Future wave climate over the west-European shelf seas

In this paper, we investigate changes in the wave climate of the west-European shelf seas under global warming scenarios. In particular, climate change wind fields corresponding to the present (control) time-slice 1961–2000 and the future (scenario) time-slice 2061–2100 are used to drive a wave generation model to produce equivalent control and scenario wave climate. Yearly and seasonal statistics of the scenario wave climates are compared individually to the corresponding control wave climate to identify relative changes of statistical significance between present and future extreme and prevailing wave heights. Using global, regional and linked global–regional wind forcing over a set of nested computational domains, this paper further demonstrates the sensitivity of the results to the resolution and coverage of the forcing. It suggests that the use of combined forcing from linked global and regional climate models of typical resolution and coverage is a good option for the investigation of relative wave changes in the region of interest of this study. Coarse resolution global forcing alone leads to very similar results over regions that are highly exposed to the Atlantic Ocean. In contrast, fine resolution regional forcing alone is shown to be insufficient for exploring wave climate changes over the western European waters because of its limited coverage. Results obtained with the combined global–regional wind forcing showed some consistency between scenarios. In general, it was shown that mean and extreme wave heights will increase in the future only in winter and only in the southwest of UK and west of France, north of about 44–45° N. Otherwise, wave heights are projected to decrease, especially in summer. Nevertheless, this decrease is dominated by local wind waves whilst swell is found to increase. Only in spring do both swell and local wind waves decrease in average height

The Fate of the Language is the Fate of the People: A Cultural Analysis of Language Education Policy in Central Asia

With a shared history under the Soviet Union, the five Central Asian republics of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan have spent the past one hundred years dealing with quickly changing language policy and ethnic relations. Under the policy of the USSR, native languages of Central Asia were repressed, and Russian was introduced as the main language of interethnic communication. After they gained independence in 1991, however, each of the five countries embarked on missions to restore the strength of each of their national languages and de-Russify their political, economic, and educational systems. Throughout the region, one of the main tools of this nation-building and language reform has been primary and secondary school education. Of particular concern in these five contexts—which languages to use as mediums of instruction, which languages to be taught as subjects, and which languages to exclude entirely. This thesis will compare the different goals regarding language policy in each country and the role of multilingualism in their societies, explore the methods each country has taken within their education systems to attempt to alter their modern linguistic setting, identify any significant issues in their plans, and analyze the degree of success that each country has seen in achieving their goal

Prevalence of ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis: A retrospective study (2012-2020)

BACKGROUND: Ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis (AP) are not well characterized in the literature. No detailed studies have described their prevalence, characteristics, distribution, or clinical relevance. HYPOTHESIS/OBJECTIVES: Describe the prevalence of ultrasonographic gastrointestinal wall changes in a population of dogs with AP and evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. ANIMALS: Referral population of 66 client‐owned dogs with AP. METHODS: Retrospective search of clinical records to identify dogs with AP. Clinical variables, clinicopathological variables and ultrasonographic findings were reported using descriptive statistics. A binary logistic regression model was used to evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. RESULTS: Sixty‐six dogs were included. Forty‐seven percent of dogs (95% confidence interval [CI], 35.0%‐59.0%; n = 31) with AP had ultrasonographic gastrointestinal wall changes. Gastrointestinal wall changes were most common in the duodenum and identified in 71% (n = 22) of affected dogs. Of dogs with gastrointestinal wall changes, 74.2% (n = 23) had wall thickening, 61.3% (n = 19) had abnormal wall layering, and 35.5% (n = 11) had wall corrugation. In the multivariable model, only heart rate remained an independent predictor of ultrasonographic gastrointestinal wall changes (P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE: Ultrasonographic gastrointestinal wall changes in this population of dogs with AP were common. Increased heart rate was the only independent predictor of gastrointestinal wall changes, which might imply more severe disease. Additional studies are required to elucidate whether ultrasonographic gastrointestinal wall changes reflect disease severity in AP

Factors influencing the use of clinical guidelines by general practitioners working in a setting of complex multimorbidity: a case study by interviews

Background: The Central Australian Remote Practitioners Association Standard Treatment Manual (CARPA) contains protocols for primary health care in remote Central Australia. This context stands in stark contrast to the mainstream settings in Australia and features an Aboriginal population with very poor health status, powerful social determinants of health, geographical isolation and high turnover of health practitioners. The manual consolidates the core elements of national guidelines, particularly as they pertain to Aboriginal health care, into a single document. The aim of this study is to explore factors that promote or impede the use of CARPA by general practitioners (GPs) in Central Australia, with a particular focus on chronic disease management. Methods: In-depth interviews were conducted with GPs and GP registrars employed in the provision of Aboriginal health care in Central Australia. Interview transcripts were thematically analysed from a critical theory perspective. Results: 11 GPs and 3 GP registrars from the two major Aboriginal primary health services in Central Australia were interviewed. The dominant theme in the data was that poor continuity of care impeded the use of CARPA. The second-most dominant theme was that electronic health record systems enhanced the use of CARPA in some ways, and impeded its use in others. Other factors influencing the use of CARPA included the culture of the health service organisation, GPs' first impressions of CARPA, the accessibility and usability of CARPA, and GPs' confidence practicing in such a unique environment. Conclusions: This study identifies factors from multiple domains that influence the use of best practice guidelines in the delivery of chronic disease care. It demonstrates that such factors may not be purely 'enablers' or 'barriers', but may be a mixture of both. It highlights the critical role of continuity of care and the potential benefits and pitfalls of using electronic health records in providing chronic disease care. This study provides empirical insights that can be used to improve chronic disease care