Extreme temperature regimes during the cool season: recent observed behavior and low frequency mode modulation

During the boreal cool season, regional climate in the United States is strongly impacted by extreme temperature regimes (ETRs), including both cold air outbreaks (CAOs) and warm waves (WWs), which have significant impacts on energy consumption, agriculture, as well as the human population. Using NCEP/NCAR and MERRA reanalysis data, the statistical characteristics of ETRs over three distinct geographical regions are studied: the Midwest (MW), Northeast Megalopolis (NE), and Deep South (SE). The regional long-term variability in the frequency and amplitude of ETRs is examined, and the modulation of these ETRs by low frequency modes is quantified. ETR behavior is characterized using three different metrics applied to both T and Twc: 1) the number of extreme cold/warm days, 2) a seasonal cumulative "impact factor", and 3) a peak normalized anomaly value. A trend analysis reveals a significant downward trend in SE WW events from 1949-2011. Otherwise, no significant trends are found for ETRs in any of the other regions. Thus, these results indicate that there has not been any significant reduction in either the amplitude or frequency of CAOs over the United States during the period of analysis. In fact, for the SE region, the recent winters of 2009/2010 and 2010/2011 both rank among the top 5 in terms of CAO metrics. In addition, strong interannual variability in ETRs is evident from 1949-2011 in each region. Linear regression analysis is then used to determine the associations between ETR metrics and the seasonal mean state of several low frequency modes, and it is found that ETRs tend to be modulated by certain low frequency modes. For instance, in the SE region, there is a significant association between ETRs and the phase of the North Atlantic (or Arctic) Oscillation (NAO/AO), the Pacific North American (PNA) pattern (for WWs only), the Pacific Decadal Oscillation (PDO) and the El Niño-Southern Oscillation (for WWs only). Over the MW region, WWs are modulated by the NAO/AO and PNA patterns, while in the NE region, the AO, NAO (for WWs only) and PDO (for WWs only) are implicated. In addition, it is found that there is an asymmetry between the low frequency mode modulation of CAOs and WWs. Multiple linear regression analysis is then used to quantify the relative roles of the various low frequency modes in explaining interannual variability in ETR metrics, and reveals that various combinations of low frequency modes can explain anywhere between 10% and 50% of the variance in the ETR metrics.MSCommittee Chair: Black, Robert; Committee Member: Curry, Judith; Committee Member: Deng, Y

De feministiske bølgenes påvirkning på norske læreplaner for samfunnsfag.

