Assessment of upper tropospheric HOx sources over the tropical Pacific based on NASA GTE/PEM data: Net effect on HOx and other photochemical parameters

Data for the tropical upper troposphere (8-12 km, 20° N-20° S) collected during NASA's Pacific Exploratory Missions have been used to carry out a detailed examination of the photochemical processes controlling HOx (OH+HO2). Of particular significance is the availability of measurements of nonmethane hydrocarbons, oxygenated hydrocarbons (i.e., acetone, methanol, and ethanol) and peroxides (i.e., H2O2 and CH3OOH). These observations have provided constraints on model calculations permitting an assessment of the potential impact of these species on the levels of HOx, CH3O2, CH2O, as well as ozone budget parameters. Sensitivity calculations using a time-dependent photochemical box model show that when constrained by measured values of the above oxygenated species, model estimated HOx levels are elevated relative to unconstrained calculations. The impact of constraining these species was found to increase with altitude, reflecting the systematic roll-off in water vapor mixing ratios with altitude. At 11-12 km, overall increases in HOx approached a factor of 2 with somewhat larger increases being found for gross and net photochemical production of ozone. While significant, the impact on HOx due to peroxides appears to be less than previously estimated. In particular, observations of elevated H2O2 levels may be more influenced by local photochemistry than by convective transport. Issues related to the uncertainty in high-altitude water vapor levels and the possibility of other contributing sources of HOx are discussed. Finally, it is noted that the uncertainties in gas kinetic rate coefficients at the low temperatures of the upper troposphere and as well as OH sensor calibrations should be areas of continued investigation. Copyright 1999 by the American Geophysical Union

Caregivers' perceived adequacy of support in end-stage lung disease: results of a population survey.

BACKGROUND: End-stage lung disease (ESLD) is a frequent cause of death. What are the differences in the supports needed by caregivers of individuals with ESLD at end of life versus other life-limiting diagnoses? METHODS: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey. In 2002, 2003 and 2005-2007, respondents were asked a range of questions about end-of-life care; there were approximately 3000 survey participants annually (participation rate 77.9%). Responses were standardised for the whole population. The families and friends who cared for someone with ESLD were the focus of this analysis. In addition to describing caring, respondents reported additional support that would have been helpful. RESULTS: Of 1504 deaths reported, 145 (9.6%) were due to ESLD. The ESLD cohort were older than those with other 'expected' causes of death (> 65 years of age; 92.6% versus 70.6%; p < 0.0001) and were less likely to access specialised palliative care services (38.4% versus 61.9%; p < 0.0001). For those with ESLD, the mean caring period was significantly longer at 25 months (standard deviation (SD) 24) than for 'other diagnoses' (15 months; SD 18; p < 0.0001). Domains where additional support would have been useful included physical care, information provision, and emotional and spiritual support. CONCLUSIONS: Caregiver needs were similar regardless of the underlying diagnosis although access to palliative care specialist services occurred less often for ESLD patients. This was despite significantly longer periods of time for which care was provided.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Evolution and chemical consequences of lightning-produced NOx observed in the North Atlantic upper troposphere

Airborne observations of NO during the Subsonics Assessment Ozone and Nitrogen Oxides Experiment (SONEX) reveal episodes of high NOx in the upper troposphere believed to be associated with lightning. Linkage to specific periods of lightning activity is possible through back trajectories and data from the National Lightning Detection Network. Lagrangian model calculations are used to explore the evolution of these high NOx plumes over the 1-2 days between their introduction and subsequent sampling by NASA's DC-8 aircraft. Simulations include expected changes in HNO3, H2O2, CH3OOH, HO2, and OH. Depending on the time of injection and dilution rate, initial NOx concentrations are estimated to range from 1 to 7 ppbv. Similar to many previous studies, simulated HNO3 concentrations tend to be greater than observations. Several possible explanations for this difference are explored. H2O2 observations are shown to be consistent with removal in convective activity. While it is possible that upper tropospheric CH3OOH is enhanced by convection, simulations show such increases in CH3OOH can be short-lived (e.g., &lt; 12 hours) with no perceptible trace remaining at the time of sampling. High NO levels further prevent elevated levels of CH3OOH from propagating into increases in H2O2. HO2 is suppressed through reaction with NO in all cases. Simulated increases in OH exceeded a factor of 2 for some cases, but for the highest NOx levels, loss of OH via OH+NO2 offset production from HO2+NO. Additional increases in OH of 30-60% could result from convection of CH3OOH. A final point of discussion concerns how the chemistry within these plumes, their long-range transport, and their potential importance in sustaining background NOx far from source regions present a challenge to global and regional model simulations. Copyright 2000 by the American Geophysical Union

