Studying soil moisture at a national level through statistical analysis of NASA NLDAS data

The purpose of this research is to enable better understanding of current environmental conditions through the relations of environmental variables to the historical record. Our approach is to organize and visualize land surface model (LSM) outputs and statistics in a web application, using the latest technologies in geographic information systems (GISs), web services, and cloud computing. The North American Land Data Assimilation System (NLDAS-2) (http://ldas.gsfc.nasa.gov/nldas/; Documentation: ftp://hydro1.sci.gsfc.nasa.gov/data/s4pa/NLDAS/README.NLDAS2.pdf) drives four LSM (e.g., Noah) (http://ldas.gsfc.nasa.gov/nldas/NLDAS2model.php) that simulate a suite of states and fluxes for central North America. The NLDAS-2 model output is accessible via multiple methods, designed to handle the outputs as time-step arrays. To facilitate data access as time series, selected NLDAS-Noah variables have been replicated byNASA as point-location files. These time series filesor 'data rods' are accessible through web services. In this research, 35-year historical daily cumulative distribution functions (CDFs) are constructed using the data rods for the top-meter soil moisture variable. The statistical data are stored in and served from the cloud. The latest values in the Noah model are compared with the CDFs and displayed in a web application. Two case studies illustrate the utility of this approach: the 2011 Texas drought, and the 31 October 2013 flash flood in Austin, Texas

P137 Supporting patients to get the best from their osteoporosis treatment; what works for whom, why and in what circumstance: a rapid realist review

Abstract Background/Aims For two decades, clinicians and academics have been writing about the problem of poor adherence in osteoporosis, while people with osteoporosis have identified a need for more follow up and information about medicines. We aimed to understand what works in supporting people with osteoporosis to get the best from their medicines, and specifically, to understand what mechanisms enable components of interventions to support osteoporosis medication optimisation and the underlying contextual conditions that enabled these mechanisms. Methods We conducted a Rapid Realist Review. The scope was informed by a workshop of the Effectiveness Working Group of the Royal Osteoporosis Society Osteoporosis and Bone Research Academy and the approach informed by background syntheses of qualitative literature and the Perceptions and Practicalities Approach as an underpinning conceptual framework. A primary search identified observational or interventional studies which aimed to improve medicines adherence or optimisation. Included studies were assessed for quality and data extracted relating to context, mechanism and outcomes. A supplementary second search was conducted to gain additional insight on included key papers and emerging mechanisms. Extracted data were interrogated by authors independently for patterns of context-mechanism-outcome configurations and further discussed in weekly team meetings. Recommendations for research and clinical practice were co-developed with clinical and lay stakeholders. Results 41 papers were included. We identified five contextual timepoints for the person with osteoporosis (identifying a problem; starting medicine; continuing medicine) and the practitioner and healthcare system (making a diagnosis and giving a treatment recommendation; reviewing medicine) and mechanisms relating to patient informed decision making, treatment burden, supporting routinisation and memory, supporting clinical decision making, targeting support, and approaches which were integrated and sustainable. Interventions which support patient informed decision making, improve patient knowledge and understanding, have potential to influence long-term commitment to treatment, although few studies explicitly addressed patients’ perceptions of illness and treatment as recommended in NICE guidelines. During treatment, targeting additional consultations to those most in need may be a cost and clinically effective approach to enable this. Supporting primary care clinician decision making and integration of primary and secondary care services also appears to be important, in improving rates of treatment initiation and adherence. Supporting patients’ ability to adhere (eg by lowering treatment burden and issuing reminders) may be helpful to address practical difficulties but there is little evidence to support the use of reminders alone. Conclusion For medicines optimisation for people with osteoporosis, we suggest a need for more patient-centred interventions to address patients’ perceptions of illness and treatment, and reduce treatment burden. Specialist services should consider the extent to which they integrate with, and support primary care clinical decision-making, in order to impact long-term clinical outcomes. Specific research recommendations have been co-developed, to address these knowledge gaps. Disclosure Z. Paskins: Grants/research support; NIHR, Versus Arthritis, Royal Osteoporosis Society. O. Babatunde: None. A. Sturrock: None. L. Toh: None. R. Horne: None. I. Maidment: None. </jats:sec

An evaluation of clouds and precipitation in convection-permitting forecasts for South Africa

Since 2016, the South African Weather Service (SAWS) has been running convective-scale simulations to assist with forecast operations across southern Africa. These simulations are run with a tropical configuration of the Met Office Unified Model (UM), nested in the Met Office global model, but without data assimilation. For November 2016, convection-permitting simulations at 4.4-km and 1.5-km grid length are compared against a simulation at 10-km grid length with convection parametrization (the current UM global atmosphere configuration) to identify the benefits of increasing model resolution for forecasting convection across southern Africa. The simulations are evaluated against satellite rainfall estimates, CloudSat vertical cloud profiles, and SAWS radar data. In line with previous studies using the UM, on a monthly time scale, the diurnal cycle of convection and the distribution of rainfall rates compare better against observations when convection-permitting model configurations are used. The SAWS radar network provides a three-dimensional composite of radar reflectivity for northeast South Africa at 6-minute intervals, allowing the evaluation of the vertical development of precipitating clouds and of the timing of the onset of deep convection. Analysis of four case study days indicates that the 4.4-km simulations have a later onset of convection than the 1.5-km simulations, but there is no consistent bias of the simulations against the radar observations across the case studies

