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We present the first systematic inventory of surge-type glaciers for the whole of Greenland compiled from published datasets and multitemporal satellite images and digital elevation models. The inventory allows us to define the spatial and climatic distribution of surge-type glaciers and to analyse the timing of surges from 1985 to 2019. We identified 274 surge-type glaciers, an increase of 37% compared to previous work. Mapping surge-type glacier distribution by temperature and precipitation variables derived from ERA5-Land reanalysis data shows that the west and east clusters occur in well-defined climatic envelopes. Analysis of the timing of surge active phases during the periods ~1985 to 2000 (T1) and ~2000 to 2019 (T2) suggests that overall surge activity is similar in T1 and T2, but there appears to be a reduction in surging in the west cluster in T2. Our climate analysis shows a coincident increase in mean annual and mean winter air temperature between T1 and T2. We suggest that as glaciers thin under current warming, some surge-type glaciers in the west cluster may be being prevented from surging due to (1) their inability to build-up sufficient mass and (2) a switch from a polythermal to a largely cold-based thermal regime.
Despite their extreme elevation, glaciers on the Tibetan Plateau are losing mass in response to atmospheric warming, the pattern of which purportedly reflects regional contrasts in climate. Here we examine the evolution of glaciers along ~500 km of the Tanggula Shan, Central-Eastern Tibetan Plateau. Using remotely sensed datasets, we quantified changes in glacier mass, area and surface velocity, and compared these results to time series of meteorological observations, in order to disentangle drivers of glacier mass loss since the 1960s. Glacier mass loss has increased (from −0.21 ± 0.12 m w.e. a−1 in 1960s–2000s, to −0.52 ± 0.18 m w.e. a−1 in 2000s–2015/18) in association with pervasive positive temperature anomalies (up to 1.85°C), which are pronounced at the end of the now lengthened ablation season. However, glacier mass budget perturbations do not mirror the magnitude of temperature anomalies in sub-regions, thus additional factors have heightened glacier recession. We show how proglacial lake expansion and glacier surging have compounded glacier recession over decadal/multi-decadal time periods, and exert similar influence on glacier mass budgets as temperature changes. Our results demonstrate the importance of ice loss mechanisms not often incorporated into broad-scale glacier projections, which need to be better considered to refine future glacier runoff estimates.
In March 2020, at the onset of the coronavirus disease 2019 (COVID-19) pandemic in the United States, the Southern California Extracorporeal Membrane Oxygenation (ECMO) Consortium was formed. The consortium included physicians and coordinators from the 4 ECMO centers in San Diego County. Guidelines were created to ensure that ECMO was delivered equitably and in a resource effective manner across the county during the pandemic. A biomedical ethicist reviewed the guidelines to ensure ECMO use would provide maximal community benefit of this limited resource. The San Diego County Health and Human Services Agency further incorporated the guidelines into its plans for the allocation of scarce resources. The consortium held weekly video conferences to review countywide ECMO capacity (including census and staffing), share data, and discuss clinical practices and difficult cases. Equipment exchanges between ECMO centers maximized regional capacity. From March 1 to November 30, 2020, consortium participants placed 97 patients on ECMO. No eligible patients were denied ECMO due to lack of resources or capacity. The Southern California ECMO Consortium may serve as a model for other communities seeking to optimize ECMO resources during the current COVID-19 or future pandemics.
Glaciers in the eastern Pamir have reportedly been gaining mass during recent decades, even though glaciers in most other regions in High Mountain Asia have been in recession. Questions still remain about whether the trend is strengthening or weakening, and how far the positive balances extend into the eastern Pamir. To address these gaps, we use three different digital elevation models to reconstruct glacier surface elevation changes over two periods (2000–09 and 2000–15/16). We characterize the eastern Pamir as a zone of transition from positive to negative mass balance with the boundary lying at the northern end of Kongur Tagh, and find that glaciers situated at higher elevations are those with the most positive balances. Most (67% of 55) glaciers displayed a net mass gain since the 21st century. This led to an increasing regional geodetic glacier mass balance from −0.06 ± 0.16 m w.e. a−1 in 2000–09 to 0.06 ± 0.04 m w.e. a−1 in 2000–15/16. Surge-type glaciers, which are prevalent in the eastern Pamir, showed fluctuations in mass balance on an individual scale during and after surges, but no statistical difference compared to non-surge-type glaciers when aggregated across the region.
Alcohol-dependent patients have a significantly increased risk of depression, contributing a cycle of relapse and attendance at acute hospital services seeking help. Care is often focused on the alcohol dependence treatment with little consideration of concomitant psychiatric disorders.