Norsk sammendrag Dette er en mastergradsoppgave i samfunnsfag ved Høgskolen i Innlandet. Oppgaven er en kvalitativ innholdsanalyse av de feministiske bølgene med tilhørende feministisk teori samt læreplanene fra 1994, 1997, 2006 og 2020. Jeg har lagt vekt på læreplanene i samfunnsfag, samfunnskunnskap og de generelle delene. Problemstilling lyder som følgende: På hvilken måte har de feministiske bølgene påvirket generell del og læreplanene for samfunnsfag både i norsk grunnskole og videregående skole? Formålet er å belyse denne relasjonen gjennom å undersøke og beskrive forholdet mellom de feministiske bølgenes kampsaker og de aktuelle læreplanene. Den metodiske tilnærmingen for undersøkelsen er kvalitativ innholdsanalyse. Jeg anså denne metoden som best egnet da jeg analyserer offentlige tekster. For å kategorisere funn fra læreplanene valgte jeg å telle fremkomsten av ulike nøkkelord og fraser som er relevante for problemstillingen. Nøkkelordene som ble brukt for å søke i læreplanene er: likestilling, kjønn/kjønnsroller, feminisme, likestillingsarbeid, kvinner, menn, jenter, gutter, likeverd, like rettigheter for alle, diskriminering og likestilling mellom menn og kvinner. Funnene gjort gjennom å analysere læreplanene etter nøkkelordene ble analysert opp mot liberalfeministisk teori, radikal feministisk teori, postmoderne feministisk teori og tidligere forskning. Funnene i oppgaven viser at de feministiske bølgenes kampsaker har hatt en viss påvirkning på læreplanenes innhold. Flere av funnene er knyttet til den tredje feministiske bølgens fokus på likhet for alle og den postmodernistiske feminismens fokus på at identitet skal kunne skapes selv og ikke være forutbestemt av tradisjoner og samfunnsforventninger. Det faktumet at flere av funnene tilhøre den tredje feministiske bølgen og postmodernistisk feministisk teori er ikke overrakende da den tredje feministiske bølgen foregår i samme periode som flere av de aktuelle læreplanene jeg har sett på har gyldighet. Det vil si fra 1990- tidlig 2000-tall. Et av de mest konkrete funnene fra dette studien er overgangen fra bruken av ordet likestilling til bruken av ordet likeverd. I løpet av den tredje feministiske bølgen endrer fokuset seg fra likestilling mellom kjønnene til likeverd mellom alle individer i samfunnet, uavhengig av hudfarge, etnisitet, kjønn, helse, seksuell orientering og lignende. Denne nye begreps bruken kommer også tydelig fram i læreplanene, spesielt i deres generelle del. Dette funnet er bare en av flere som er presentert i dette masterstudiet. Oppgavens funn blir naturligvis formet av de ulike teoriene jeg har valgt. Det er derfor viktig å legge vekt på at det er mulig at annen teori kunne gitt en annen vinkling på funnene.Engelsk sammendrag (abstract) This is a master´s thesis in social science at the Innlandet University Collage. The thesis is a qualitative content analysis of the feminist waves, including feminist theory, and the curricula from 1994, 1997, 2006 and 2020. The focus is on the curricula for social studies, civic educations, and the general parts. The research question is: In what ways have the feminist waves influenced the general parts and curricula for social studies in Norwegian primary and secondary schools? The aim is to illuminate the relationship between these by examining and describing the connection between the themes in the feminist waves and the relevant curricula. The chosen methodological approach for the study is qualitative content analysis, which is considered most appropriate for analyzing public texts. To categorize the findings from the curricula, the occurrence of various keywords and phrases relevant to the research question were counted. The keywords used to search the curricula are: equality, gender/gender roles, feminism, gender equality work, women, men, girl, boys, equal worth, equal rights for all, discrimination and equality between men and women. The findings from the analysis of the curricula using the keywords were analyzed in relation to liberal feminism theory, radical feminist theory, postmodern feminist theory, and previous research. The study´s findings show that the themes in feminist waves have had some influence on the curricula´s content. Several of the findings are related to the third feminist wave´s focus on equality for all and postmodern feminist theory´s emphasis on creating identity independently and not being predetermined by traditions and social expectations. The fact that several of the findings belong to the third feminist wave and the postmodern feminist theory is not surprising since the third feminist wave occurred during the same period as several of the relevant curricula that were examined, which is from the 1990s to the early 2000s. One of the most concrete findings from this study is the transition from using the term “equality” to “equal worth”. During the third feminist wave, the focus shifted from gender equality to equal worth among all individuals in society, regardless of skin color, ethnicity, gender, health, sexual orientation, and similar factors. This new concept is also clearly reflected in multiple of the curriculums, especially in their general parts. This finding is just one of several presented in this master´s thesis. The findings of the thesis are naturally shaped by the chosen theories. Therefore, it is essential to emphasize that other theories could have given a different perspective on the findings

Canadian Physiotherapists\u27 Views on Certification, Specialisation, Extended Role Practice, and Entry-Level Training in Rheumatology

Background: Since the last decade there has been a gradual change of boundaries of health professionsin providing arthritis care. In Canada, some facilities have begun to adopt new arthritis care models, someof which involve physiotherapists (PT) working in extended roles. However, little is known about PTs\u27interests in these new roles. The primary objective of this survey was to determine the interests amongorthopaedic physiotherapists (PTs) in being a certified arthritis therapist, a PT specialized in arthritis, oran extended scope practitioner in rheumatology, and to explore the associated factors, including thecoverage of arthritis content in the entry-level physiotherapy training.Methods: Six hundred PTs practicing in orthopaedics in Canada were randomly selected to receive apostal survey. The questionnaire covered areas related to clinical practice, perceptions of rheumatologytraining received, and attitudes toward PT roles in arthritis care. Logistic regression models weredeveloped to explore the associations between PTs\u27 interests in pursuing each of the three extendedscope practice designations and the personal/professional/attitudinal variables.Results: We received 286 questionnaires (response rate = 47.7%); 258 contained usable data. Theaverage length of time in practice was 15.4 years (SD = 10.4). About 1 in 4 PTs agreed that they wereinterested in assuming advanced practice roles (being a certified arthritis therapist = 28.9%, being a PTspecialized in rheumatology = 23.3%, being a PT practitioner = 20.9%). Having a caseload of ≥ 40% inarthritis, having a positive attitude toward advanced practice roles in arthritis care and toward the formalcredentialing process, and recognizing the difference between certification and specialisation wereassociated with an interest in pursing advanced practice roles.Conclusion: Orthopaedic PTs in Canada indicated a fair level of interest in pursuing certification,specialisation and extended scope practice roles in arthritis care. Future research should focus on theeffectiveness and cost-effectiveness of the emerging health service delivery models involving certified,specialized or extended scope practice PTs in the management of arthritis

