and the relevant aspect of psychological type accessed by the Keirsey Temperament Sorter. These data support the theory that psychological type influences the way in which people pray

The INCLUDE study: INtegrating and improving Care for patients with infLammatory rheUmatological DisordErs in the community; identifying multimorbidity: Protocol for a pilot randomized controlled trial.

Background: Patients with inflammatory rheumatic conditions such as rheumatoid arthritis, polymyalgia rheumatica and ankylosing spondylitis are at increased risk of common comorbidities such as cardiovascular disease, osteoporosis and anxiety and depression which lead to increased morbidity and mortality. These associated morbidities are often un-recognized and under-treated. While patients with other long-term conditions such as diabetes are invited for routine reviews in primary care, which may include identification and management of co-morbidities, at present this does not occur for patients with inflammatory conditions, and thus, opportunities to diagnose and optimally manage these comorbidities are missed. Objective: To evaluate the feasibility and acceptability of a nurse-led integrated care review (the INtegrating and improving Care for patients with infLammatory rheUmatological DisordErs in the community (INCLUDE) review) for people with inflammatory rheumatological conditions in primary care. Design: A pilot cluster randomized controlled trial will be undertaken to test the feasibility and acceptability of a nurse-led integrated primary care review for identification, assessment and initial management of common comorbidities including cardiovascular disease, osteoporosis and anxiety and depression. A process evaluation will be undertaken using a mixed methods approach including participant self-reported questionnaires, a medical record review, an INCLUDE EMIS template, intervention fidelity checking using audio-recordings of the INCLUDE review consultation and qualitative interviews with patient participants, study nurses and study general practitioners (GPs). Discussion: Success of the pilot study will be measured against the engagement, recruitment and study retention rates of both general practices and participants. Acceptability of the INCLUDE review to patients and practitioners and treatment fidelity will be explored using a parallel process evaluation. Trial Registration: ISRCTN12765345

Implications of improved representation of convection for the East Africa water budget using a convection-permitting model

The precipitation and diabatic heating resulting from moist convection make it a key component of the atmospheric water budget in the tropics. With convective parametrisation being a known source of uncertainty in global models, convection-permitting (CP) models are increasingly being used to improve understanding of regional climate. Here, a new 10-year CP simulation is used to study the characteristics of rainfall and atmospheric water budget for East Africa and the Lake Victoria basin. The explicit representation of convection leads to a widespread improvement in the intensities and diurnal cycle of rainfall when compared with a parametrised simulation. Differences in large-scale moisture fluxes lead to a shift in the mean rainfall pattern from the Congo to Lake Victoria basin in the CP simulation - highlighting the important connection between local changes in the representation of convection and larger scale dynamics and rainfall. Stronger lake-land contrasts in buoyancy in the CP model lead to a stronger nocturnal land breeze over Lake Victoria, increasing evaporation and moisture flux convergence (MFC), and likely unrealistically high rainfall. However, for the mountains east of the lake, the CP model produces a diurnal rainfall cycle much more similar to satellite estimates, which is related to differences in the timing of MFC. Results here demonstrate that, whilst care is needed regarding lake forcings, a CP approach offers a more realistic representation of several rainfall characteristics through a more physically-based realisation of the atmospheric dynamics around the complex topography of East Africa

Relationship of anxiety with joint pain and its management: A population survey

Objectives The aims of the present study was to examine the associations between the severity of pain and anxiety in a community population reporting joint pain, and to investigate the management of joint pain in the presence of comorbid anxiety. Methods A population survey was carried out of people aged ≥45 years, registered with eight general practices in Cheshire, Shropshire and Staffordshire, UK. Respondents were asked to report pain intensity in their hands, hips, knees and feet (on a numerical rating scale), anxiety symptoms (Generalized Anxiety Disorder seven‐item [GAD‐7] scale) and guideline‐recommended treatments used to manage pain. Clinical anxiety was defined by a GAD‐7 score of 10 or more. Results A total of 11,222 respondents with joint pain were included in the analysis, with 1,802 (16.1%) reporting clinical anxiety. Respondents reporting more severe pain were more likely to report clinical anxiety (severe versus mild pain, odds ratio [OR] 5.36, 95% confidence interval [CI] 4.56 to 6.31). The number of pain sites was also positively associated with clinical anxiety (four versus one site; OR 3.64, 95% CI 3.09 to 4.30). Those with clinical anxiety were less likely to undertake general fitness exercises (OR 0.60, 95% CI 0.52 to 0.70), but more likely to diet (OR 1.43, 95% CI 1.21 to 1.69), use walking aids (OR 1.53, 95% CI 1.32 to 1.77) and assistive devices (OR 1.24, 95% CI 1.04 to 1.49), and more likely to use opioids (OR 1.34, 95% CI 1.18 to1.52). Conclusions Anxiety is common among patients presenting to primary care with joint pain. Patients with anxiety are likely to manage their joint pain differently to those without. Case‐finding to identify and treat anxiety would be appropriate in this population, with caution about opioid prescribing and consideration of exercise as an intervention

