Iran has faced many water shortage crises in the past. Iran’s moisture sources for precipitation were identified by Lagrangian approach using the FLEXible PARTicle dispersion model (FLEXPART) v9.0 ...model. The results demonstrate that Iran receives its moisture from both continental and oceanic sources. During the wet season, moisture uptake from the Arabian Sea, the Persian Gulf, and the Mediterranean Sea is dominant, while during the dry season, the role of the Red Sea, the Caspian Sea, and the Persian Gulf is intensified. Studying drought conditions by comparing 1-month, 6-month, and 12-month standardized precipitation index (SPI) with (E-P) values of oceanic and continental moisture sources (E stands for the evaporation and P the precipitation) using multiregression model demonstrates that among oceanic sources the Arabian Sea, the Persian Gulf, the Mediterranean Sea, and the Indian Ocean affect SPI values and among continental sources, moisture from bare grounds and cultivated lands influences SPI values during wet season. However, no correlation exists between oceanic and continental (E-P) and SPI values during the dry season. The results obtained by this study can be used by meteorologists and hydrology scientists for future water management programmes in Iran.
Abstract Background Multiple parameters influence adherence to drug treatment, including socio-economic, healthcare, condition, therapy, and patient-related factors. However, studies of the impact of ...patient-related factors, particularly regarding comorbid conditions, have produced conflicting results. Objectives To analyse the association between mental and physical comorbidity and non-adherence to antihypertensive medication in patients attending primary care, after including a comprehensive range of chronic comorbidities and potential confounders. Methods Cross-sectional study of 113,397 adults with a diagnosis of hypertension in 2010 assigned to the public health service of a region in northeastern Spain. Pharmacy billing records were linked to data from electronic health records at individual level. Non-adherence was defined as an antihypertensive medication possession ratio (MPR) < 80%. Multivariable logistic regression models were used to estimate the odds ratio for non-adherence. Potential predictors included mental and physical comorbidity, age, sex, blood pressure level, nationality, rurality, polypharmacy, and number of visits to the GP and to different specialties. Results One fifth of the study population showed poor adherence levels. Female sex, younger age, foreign nationality, living in a rural area, low blood pressure levels, polypharmacy, and mental comorbidity were positively and significantly associated with non-adherence. Conversely, non-adherence was negatively and significantly associated with the presence of cardiovascular risk factors and higher annual rates of GP visits. Conclusion The majority of patient-related determinants identified here (e.g., the presence of mental comorbidity, polypharmacy, foreign nationality) underscores the need for a patient- rather than a disease-centred care approach, as well as adequate physician-patient communication.
There is little verified information on global healthcare utilization by irregular migrants. Understanding how immigrants use healthcare services based on their needs is crucial to establish ...effective health policy. We compared healthcare utilization between irregular migrants, documented migrants, and Spanish nationals in a Spanish autonomous community.
This retrospective, observational study included the total adult population of Aragon, Spain: 930,131 Spanish nationals; 123,432 documented migrants; and 17,152 irregular migrants. Healthcare utilization data were compared between irregular migrants, documented migrants and Spanish nationals for the year 2011. Multivariable standard or zero-inflated negative binomial regression models were generated, adjusting for age, sex, length of stay, and morbidity burden.
The average annual use of healthcare services was lower for irregular migrants than for documented migrants and Spanish nationals at all levels of care analyzed: primary care (0.5 vs 4 vs 6.7 visits); specialized care (0.2 vs 1.8 vs 2.9 visits); planned hospital admissions (0.3 vs 2 vs 4.23 per 100 individuals), unplanned hospital admissions (0.5 vs 3.5 vs 5.2 per 100 individuals), and emergency room visits (0.4 vs 2.8 vs 2.8 per 10 individuals). The average annual prescription drug expenditure was also lower for irregular migrants (€9) than for documented migrants (€77) and Spanish nationals (€367). These differences were only partially attenuated after adjusting for age, sex, and morbidity burden.
Under conditions of equal access, healthcare utilization is much lower among irregular migrants than Spanish nationals (and lower than that of documented migrants), regardless of country of origin or length of stay in Spain.