Intracontinental Orogeny Enhanced by Far-field Extension and Local Weak Crust

The accommodation of intraplate stresses in preexisting weak regions of plate interiors is here investigated using thin viscous sheet numerical models. The intraplate stresses are governed by multicomponent and multidirectional stresses originating at plate boundaries. The modeled scenarios mimic plate boundary conditions during the intraplate Alice Springs Orogeny (ASO), central Australia, and include (1) a northwest‐southeast zone of weak lithosphere within strong continental blocks to the north and southand (2) a principal south directed stress condition at the northern boundary that causes minor clockwise rotation of the northern block. Alternative tectonic environments are investigated in additional models that include (1) secondary compressional or extensional stresses acting at the eastern boundary, representing the temporally variable stress conditions during the Tasmanides Orogeny, and (2) an eastern wedge‐shaped zone of rheologically weak lithosphere, mirroring rift fill of the Irindina subbasin. Our results highlight that a low angle between major crustal features (e.g., orogenic elongation and preexisting regional structures) and the principal transmitted stresses is highly relevant in the concentration of elevated levels of differential stress and subsequent localization of deformation in plate interiors. Secondary stresses orthogonal to the principal acting stresses may introduce effects that explain the episodic orogenic activity in the case of the ASO. The combination of secondary extensional stresses at the eastern boundary of Australia and weak lithosphere of the preexisting Irindina subbasin strongly influences the observed spatial strain intensity, localization, and kinematics of deformation during the ASO

Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay?

Primary objective: To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. Research design: A retrospective case note review assessed total rehabilitation unit admission. Methods and procedures: Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge. Main outcomes and results: A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = −6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36–68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002–0.35). Conclusions: There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort

Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community:a mixed studies review

BACKGROUND: Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. METHODS: A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). RESULTS: Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. CONCLUSIONS: This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes

The CUAHSI Community Hydrologic Information System (Invited)

Hydrologic information is collected by many individuals and organizations in government and academia for many purposes, including general monitoring of the condition of the water environment and specific investigations of hydrologic processes. Comprehensive understanding of hydrology requires integration of this information from multiple sources. The Consortium of Universities for the Advancement of Hydrologic Science, Inc. (CUAHSI) has developed a Hydrologic Information System (HIS) to provide better access to data by enabling the publication, cataloging, discovery and retrieval of hydrologic data using web services. This paper describes HIS capability developed to promote data sharing and interoperability in the Hydrologic Sciences with the purpose of enabling hydrologic analyses that integrate data from multiple sources. The CUAHSI HIS is an Internet based system comprised of hydrologic databases and servers connected through web services as well as software for data publication, discovery and access. The system that has been developed provides new opportunities for the water research community to approach the management, publication, and analysis of their data systematically. The system\u27s flexibility in storing and enabling public access to similarly formatted data and metadata has created a community data resource from public and academic data that might otherwise have been confined to the private files of agencies or individual investigators. Additionally, HIS provides an analysis environment within which data from multiple sources can be discovered, accessed and integrated. The CUAHSI HIS serves as a prototype for the infrastructure to support a network of large scale environmental observatories or research watersheds, and indeed, components of the CUAHSI HIS have now been adopted or modified for use within the Critical Zone Observatory (CZO) network. Software and further information may be obtained from http://his.cuahsi.org

The vertical cloud structure of the West African monsoon: a 4 year climatology using CloudSat and CALIPSO

The West African summer monsoon (WAM) is an important driver of the global climate and locally provides most of the annual rainfall. A solid climatological knowledge of the complex vertical cloud structure is invaluable to forecasters and modelers to improve the understanding of the WAM. In this paper, 4 years of data from the CloudSat profiling radar and CALIPSO are used to create a composite zonal mean vertical cloud and precipitation structure for the WAM. For the first time, the near-coincident vertical radar and lidar profiles allow for the identification of individual cloud types from optically thin cirrus and shallow cumulus to congestus and deep convection. A clear diurnal signal in zonal mean cloud structure is observed for the WAM, with deep convective activity enhanced at night producing extensive anvil and cirrus, while daytime observations show more shallow cloud and congestus. A layer of altocumulus is frequently observed over the Sahara at night and day, extending southward to the coastline, and the majority of this cloud is shown to contain supercooled liquid in the top. The occurrence of deep convective systems and congestus in relation to the position of the African easterly jet is studied, but only the daytime cumulonimbus distribution indicates some influence of the jet position