Palliative medicine practitioners' views on the concept of depression in the palliative care setting

Background: Despite its clinical importance in palliative care, depression remains an ambiguous concept. Objective: The purpose of this study was to explore how medical practitioners working in palliative care conceptualize depression in that setting. Design: Medical practitioners who attended a palliative medicine conference (N=185) were invited to respond to a questionnaire, which explored their views on the concept of depression in the palliative care context. Descriptive statistics were used to summarize responses, and comparison between groups was conducted using nonparametric statistics. Themes in free-text comments were identified. Results: Seventy-nine responses were obtained (response rate 43%). Depression was not a unified concept, but was generally considered to be an illness with psychological, spiritual, and existential causes. Respondents were more uncertain about depression being an illness in the palliative care setting compared with other settings, and were ambivalent about its causality. Treatment preferences leaned towards psychological interventions. Depression being different in the palliative care setting was a theme. It was considered to be more prevalent, different in quality, harder to define, and associated with greater barriers to diagnosis and treatment. Conceptual differences were associated with the respondents' area of work, work position, duration of practice, and previous mental health training. Conclusions: Depression in the palliative care setting is a variable concept for palliative medicine practitioners. The conceptual diversity and complexities of depression in this setting must be acknowledged and further explored in order to develop nuanced approaches in clinical practice and in research.Felicity Ng, Gregory B. Crawford and Anna Chur-Hanse

Implications of large scale shifts in tropospheric NOx levels in the remote tropical Pacific

A major observation recorded during NASA's western Pacific Exploratory Mission (PEM-West B) was the large shift in tropical NO levels as a function of geographical location. High-altitude NO levels exceeding 100 pptv were observed during portions of tropical flights 5-8, while values almost never exceeded 20 pptv during tropical flights 9 and 10. The geographical regions encompassing these two flight groupings are here labeled "high" and "low" NOx regimes. A comparison of these two regimes, based on back trajectories and chemical tracers, suggests that air parcels in both were strongly influenced by deep convection. The low NOx regime appears to have been predominantly impacted by marine convection, whereas the high NOx regime shows evidence of having been more influenced by deep convection over a continental land mass. DMSP satellite observations point strongly toward lightning as the major source of NOx in the latter regime. Photochemical ozone formation in the high NOx regime exceeded that for low NOx by factors of 2 to 6, whereas O3 destruction in the low NOx regime exceeded that for high NOx by factors of up to 3. Taking the tropopause height to be 17 km, estimates of the net photochemical effect on the O3 column revealed that the high NOx regime led to a small net production. By contrast, the low NOx regime was shown to destroy O3 at the rate of 3.4% per day. One proposed mechanism for off-setting this projected large deficit would involve the transport of O3 rich midlatitude air into the tropics. Alternatively, it is suggested that O3 within the tropics may be overall near self-sustaining with respect to photochemical activity. This scenario would require that some tropical regions, unsampled at the time of PEM-B, display significant net column O3 production, leading to an overall balanced budget for the "greater" tropical Pacific basin. Details concerning the chemical nature of such regimes are discussed

An assessment of ozone photochemistry in the extratropical western North Pacific: Impact of continental outflow during the late winter/early spring