The association between infant salivary cortisol and parental presence in the neonatal intensive care unit during and after COVID-19 visitation restrictions: A cross-sectional study

Objectives: Parent-infant interaction in the neonatal intensive care unit (NICU) promotes health and reduces infant stress. During the COVID-19 pandemic, however, NICUs restricted parent-infant interaction to reduce viral transmission. This study examined the potential relationship between pandemic visitation restrictions, parental presence and infant stress as measured by salivary cortisol. Methods: A two-NICU cross-sectional study of infants with gestational age (GA) 23–41 weeks, both during (n = 34) and after (n = 38) visitation restrictions. We analysed parental presence with and without visitation restrictions. The relationship between infant salivary cortisol and self-reported parental NICU presence in hours per day was analysed using Pearson's r. A linear regression analysis included potential confounders, including GA and proxies for infant morbidity. The unstandardised B coefficient described the expected change in logtransformed salivary cortisol per unit change in each predictor variable. Results: Included infants had a mean (standard deviation) GA of 31(5) weeks. Both maternal and paternal NICU presence was lower with versus without visitation restrictions (both p ≤0.05). Log-transformed infant salivary cortisol correlated negatively with hours of parental presence (r = − 0.40, p = .01). In the linear regression, GA (B = -0.03, p = .02) and central venous lines (B = 0.23, p = .04) contributed to the variance in salivary cortisol in addition to parental presence (B = -0.04 p = .04). Conclusion: COVID-19–related visitation restrictions reduced NICU parent-infant interaction and may have increased infant stress. Low GA and central venous lines were associated with higher salivary cortisol. The interaction between immaturity, morbidity and parental presence was not within the scope of this study and merits further investigation

Canadian physiotherapists' views on certification, specialisation, extended role practice, and entry-level training in rheumatology

<p>Abstract</p> <p>Background</p> <p>Since the last decade there has been a gradual change of boundaries of health professions in providing arthritis care. In Canada, some facilities have begun to adopt new arthritis care models, some of which involve physiotherapists (PT) working in extended roles. However, little is known about PTs' interests in these new roles. The primary objective of this survey was to determine the interests among orthopaedic physiotherapists (PTs) in being a certified arthritis therapist, a PT specialized in arthritis, or an extended scope practitioner in rheumatology, and to explore the associated factors, including the coverage of arthritis content in the entry-level physiotherapy training.</p> <p>Methods</p> <p>Six hundred PTs practicing in orthopaedics in Canada were randomly selected to receive a postal survey. The questionnaire covered areas related to clinical practice, perceptions of rheumatology training received, and attitudes toward PT roles in arthritis care. Logistic regression models were developed to explore the associations between PTs' interests in pursuing each of the three extended scope practice designations and the personal/professional/attitudinal variables.</p> <p>Results</p> <p>We received 286 questionnaires (response rate = 47.7%); 258 contained usable data. The average length of time in practice was 15.4 years (SD = 10.4). About 1 in 4 PTs agreed that they were interested in assuming advanced practice roles (being a certified arthritis therapist = 28.9%, being a PT specialized in rheumatology = 23.3%, being a PT practitioner = 20.9%). Having a caseload of ≥ 40% in arthritis, having a positive attitude toward advanced practice roles in arthritis care and toward the formal credentialing process, and recognizing the difference between certification and specialisation were associated with an interest in pursing advanced practice roles.</p> <p>Conclusion</p> <p>Orthopaedic PTs in Canada indicated a fair level of interest in pursuing certification, specialisation and extended scope practice roles in arthritis care. Future research should focus on the effectiveness and cost-effectiveness of the emerging health service delivery models involving certified, specialized or extended scope practice PTs in the management of arthritis.</p

First steps in developing clinical practice guidelines for post-acute rehabilitation after primary total hip and knee arthroplasty