To help bridge this gap in care planning and aim toward multidisciplinary long-term support.
We collected data on all patients referred to our alcohol complex patient MDT. We investigated the range of disciplines involved in patient care. We spoke to our patients about why they had chosen to attend hospital. We then developed a referral system to our alcohol MDT where a bespoke pathways of care was developed with all current and future care providers.
Our patients were often being cared for by multiple services, however much of this work was happening in isolation and was at times conflicting. Importantly, the patients were unclear where to go for what, and were utilizing the ED as a fail-safe when they were troubled.
Of 15 patients referred to MDT, 7 (50%) had a diagnosis of depression (DSM-IV). These patients had an average of 5.1 hospital attendances and 2.2 hospital admissions in the 3 months prior to MDT. At 3 months post-MDT, we were able to demonstrate a reduction in hospital admissions and attendances (average 2.2 & 1.4, respectively).
An MDT for alcohol-dependent patients with depression facilitates effective and collaborative working for the benefit of patients and services.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This qualitative study highlights the experiences of ten Serbian refugees who migrated to South Australia from former Yugoslavia as a result of the Balkan conflicts of the 1990s. Multiple semi-structured interviews were employed to examine participants' experiences before, during and after the conflicts. Eight stages of the refugee journey were identified: prewar peaceful co-existence, outbreak of war, fleeing towards refuge in Serbian-held territory, realisation that the pre-war life cannot be regained, dissatisfaction with the family's transition situation, decision and application to emigrate, migration and resettlement in Australia, and adaptation to life in Australia. A number of factors were found to influence each stage of the refugee journey (e.g., social, practical and health challenges, age, and negative Serbian stereotypes). From these findings, three adaptation patterns — active integration, passive integration, and segregation — were identified as specific to the participants in the current study.
This chapter examines the conceptualization and structure of global self-esteem (hereafter SE): that is, SE not tied to any particular societal context, personal attribute, social activity, or role (e.g., spouse and blues guitarist, physical appearance and intelligence, or school and work, respectively). Although there are several possible approaches to conceptualizing SE, we focus our examination on SE as an attitude people take toward their self à la Rokeach's (1968) widely accepted definition of attitude. Even though a multitude of SE measures exist (see Blascovich & Tomaka, 1991; Wylie, 1979), we limit our comments and analyses primarily to Rosenberg's (1965) oft cited and employed SE construct. We focus on the Rosenberg Self-Esteem Scale (hereafter RSES) because of its preeminence among social scientists and other students of SE.
Our chapter has three specific, though interrelated, goals: a clarification, an expansion, and an analysis of the meaning, measurement, and structure of global SE. Our clarification revolves around three chief aims. First, we explore in detail how Rosenberg (1965) actually conceptualized SE. Oddly, despite a plethora of ink devoted each year to the topic, this has not been thoroughly addressed. As we shall show, a careful look at Rosenberg's original Guttman scaling instructions for SE reveals a rather surprising and counterintuitive idea of what it means to be a high SE person. Second, we hope to bring terminological unity and clarity to some SE terms and offer corrections for some past imprecision.
The American scholar claims for himself the forgotten wastes and undisclosed lands. Like a character from Cooper, he travels from the walls and academes into the burnings of a prairie, thence to return and publish his message, discovering the horrid and yet holy measures of controls, the ways of fencing the wilds, and the singular terrors of his mind. He demands not the allegory Bunyan offered, nor the timeless locations Bunyan portrayed, but that allegory be stripped, that dream and its terror be held to place, located exactly where the scholar stands. He demands a material, measurement, place—somewhere and sometime in which to describe his crisis. He demands a particular machine, some object foreign enough, lawful enough, against which to measure himself and then destroy himself unto another life. He demands a compulsion to declare compulsion is fatal. He builds control and provides structure and works thereby his irony, tearing apart his devices, declaring his strangeness, his living out of place, his sense of himself as removed, of himself as a holy or at least as a special seer. He conflates history to the point of himself, places a local or even a world economy within himself, locates in his own psychomachia the material history of his culture. His expression of history, whatever the material or “artifact” claimed, is psychological, for the generative force, the historical explanation, is one of terror and of terror's control, of building not from innate designs or material exigencies or clashes of class or movements of world and regional economies but from the terrors of a bewilderment, from horrors to be externalized in the uniqueness of the American place—for Cotton Mather, Satan's home, the most vile and holy of deserts.