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Griffiths, G. M.,Chambers, L. E.,Haylock, M. R.,Manton, M. J.,Nicholls, N.,Baek, H.-J.,Choi, Y.,Della-Marta, P. M.,Gosai, A.,Iga, N.,Lata, R.,Laurent, V.,Maitrepierre, L.,Nakamigawa, H.,Ouprasitwong, John Wiley Sons, Ltd. 2005 International journal of climatology Vol.25 No.10
<P>Trends (1961–2003) in daily maximum and minimum temperatures, extremes and variance were found to be spatially coherent across the Asia–Pacific region. The majority of stations exhibited significant trends: increases in mean maximum and mean minimum temperature, decreases in cold nights and cool days, and increases in warm nights. No station showed a significant increase in cold days or cold nights, but a few sites showed significant decreases in hot days and warm nights. Significant decreases were observed in both maximum and minimum temperature standard deviation in China, Korea and some stations in Japan (probably reflecting urbanization effects), but also for some Thailand and coastal Australian sites. The South Pacific convergence zone (SPCZ) region between Fiji and the Solomon Islands showed a significant increase in maximum temperature variability.</P><P>Correlations between mean temperature and the frequency of extreme temperatures were strongest in the tropical Pacific Ocean from French Polynesia to Papua New Guinea, Malaysia, the Philippines, Thailand and southern Japan. Correlations were weaker at continental or higher latitude locations, which may partly reflect urbanization.</P><P>For non-urban stations, the dominant distribution change for both maximum and minimum temperature involved a change in the mean, impacting on one or both extremes, with no change in standard deviation. This occurred from French Polynesia to Papua New Guinea (except for maximum temperature changes near the SPCZ), in Malaysia, the Philippines, and several outlying Japanese islands. For urbanized stations the dominant change was a change in the mean and variance, impacting on one or both extremes. This result was particularly evident for minimum temperature.</P><P>The results presented here, for non-urban tropical and maritime locations in the Asia–Pacific region, support the hypothesis that changes in mean temperature may be used to predict changes in extreme temperatures. At urbanized or higher latitude locations, changes in variance should be incorporated. Copyright © 2005 Royal Meteorological Society.</P>
Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.
This article examines Bangladesh in the context of the debate over the conditions under which Islamist groups are likely to subvert democracy or to be transformed by the democratic process. Bangladesh signals two conditions that play an important role. Thefirst is the role of governments in promoting religion as a source of national identity. Successive governments in Bangladesh have consistently moved away from the promise of secularism that underpinned the creation of the country. The danger of establishing political legitimacy on the basis of religion is the absence of any authoritative interpretation of what religion requires in terms of public policy and how it can coexist with basic liberal freedoms and human rights. The second condition is the role of the government in providing and adequately regulating basic public goods such as education.
Study Design: Prospective, prognostic study, level II evidence. Purpose: To define the normal change in the creatine kinase (CK) levels in patients undergoing prone or supine lumbar or cervical spine surgery and to determine if positioning influences the postoperative changes in the CK levels. Overview of Literature: Spine surgery is one of the most commonly performed and fastest growing areas of surgery in the United States. Thus, the various possible complications need to be understood, and risk factors for these complications need to be mitigated. One of the rare complications, reported in the literature as small case series and case reports, is rhabdomyolysis, diagnosed by high CK levels. Thus far, very few studies have examined the rise in CK levels following spine surgery, and to our knowledge, none has assessed the potential association of surgical positioning and the rise in CK levels. Methods: We retrospectively analyzed 94 patients. We obtained their preoperative CK levels, and re-assessed their CK levels at postoperative day (POD) 1, 2, and 3, as well as at their 2-week follow-up. The data were analyzed with respect to the spine level and positioning to determine if positioning had any effect on the postoperative rise in the CK level. Results: Total 94 consecutive patients were enrolled in this study. The average preoperative CK level was 179.64, and the average CK level was 847.04 on POD 1. Prone positioning showed a greater rise in the CK levels following surgery than the supine positioning. In a similar manner, lumbar procedures led to a larger rise in the CK levels than cervical surgery. Prone/lumbar surgery showed the largest increase among all groups. Finally, revision surgery and instrumentation both increased the postoperative CK levels. Conclusions: This study demonstrated that positioning can affect the postoperative CK level rise, with patients undergoing prone/lumbar surgery showing the greatest rise in the postoperative CK levels. This rise, however, may be related to paraspinal muscle damage, rather than the positioning itself.