Total hip (THA) and total knee arthroplasty (TKA) are cost-effective interventions for advanced osteoarthritis (OA) of the knee and hip. With the rapidly growing number of these procedures performed annually in Canada and the United States, greater attention needs to be directed to identify rehabilitation practices that optimize outcomes and minimize cost. Currently, there is no consensus on rehabilitation best practice and no evidence-based clinical practice guidelines to inform clinical decision-making on post-acute rehabilitation following THA and TKA. A multi-phase, mixed-method project integrated stakeholder perspectives, research evidence and expert opinion to develop best practice recommendations for THA and TKA rehabilitation. Chapter 2 involved 11 focus groups and eight interviews to identify key themes related from North American patients and health care professionals on rehabilitation practices and outcomes. Chapters 3-4 are Cochrane systematic reviews examining the strength of the evidence for post-acute physiotherapy after THA and TKA. Chapter 5-6 involved two parallel Delphi surveys with consumers, clinicians and researchers to develop consensus on a range of rehabilitation topics to inform best practice for THA and TKA rehabilitation. Chapter 2: Six key themes emerged relating to communication, patient expectations, patient attitude, forms of support, barriers to recovery, and diversity of outcomes. Chapters 3-4: Systematic reviews of THA (n=8) and TKA (n=7) trials revealed limited, low to high quality evidence with mixed findings for various forms of post-acute physiotherapy on pain, function and health-related quality of life. Trial heterogeneity prevented meta-analysis. Chapters 5-6: Consensus (80% agreement) was reached on the need for post-acute rehabilitation, types of interventions, rehabilitation providers, treatment settings, outcomes and outcome measurement. Consensus was not reached regarding timing and dosage of rehabilitation. Sub-group analysis revealed few differences comparing responses by profession, primary role and country. This thesis has taken important first steps in identifying appropriate rehabilitation interventions and health care resources to optimize individuals’ activity, participation and health-related quality of life after THA and TKA. Further, it highlights the need for more high quality research to address the knowledge gaps and inform policy on this important and understudied aspect of arthroplasty surgery.Medicine, Faculty ofGraduat

Extreme temperature regimes during the cool season: Their trends, variability, triggers and physical connections to low frequency modes

During the boreal cool season (December – February) extreme temperature regimes (ETRs), including cold air outbreaks (CAOs) and warm waves (WWs), affect regional economies and human safety via their significant impacts on energy consumption, local agriculture and human health. This work aims to improve our understanding of the trends and variability in ETRs, their physical connections to low frequency modes, and the dynamical mechanisms leading to ETR onset. Earlier studies on ETR trends and variability do not consider the last decade. Further, little is known about the physical and dynamical nature of ETR onset. These unknowns motivate this dissertation and are particularly important for WWs, which have rarely been studied. This study begins with an updated analysis of the long-term trends and interannual variability in ETRs. Even with the inclusion of the last decade, no significant trends in either WW or CAO occurrence are identified over the continental United States between 1949-2011. The accompanying correlation analysis reveals that on interannual time scales, ETRs in specific regions of the U.S. tend to be modulated by certain low frequency modes. This analysis highlights an important regional asymmetry in the low frequency mode modulation of ETRs, and also indicates that the influence of ENSO upon ATRs is mainly limited to a modest modulation of WWs over the southeast US. Further, a multiple linear regression analysis reveals that the regional collective influence of low-frequency modes accounts for as much as 50% of interannual ETR variability. A synoptic-dynamic characterization of ETR onset over the southeast US is then performed using composite time-evolution analyses of events occurring between 1949-2011 to provide a qualitative indication of the role of low frequency modes. During CAO (WW) onset, negative (positive) geopotential height anomalies are observed in the upper troposphere over the Southeast with oppositely-signed anomalies in the lower troposphere over the central US. In most cases, there is a surface east-west height anomaly dipole, with anomalous northerly (CAO) or southerly (WW) flow into the Southeast leading to cold or warm surface air temperature anomalies, respectively. Companion potential vorticity anomaly analyses reveal prominent features in the mid- to upper-troposphere consistent with the geopotential height anomaly patterns. The composite analyses reveal significant roles for both synoptic and large-scale disturbances in ETR development. Synoptic-scale disturbances serve as dynamic triggers for ETR events, while low-frequency modes can provide a favorable environment for ETR onset. A suite of diagnostic analyses is conducted next and aims to identify the primary thermodynamic processes and dynamical mechanisms responsible for ETR development over the Southeast US. Heat budget analyses implicate linear temperature advection as the primary contributor to ETR development, while nonlinear advection plays a smaller role. Both the linear and the nonlinear terms contribute positively to the temperature tendencies of interest, while the adiabatic and diabatic terms offset some of the advection contributions. Piecewise PV inversion analyses are then conducted to assess which dynamical features directly contribute to the local temperature changes that occur in association with ETRs. A novel result is the discovery of the potential pathway through which the low frequency mode modulation of ETRs takes place. An upper-tropospheric PV feature first induces near-surface temperature advection, which then creates a near-surface temperature anomaly and a corresponding circulation that further enhances the initial temperature advection and ultimately leads to the ETR event.Ph.D