Evaluation of HOAPS-3 ocean surface freshwater flux components

Today, latent heat flux and precipitation over the global ocean surface can be determined from microwave satellite data as a basis for estimating the related fields of the ocean surface freshwater flux. The Hamburg Ocean Atmosphere Parameters and Fluxes from Satellite Data (HOAPS) is the only generally available satellite-based dataset with consistently derived global fields of both evaporation and precipitation and hence of freshwater flux for the period 1987–2005. This paper presents a comparison of the evaporation E, precipitation P, and the resulting freshwater flux E − P in HOAPS with recently available reference datasets from reanalysis and other satellite observation projects as well as in situ ship measurements. In addition, the humidity and wind speed input parameters for the evaporation are examined to identify sources for differences between the datasets. Results show that the general climatological patterns are reproduced by all datasets. Global mean time series often agree within about 10% of the individual products, while locally larger deviations may be found for all parameters. HOAPS often agrees better with the other satellite-derived datasets than with the in situ or the reanalysis data. The agreement usually improves in regions of good in situ sampling statistics. The biggest deviations of the evaporation parameter result from differences in the near-surface humidity estimates. The precipitation datasets exhibit large differences in highly variable regimes with the largest absolute differences in the ITCZ and the largest relative biases in the extratropical storm-track regions. The resulting freshwater flux estimates exhibit distinct differences in terms of global averages as well as regional biases. In comparison with long-term mean global river runoff data, the ocean surface freshwater balance is not closed by any of the compared fields. The datasets exhibit a positive bias in E − P of 0.2–0.5 mm day−1, which is on the order of 10% of the evaporation and precipitation estimates

Intercomparison of freshwater fluxes over ocean and investigations into water budget closure

The development of algorithms for the retrieval of water cycle components from satellite data – such as total column water vapor content (TCWV), precipitation (P), latent heat flux, and evaporation (E) – has seen much progress in the past 3 decades. In the present study, we compare six recent satellite-based retrieval algorithms and ERA5 (the European Centre for Medium-Range Weather Forecasts' fifth reanalysis) freshwater flux (E−P) data regarding global and regional, seasonal and interannual variation to assess the degree of correspondence among them. The compared data sets are recent, freely available, and documented climate data records (CDRs), developed with a focus on stability and homogeneity of the time series, as opposed to instantaneous accuracy. One main finding of our study is the agreement of global ocean means of all E−P data sets within the uncertainty ranges of satellite-based data. Regionally, however, significant differences are found among the satellite data and with ERA5. Regression analyses of regional monthly means of E, P, and E−P against the statistical median of the satellite data ensemble (SEM) show that, despite substantial differences in global E patterns, deviations among E−P data are dominated by differences in P throughout the globe. E−P differences among data sets are spatially inhomogeneous. We observe that for ERA5 long-term global E−P is very close to 0 mm d−1 and that there is good agreement between land and ocean mean E−P, vertically integrated moisture flux divergence (VIMD), and global TCWV tendency. The fact that E and P are balanced globally provides an opportunity to investigate the consistency between E and P data sets. Over ocean, P (nearly) balances with E if the net transport of water vapor from ocean to land (approximated by over-ocean VIMD, i.e., ∇⋅(vq)ocean) is taken into account. On a monthly timescale, linear regression of Eocean−∇⋅(vq)ocean with Pocean yields R2=0.86 for ERA5, but smaller R2 values are found for satellite data sets. Global yearly climatological totals of water cycle components (E, P, E−P, and net transport from ocean to land and vice versa) calculated from the data sets used in this study are in agreement with previous studies, with ERA5 E and P occupying the upper part of the range. Over ocean, both the spread among satellite-based E and the difference between two satellite-based P data sets are greater than E−P, and these remain the largest sources of uncertainty within the observed global water budget. We conclude that, for a better understanding of the global water budget, the quality of E and P data sets needs to be improved, and the uncertainties more rigorously quantified

Acute maternal stress in pregnancy and schizophrenia in offspring: A cohort prospective study