Mortality is a robust indicator of health and offers valuable insight into the health of immigrants. However, mortality estimates can vary significantly depending on the manner in which immigrant ...status is defined. Here, we assess the impact of nationality, country of origin, and length of stay in the host country on mortality estimates in an immigrant population in Aragón, Spain.
Cross-sectional retrospective study of all adult subjects from the EpiChron Cohort in 2011 (n = 1,102,544), of whom 146,100 were foreign-born (i.e., according to place of birth) and 127,213 were non-nationals (i.e., according to nationality). Directly standardized death proportions between years 2012-2015 were calculated, taking into account the age distribution of the European population in 2013. Binary logistic regression was used to compare the four-year probability of death.
The age- and sex-standardized number of deaths per 1000 subjects were 45.1 (95%CI 44.7-45.2) for the Spanish-born population, 29.3 (95%CI 26.7-32.1) for the foreign-born population, and 18.4 (95%CI 15.6-21.6) for non-Spanish nationals. Compared with the Spanish-born population, the age- and sex-adjusted likelihood of dying was equally reduced in the foreign-born and non-national populations (OR 0.6; 95%CI 0.5-0.7) when the length of stay was less than 10 years. No significant differences in mortality estimates were detected when the length of stay was over 10 years.
Mortality estimates in immigrant populations were lower than those of the native Spanish population, regardless of the criteria applied. However, the proportion of deaths was lower when immigrant status was defined using nationality instead of country of birth. Age- and sex-standardized death proportions tended to increase with increased length of stay in the host country.
Understanding moisture transport is crucial for understanding continental precipitation and extreme precipitation events, which are expected to become substantially more frequent under global warming ...conditions. In this work, the influence of major global moisture sources on extreme continental precipitation during the peak precipitation month is estimated and compared with climatological patterns. The results show a general change in the pattern of contribution of the primary source of precipitation (the source with the highest contribution) during extreme precipitation events. Most primary sources show a general reduction in their area of influence and a notable reduction in their contribution to the total precipitation.
In the last few decades, many studies have identified an increasing number of natural hazards associated with extreme precipitation and drought events in Europe. During the 20th century, the climate ...in Central Europe and the Mediterranean region was characterised by an overall temperature increase, and the beginning of the 21st century has been marked by severe and prolonged drought events. The aim of this study is to analyse variations in the moisture supply during the 2003 drought episode that affected large portions of Europe. In order to better characterise the evolution of the episodes across the continent, separate analyses were performed for two spatial domains: Central Europe and the Mediterranean region. These regions were defined according to the 5th Intergovernmental Panel on Climate Change Assessment Report. For both regions, this drought episode was most severe from 1980 to 2015, according to the one-month Standardised Precipitation Evapotranspiration Index (SPEI-1) analysis, which was conducted using monthly precipitation and potential evapotranspiration data from the Climate Research Unit. Analyses of precipitation, potential evapotranspiration, pressure velocity at 500 hPa, and vertically integrated moisture flux were conducted to characterise the anomalous patterns over the regions during the event. A Lagrangian approach was then applied in order to investigate possible continental-scale changes in the moisture supply over the Central European and Mediterranean regions during 2003. This approach is based on the FLEXible PARTicle (FLEXPART) dispersion model, integrated with data from the European Centre for Medium-Range Weather Forecasts (ECMWF): the ECMWF Re-Analysis ERA-Interim. The results indicate that anomalous subsidence, increased evapotranspiration, and reduced precipitation predominated over both regions during the episode. The most intense reduction in the moisture supply over Central Europe was registered for the Mediterranean Sea (MDS) and the Central European region, while for the Mediterranean region, most intense reduction in the moisture supply was observed in the MDS and—in minor-scale—Gibraltar regions.
