The subtropical recirculation of Mode Waters

A Mode Water is a particular type of water mass characterized by its vertical homogeneity. There are two general varieties in the world ocean: Subtropical Mode Waters and Subpolar Mode Waters. The vertical homogeneity of a Mode Water is acquired by the process of deep vertical convection in winter. The low vertical density gradient imparted to the water column by convection persists laterally as the general circulation carries the Mode Water away from the formation zone...

Fluorescent molecular hydrogen in the reflection nebula NGC 2023

Photodissociation regions (PDRs) are described in the context of the interstellar medium and star-forming regions. Observations of PDRs and molecular hydrogen are reviewed and the reflection nebula NGC 2023 is discussed in detail. NGC 2023 is a bright and well-studied reflection nebula at a distance of 450 parsecs in the Orion region. Illuminated primarily by a B-type star, it offers an ideal opportunity to study UV-excited molecular hydrogen.The theory of the hydrogen molecule is described: the energy states and their relationship with the quantum numbers which represent the vibrational and rotational states of the molecule, the radiative processes which determine the optical and infrared emission spectrum of H2, the effect collisions have on the excited states of the molecule and the processes which govern the formation and destruction of H2. Particular attention is given to the process of formation on the surface of dust grains and the resulting energy states of the ejected H2 molecule.nfrared and optical far-red observations of fluorescent H2 line emission from NGC 2023 are presented. The resulting datasets contain flux measurements of over ninety lines. These are combined with published data to produce column densities for 81 energy states of the H2 molecule, the most extensive dataset yet compiled for a PDR. The processes of observing in the infrared and optical wavelength regimes are outlined. The emission lines of H2 are intrinsically very faint and thus measurements require careful data reduction to minimise sources of noise wherever possible. The data reduction steps which were applied to the observations are described in detail. An optical extinction of Av = 5.7 ± 1.0 to the H2 emission region and ortho/para abundance ratio of 2.0 ± 0.2 are derived from flux ratios of emission lines and by minimising the scatter on a diagram which plots the logarithm of the column density against the energy level of each state.The theory of photodissociation regions is summarised and the effect of the incident ultraviolet radiation field and hydrogen nucleus number density on the H2 emission spectrum is discussed. Steady-state and time-dependent PDR models are reviewed and their predictions are compared to the observational data. Deviations from the pure fluorescent case are apparent; the v = 1 vibrational level displays a column density distribution indicative of collisional processes. There is also strong evidence for a trend within each vibrational level, for v > 1, whereby excess populations increase with rotational level, J, with a possible ‘turnover’ and peak excess at high J. The overall intensity of the H2 emission lines is an order of magnitude greater than that predicted by face- on, steady-state PDR models. The emission can be explained by intense ultraviolet radiation (Go _ 5 x 103) incident on dense gas (n ~ 105cm~3) at a high temperature (T ~ 1000K). The ortho/para abundance ratio is discussed and it is proposed that the observed PDR in NGC 2023 has not yet reached equilibrium and the photodissociation front, which is advancing into the molecular cloud, is more accurately described by time-dependent PDR models

Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review

BACKGROUND: 'Adverse childhood experiences' (ACEs) are associated with increased risk of negative outcomes in later life: ACEs have consequently become a policy priority in many countries. Despite ACEs being highly socially patterned, there has been very little discussion in the political discourse regarding the role of childhood socioeconomic position (SEP) in understanding and addressing them. The aim here was to undertake a systematic review of the literature on the relationship between childhood SEP and ACEs. METHODS: MEDLINE, PsycINFO, ProQuest and Cochrane Library databases were searched. Inclusion criteria were: (1) measurement of SEP in childhood; (2) measurement of multiple ACEs; (3) ACEs were the outcome; and (4) statistical quantification of the relationship between childhood SEP and ACEs. Search terms included ACEs, SEP and synonyms; a second search additionally included 'maltreatment'. Overall study quality/risk of bias was calculated using a modified version of the Hamilton Tool. RESULTS: In the ACEs-based search, only 6 out of 2825 screened papers were eligible for qualitative synthesis. The second search (including maltreatment) increased numbers to: 4562 papers screened and 35 included for synthesis. Eighteen papers were deemed 'high' quality, five 'medium' and the rest 'low'. Meaningful statistical associations were observed between childhood SEP and ACEs/maltreatment in the vast majority of studies, including all except one of those deemed to be high quality. CONCLUSION: Lower childhood SEP is associated with a greater risk of ACEs/maltreatment. With UK child poverty levels predicted to increase markedly, any policy approach that ignores the socioeconomic context to ACEs is therefore flawed

An Empirical Chart Analysis of the Suitability of Telemedicine for Hospice Visits

This is the publisher's version, also available electronically from http://online.liebertpub.com/doi/abs/10.1089/tmj.2005.11.90.Telehospice® (TH) utilizes telemedicine technology to provide care at the end of life. A bistate project was launched in 1998 to study the use of home-based telemedicine for routine hospice care. Videophones were deployed for telenursing visits and evaluations by social workers. In order to determine what proportion of home hospice visits could be performed using currently available telemedicine technology, we reviewed clinical records retrospectively for hospice nurse home visits. Clinical notes documenting home nursing visits were obtained from two large hospices, one based in Kansas, and the other in Michigan. Records were randomly selected for patients who received hospice nurse visits during the month of January 2000. The charts were reviewed for patient demographic information, patient assessments, teaching activities, and interventions. Five hundred ninety-seven nursing notes were analyzed using an 85-item coding instrument. After careful review of the records, the coders also made a subjective observation regarding the suitability of each visit for telemedicine. As part of this analysis, we found that 64.5% of home hospice nursing visits could be performed by telemedicine. Using TH, it is possible to reduce the number of in-person visits, thereby significantly decreasing the cost of providing hospice care

An Analysis of Folic Acid Supplementation in Women Presenting For Antenatal Care

Background: Neural tube defects (NTDs) are major congenital malformations that are potentially preventable if the woman takes periconceptional folic acid (FA) supplements. A recent report found that NTD incidence had increased in Ireland. This study examined the usage of FA supplementation in women presenting for antenatal care in a maternity hospital