Inference of hidden structures in complex physical systems by multi-scale clustering

We survey the application of a relatively new branch of statistical physics--"community detection"-- to data mining. In particular, we focus on the diagnosis of materials and automated image segmentation. Community detection describes the quest of partitioning a complex system involving many elements into optimally decoupled subsets or communities of such elements. We review a multiresolution variant which is used to ascertain structures at different spatial and temporal scales. Significant patterns are obtained by examining the correlations between different independent solvers. Similar to other combinatorial optimization problems in the NP complexity class, community detection exhibits several phases. Typically, illuminating orders are revealed by choosing parameters that lead to extremal information theory correlations.Comment: 25 pages, 16 Figures; a review of earlier work

Neighborhood Socioeconomic Status and Use of Colonoscopy in an Insured Population – A Retrospective Cohort Study

Background: Low-socioeconomic status (SES) is associated with a higher colorectal cancer (CRC) incidence and mortality. Screening with colonoscopy, the most commonly used test in the US, has been shown to reduce the risk of death from CRC. This study examined if, among insured persons receiving care in integrated healthcare delivery systems, differences exist in colonoscopy use according to neighborhood SES. Methods We assembled a retrospective cohort of 100,566 men and women, 50–74 years old, who had been enrolled in one of three US health plans for $\geq$ 1 year on January 1, 2000. Subjects were followed until the date of first colonoscopy, date of disenrollment from the health plan, or December 31, 2007, whichever occurred first. We obtained data on colonoscopy use from administrative records. We defined screening colonoscopy as an examination that was not preceded by gastrointestinal conditions in the prior 6-month period. Neighborhood SES was measured using the percentage of households in each subject's census-tract with an income below 1999 federal poverty levels based on 2000 US census data. Analyses, adjusted for demographics and comorbidity index, were performed using Weibull regression models. Results: The average age of the cohort was 60 years and 52.7% were female. During 449,738 person-years of follow-up, fewer subjects in the lowest SES quartile (Q1) compared to the highest quartile (Q4) had any colonoscopy (26.7% vs. 37.1%) or a screening colonoscopy (7.6% vs. 13.3%). In regression analyses, compared to Q4, subjects in Q1 were 16% (adjusted HR = 0.84, 95% CI: 0.80–0.88) less likely to undergo any colonoscopy and 30%(adjusted HR = 0.70, CI: 0.65–0.75) less likely to undergo a screening colonoscopy. Conclusion: People in lower-SES neighborhoods are less likely to undergo a colonoscopy, even among insured subjects receiving care in integrated healthcare systems. Removing health insurance barriers alone is unlikely to eliminate disparities in colonoscopy use

Design of Experiments for Screening

The aim of this paper is to review methods of designing screening experiments, ranging from designs originally developed for physical experiments to those especially tailored to experiments on numerical models. The strengths and weaknesses of the various designs for screening variables in numerical models are discussed. First, classes of factorial designs for experiments to estimate main effects and interactions through a linear statistical model are described, specifically regular and nonregular fractional factorial designs, supersaturated designs and systematic fractional replicate designs. Generic issues of aliasing, bias and cancellation of factorial effects are discussed. Second, group screening experiments are considered including factorial group screening and sequential bifurcation. Third, random sampling plans are discussed including Latin hypercube sampling and sampling plans to estimate elementary effects. Fourth, a variety of modelling methods commonly employed with screening designs are briefly described. Finally, a novel study demonstrates six screening methods on two frequently-used exemplars, and their performances are compared