This study examines the influence of photochemical processes on tropospheric ozone distributions over the extratropical western North Pacific. The analysis presented ere is based on data collected during the Pacific Exploratory Mission-West Phase B (PEM-West B) field study conducted in February-March 1994. Sampling in the study region involved altitudes of 0-12 km and latitudes of 10°S to 50°N. The extratropical component of the data set (i.e., 20-50°N) was defined by markedly different photochemical environments north and south of 30°N. This separation was clearly defined by an abrupt decrease in the tropopause height near 30°N and a concomitant increase in total O3 column density. This shift in overhead O3 led to highly reduced rates of O3 formation and destruction for the 30-50°N latitude regime. Both latitude ranges, however, stili exhibited net O3 production at all altitudes. Of special significance was the finding that net O3 production prevailed even at boundary layer and lower free tropospheric altitudes (e.g., &lt; 4 km), a condition uncommon to Pacific marine environments. These results reflect the strong impact of continental outflow of O3 precursors (e.g., NO and NMHCs) into the northwestern Pacific Basin. Comparisons with PEM-West A, which sampled the same region in a different season (September-October), revealed major differences at altitudes below 4 km, the altitude range most influenced by continental outflow. The resulting net rate of increase in the tropospheric O3 column for PEM-West B was 1-3% per day, while for PEM-West A it was approximately zero. Unique to the PEM-West B study is the finding that even under wintertime conditions substantial column production of tropospheric O3 can occur at subtropical and mid-latitudes. While such impacts may not be totally unexpected at near coast locations, the present study suggests that the impact from continental outflow on the marine BL could extend out to distances of more than 2000 km from the Asian Pacific Rim

OH and HO2 chemistry in the North Atlantic free troposphere

Interactions between atmospheric hydrogen oxides and aircraft nitrogen oxides determine the impact of aircraft exhaust on atmospheric chemistry. To study these interactions, the Subsonic Assessment: Ozone and Nitrogen Oxide Experiment (SONEX) assembled the most complete measurement complement to date for studying HO(x) (OH and HO2) chemistry in the free troposphere. Observed and modeled HO(x) agree on average to within experimental uncertainties (±40%). However, significant discrepancies occur as a function of NO and at solar zenith angles &gt;70°. Some discrepancies appear to be removed by model adjustments to HO(x)-NO(x) chemistry, particularly by reducing HO2NO2 (PNA) and by including heterogeneous reactions on aerosols and cirrus clouds

Assessment of ozone photochemistry in the western North Pacific as inferred from PEM-West A observations during the fall 1991

This study examines the influence of photochemical processes on ozone distributions in the western North Pacific. The analysis is based on data generated during NASA's western Pacific Exploratory Mission (PEM-West A) during the fall of 1991. Ozone trends were best described in terms of two geographical domains: the western North Pacific rim (WNPR) and the western tropical North Pacific (WTNP). For both geographical regions, ozone photochemical destruction, D(O3), decreased more rapidly with altitude than did photochemical formation, F(O3). Thus the ozone tendency, P(O3), was typically found to be negative for z &lt;6 km and positive for z &gt; 6-8 km. For nearly all altitudes and latitudes, observed nonmethane hydrocarbon (NMHC) levels were shown to be of minor importance as ozone precursor species. Air parcel types producing the largest positive values of P(O3) included fresh continental boundary layer (BL) air and high-altitude (z &gt; 7 km) parcels influenced by deep convection/lightning. Significant negative P(O3) values were found when encountering clean marine BL air or relatively clean lower free-tropospheric air. Photochemical destruction and formation fluxes for the Pacific rim region were found to exceed average values cited for marine dry deposition and stratospheric injection in the northern hemisphere by nearly a factor of 6. This region was also found to be in near balance with respect to column-integrated O3 photochemical production and destruction. By contrast, for the tropical regime column-integrated O3 showed photochemical destruction exceeding production by nearly 80%. Both transport of O3 rich midlatitude air into the tropics as well as very high-altitude (10-17 km) photochemical O3 production were proposed as possible additional sources that might explain this estimated deficit. Results from this study further suggest that during the fall time period, deep convection over Asia and Malaysia/Indonesia provided a significant source of high-altitude NOx to the western Pacific. Given that the high-altitude NOx lifetime is estimated at between 3 and 9 days, one would predict that this source added significantly to high altitude photochemical O3 formation over large areas of the western Pacific. When viewed in terms of strong seasonal westerly flow, its influence would potentially span a large part of the Pacific. Copyright 1996 by the American Geophysical Union