Summer snow extent heralding of the winter North Atlantic Oscillation

[1] Winter climate over the North Atlantic and European sector is modulated by the North Atlantic Oscillation (NAO). We find that the summer extent of snow cover over northern North America and northern Eurasia is linked significantly (p < 0.01) to the upcoming winter NAO state. Summers with high/low snow extent precede winters of low/high NAO index phase. We suggest the linkage arises from the summer snow-associated formation of anomalous longitudinal differences in surface air temperature with the subpolar North Atlantic. Our findings indicate the seasonal predictability of North Atlantic winter climate may be higher and extend to longer leads than thought previously

Exploring the relationship between falls in long-term care and psychoactive prescribing

The author is completing the work as part of a National Education Scotland funded fellowship.Almost half of patients of nursing home residents experience one fall per year. Falls have associated significant morbidity and mortality, and a proportion of falls can be deemed avoidable. There are a variety of risk factors associated with falls, many of which are not modifiable. There has been increasing focus upon the relationship between psychotropic medications and falls as this is seen a potentially modifiable risk factor. This article reviews some of the clinical challenges about balancing falls risk mitigation strategies with the management of behavioral and psychological symptoms of dementia.Publisher PDFPeer reviewe

The impracticality of a universal drought definition

This paper demonstrates the impracticality of a comprehensive mathematical definition of the term `drought' which formalises the general qualitative definition that drought is `a deficit of water relative to normal conditions'. Starting from the local water balance, it is shown that a universal description of drought requires reference to water supply, demand and management. The influence of human intervention through water management is shown to be intrinsic to the definition of drought in the universal sense and can only be eliminated in the case of purely meteorological drought. The state of `drought' is shown to be predicated on the existence of climatological norms for a multitude of process specific terms. In general these norms are either difficult to obtain or even non-existent in the non-stationary context of climate change. Such climatological considerations, in conjunction with the difficulty of quantifying human influence, lead to the conclusion that we cannot reasonably expect the existence of any workable generalised objective definition of drought

A spatio-temporal structure-based approach to drought characterisation

Drought characterisation is an intrinsically spatio-temporal problem. A limitation of previous approaches to characterisation is that they discard much of the spatio-temporal information by reducing events to a lower-order subspace. To address this, an explicit 3-dimensional (longitude, latitude, time) structure-based method is described in which drought events are defined by a spatially and temporarily coherent set of points displaying standardised precipitation below a given threshold. Geometric methods can then be used to measure similarity between individual drought structures. Groupings of these similarities provide an alternative to traditional methods for extracting recurrent space-time signals from geophysical data. The explicit consideration of structure encourages the construction of summary statistics which relate to the event geometry. Example measures considered are the event volume, centroid, and aspect ratio. The utility of a 3-dimensional approach is demonstrated by application to the analysis of European droughts (15 °W to 35°E, and 35 °N to 70°N) for the period 1901–2006. Large-scale structure is found to be abundant with 75 events identified lasting for more than 3 months and spanning at least 0.5 × 106 km2. Near-complete dissimilarity is seen between the individual drought structures, and little or no regularity is found in the time evolution of even the most spatially similar drought events. The spatial distribution of the event centroids and the time evolution of the geographic cross-sectional areas strongly suggest that large area, sustained droughts result from the combination of multiple small area (∼106 km2) short duration (∼3 months) events. The small events are not found to occur independently in space. This leads to the hypothesis that local water feedbacks play an important role in the aggregation process

Causes and correlates of 30 day and 180 day readmission following discharge from a Medicine for the Elderly Rehabilitation unit