Schizophrenia has been linked with intrauterine exposure to maternal stress due to bereavement, famine and major disasters. Recent evidence suggests that human vulnerability may be greatest in the first trimester of gestation and rodent experiments suggest sex specificity. We aimed to describe the consequence of an acute maternal stress, through a follow-up of offspring whose mothers were pregnant during the Arab-Israeli war of 1967. A priori, we focused on gestational month and offspring's sex. Method: In a pilot study linking birth records to Israel's Psychiatric Registry, we analyzed data from a cohort of 88,829 born in Jerusalem in 1964–76. Proportional hazards models were used to estimate the relative risk (RR) of schizophrenia, according to month of birth, gender and other variables, while controlling for father's age and other potential confounders. Other causes of hospitalized psychiatric morbidity (grouped together) were analyzed for comparison. Results: There was a raised incidence of schizophrenia for those who were in the second month of fetal life in June 1967 (RR = 2.3, 1.1–4.7), seen more in females (4.3, 1.7–10.7) than in males (1.2, 0.4–3.8). Results were not explained by secular or seasonal variations, altered birth weight or gestational age. For other conditions, RRs were increased in offspring who had been in the third month of fetal life in June 1967 (2.5, 1.2–5.2), also seen more in females (3.6, 1.3–9.7) than males (1.8, 0.6–5.2). Conclusion: These findings add to a growing literature, in experimental animals and humans, attributing long term consequences for offspring of maternal gestational stress. They suggest both a sex-specificity and a relatively short gestational time-window for gestational effects on vulnerability to schizophrenia

The STRATOB study: design of a randomized controlled clinical trial of Cognitive Behavioral Therapy and Brief Strategic Therapy with telecare in patients with obesity and binge-eating disorder referred to residential nutritional rehabilitation

bstract BACKGROUND: Overweight and obesity are linked with binge eating disorder (BED). Effective interventions to significantly reduce weight, maintain weight loss and manage associated pathologies like BED are typically combined treatment options (dietetic, nutritional, physical, behavioral, cognitive-behavioral, pharmacological, surgical). Significant difficulties with regard to availability, costs, treatment adherence and long-term efficacy are present. Particularly Cognitive Behavioral Therapy (CBT) is the therapeutic approach indicated both in in-patient and in out-patient settings for BED. In recent years systemic and systemic-strategic psychotherapies have been implemented to treat patients with obesity and BED involved in familiar problems. Particularly a brief protocol for the systemic-strategic treatment of BED, using overall the strategic dialogue, has been recently developed. Moreover telemedicine, a new promising low cost method, has been used for obesity with BED in out-patient settings in order to avoid relapse after the in-patient step of treatment and to keep on a continuity of care with the involvement of the same clinical in-patient team. METHODS: The comparison between CBT and Brief Strategic Therapy (BST) will be assessed in a two-arm randomized controlled clinical trial. Due to the novelty of the application of BST in BED treatment (no other RCTs including BST have been carried out), a pilot study will be carried out before conducting a large scale randomized controlled clinical trial (RCT). Both CBT and BST group will follow an in-hospital treatment (diet, physical activity, dietitian counseling, 8 psychological sessions) plus 8 out-patient telephone-based sessions of psychological support and monitoring with the same in-patient psychotherapists. Primary outcome measure of the randomized trial will be the change in the Global Index of the Outcome Questionnaire (OQ-45.2). Secondary outcome measures will be the percentage of BED patients remitted considering the number of weekly binge episodes and the weight loss. Data will be collected at baseline, at discharge from the hospital (c.a. 1 month after) and after 6-12-24 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through tele-sessions. DISCUSSION: The STRATOB (Systemic and STRATegic psychotherapy for OBesity), a comprehensive two-phase stepped down program enhanced by telepsychology for the medium-term treatment of obese people with BED seeking intervention for weight loss, will shed light about the comparison of the effectiveness of the BST with the gold standard CBT and about the continuity of care at home using a low-level of telecare (mobile phones). TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT0109625

Can mental health diagnoses in administrative data be used for research? A systematic review of the accuracy of routinely collected diagnoses

BACKGROUND: There is increasing availability of data derived from diagnoses made routinely in mental health care, and interest in using these for research. Such data will be subject to both diagnostic (clinical) error and administrative error, and so it is necessary to evaluate its accuracy against a reference-standard. Our aim was to review studies where this had been done to guide the use of other available data. METHODS: We searched PubMed and EMBASE for studies comparing routinely collected mental health diagnosis data to a reference standard. We produced diagnostic category-specific positive predictive values (PPV) and Cohen’s kappa for each study. RESULTS: We found 39 eligible studies. Studies were heterogeneous in design, with a wide range of outcomes. Administrative error was small compared to diagnostic error. PPV was related to base rate of the respective condition, with overall median of 76 %. Kappa results on average showed a moderate agreement between source data and reference standard for most diagnostic categories (median kappa = 0.45–0.55); anxiety disorders and schizoaffective disorder showed poorer agreement. There was no significant benefit in accuracy for diagnoses made in inpatients. CONCLUSIONS: The current evidence partly answered our questions. There was wide variation in the quality of source data, with a risk of publication bias. For some diagnoses, especially psychotic categories, administrative data were generally predictive of true diagnosis. For others, such as anxiety disorders, the data were less satisfactory. We discuss the implications of our findings, and the need for researchers to validate routine diagnostic data. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-016-0963-x) contains supplementary material, which is available to authorized users