Abstract Background Recently hospitalized patients experience a period of generalized risk of adverse health events. This study examined reasons for, and predictors of, readmission to acute care facilities within 30 and 180 days of discharge from an inpatient rehabilitation unit for older people. Methods Routinely collected, linked clinical data on admissions to a single inpatient rehabilitation facility over a 13-year period were analysed. Data were available regarding demographics, comorbid disease, admission and discharge Barthel scores, length of hospital stay, and number of medications on discharge. Discharge diagnoses for the index admission and readmissions were available from hospital episode statistics. Univariate and multivariate Cox regression analyses were performed to identify baseline factors that predicted 30 and 180-day readmission. Results A total of 3984 patients were included in the analysis. The cohort had a mean age of 84.1 years (SD 7.4), and 39.7% were male. Overall, 5.6% (n = 222) and 23.2% (n = 926) of the patients were readmitted within 30 days and 180 days of discharge respectively. For patients readmitted to hospital, 26.6% and 21.1% of patients were readmitted with the same condition as their initial admission at 30 days and 180 respectively. For patients readmitted within 30 days, 13.5% (n = 30) were readmitted with the same condition with the most common diagnoses associated with readmission being chest infection, falls/immobility and stroke. For patients readmitted within 180 days, 12.4% (n = 115) of patients were readmitted with the same condition as the index condition with the most common diagnoses associated with readmission being falls/immobility, cancer and chest infections. In multivariable Cox regression analyses, older age, male sex, length of stay and heart failure predicted 30 or 180-day readmission. In addition, discharge from hospital to patients own home predicted 30-day readmission, whereas diagnoses of cancer, previous myocardial infarction or chronic obstructive pulmonary disease predicted 180-day readmission. Conclusion Most readmissions of older people after discharge from inpatient rehabilitation occurred for different reasons to the original hospital admission. Patterns of predictors for early and late readmission differed, suggesting the need for different mitigation strategies

Optimum optical designs for diffraction-limited terahertz spectroscopy and imaging systems using off-axis parabolic mirrors

Off-axis parabolic mirrors (OAPMs) are widely used in the THz and mm-wave communities for spectroscopy and imaging applications, as a result of their broadband, low-loss operation and high numerical apertures. However, the aspherical shape of an OAPM creates significant geometric aberrations that make achieving diffraction-limited performance a challenge, and which lowers the peak electric field strength in the focal plane. Here we quantify the impact of geometric aberrations on the performance of the most widely-used spectrometer designs, by investigating whether diffraction-limited performance can be achieved in both the sample and the detector plane. We identify simple rules, based on marginal ray propagation, that allow spectrometers to be designed that are more robust to misalignment errors, and which have minimal aberrations for THz beams. For a given source this allows the design of optical paths that give the smallest THz beam focal spot, with the highest THz electric field strength possible. This is desirable for improved THz imaging, for better signal-to-noise ratios in linear THz spectroscopy and optical-pump THz-probe spectroscopy, and to achieve higher electric field strengths in non-linear THz spectroscopy.Comment: 10 pages and 6 figure

Simulation and optimisation of terahertz emission from InGaAs and InP photoconductive switches

We simulate the terahertz emission from laterally-biased InGaAs and InP using a three-dimensional carrier dynamics model in order to optimise the semiconductor material. Incident pump-pulse parameters of current Ti:Sapphire and Er:fibre lasers are chosen, and the simulation models the semiconductor's bandstructure using parabolic Gamma, L and X valleys, and heavy holes. The emitted terahertz radiation is propagated within the semiconductor and into free space using a model based on the Drude-Lorentz dielectric function. As the InGaAs alloy approaches InAs an increase in the emitted power is observed, and this is attributed to a greater electron mobility. Additionally, low-temperature grown and ion-implanted InGaAs are modelled using a finite carrier trapping time. At sub-picosecond trapping times the terahertz bandwidth is found to increase significantly at the cost of a reduced emission power.Comment: 9 pages, 7 figure

Carrier dynamics in ion-implanted GaAs studied by simulation and observation of terahertz emission

We have studied terahertz (THz) emission from arsenic-ion implanted GaAs both experimentally and using a three-dimensional carrier dynamics simulation. A uniform density of vacancies was formed over the optical absorption depth of bulk GaAs samples by performing multi-energy implantations of arsenic ions (1 and 2.4MeV) and subsequent thermal annealing. In a series of THz emission experiments the frequency of peak THz power was found to increase significantly from 1.4 to 2.2THz when the ion implantation dose was increased from 10^13 to 10^16 cm-3. We used a semi-classical Monte-Carlo simulation of ultra-fast carrier dynamics to reproduce and explain these results. The effect of the ion-induced damage was included in the simulation by considering carrier scattering at neutral and charged impurities, as well as carrier trapping at defect sites. Higher vacancy concentrations and shorter carrier trapping times both contributed to shorter simulated THz pulses, the latter being more important over experimentally realistic parameter ranges.Comment: 6 pages, 7 figure