This study investigates the impact of precipitation on Middle Eastern countries like Iran using precise methods such as stable isotope techniques. Stable isotope data for precipitation in Tehran were ...obtained from the Global Network of Isotopes in Precipitation (GNIP) station and sampled for two periods: 1961–1987 and 2000–2004. Precipitation samples were collected, stored, and shipped to a laboratory for stable isotope analyses using the GNIP procedure. Several models, including artificial neural networks (ANNs), stepwise regression, and ensemble machine learning approaches, were applied to simulate stable isotope signatures in precipitation. Among the studied machine learning models, XGboost showed the most accurate simulation with higher R2 (0.84 and 0.86) and lower RMSE (1.97 and 12.54), NSE (0.83 and 0.85), AIC (517.44 and 965.57), and BIC values (531.42 and 979.55) for 18O and 2H compared to other models, respectively. The uncertainty in the simulations of the XGboost model was assessed using the bootstrap technique, indicating that this model accurately predicted stable isotope values. Various wavelet coherence analyses were applied to study the associations between stable isotope signatures and their controlling parameters. The BWC analysis results show coherence relationships, mainly ranging from 16 to 32 months for both δ18O–temperature and δ2H–temperature pairs with the highest average wavelet coherence (AWC). Temperature is the dominant predictor influencing stable isotope signatures of precipitation, while precipitation has lower impacts. This study provides valuable insights into the relationship between stable isotopes and climatological parameters of precipitation in Tehran.
We herein investigate the role of the Tropical Western Hemisphere Warm Pool (WHWP) in providing moisture to the atmosphere throughout its annual cycle and identify those regions that could be ...affected by precipitation whose origin lies in this source. We use data from the Lagrangian FLEXPART model for the period 2000–2004 to identify the contributions of humidity from a region, by determining changes in specific humidity along the forward trajectories over a 10 day period. An analysis was performed for all the air parcels that lay in the region of the WHWP (defined according to the 28.5°C threshold applied in SST), and the monthly average conditions over the 5 year period were analyzed for May to October, inclusive. Our results show that this source provides a higher contribution of moisture to North America from June onward, when warmer waters may be observed over the Atlantic side of the warm pool and the transport of moisture may be increased by the Great Plains Low Level Jet. During the boreal summer, this contribution extends toward western Europe, probably as a result of the transport of moisture by the warm conveyor belts and the North Atlantic anticyclone. A qualitative similarity between the results of our Lagrangian analyses and the observed patterns of precipitation highlights the contribution of the source of moisture of the WHWP for the regimes of precipitation over eastern North America, the North Atlantic, and the Intertropical Convergence Zone.
Key Points
Role of WHWP as a moisture source
Contribution of WHWP for precipitation in North America and western Europe
Transport of moisture toward extratropics by GPLLJ and warm conveyor belt
Eurasian fall snow cover changes have been suggested as a driver for changes in the Arctic Oscillation and might provide a link between sea-ice decline in the Arctic during summer and atmospheric ...circulation in the following winter. However, the mechanism connecting snow cover in Eurasia to sea-ice decline in autumn is still under debate. Our analysis is based on snow observations from 820 Russian land stations, moisture transport using a Lagrangian approach derived from meteorological re-analyses. We show that declining sea-ice in the Barents and Kara Seas (BKS) acts as moisture source for the enhanced Western Siberian snow depth as a result of changed tropospheric moisture transport. Transient disturbances enter the continent from the BKS region related to anomalies in the planetary wave pattern and move southward along the Ural mountains where they merge into the extension of the Mediterranean storm track.
The climate in Central Europe (CEU) during the 20th century is characterized by an overall temperature increase. Severe and prolonged drought events began occurring towards the end and these have ...continued into the 21st century. This study aims to analyze variations in the moisture supply from the Mediterranean Sea (MDS) during meteorological drought episodes occurring over the CEU region over the last three decades. A total of 51 meteorological drought episodes (22 with summer onsets, and 29 with winter) are identified over the CEU during the period 1980–2015 through the one-month Standardized Precipitation Evapotranspiration Index (SPEI-1), and their respective indicators, including duration, severity, intensity, and peak values, are then computed. Lagrangian forward-in-time analysis reveals that negative anomalies of moisture coming from the MDS prevail in all episodes except seven. Linear regression analysis between variations in the MDS anomalies and indicators of the drought episodes shows a significant linear relationship between severity, duration, peak values (winter), and MDS anomalies, which implies that drought episodes last longer and are more severe with an increase in the negative anomaly of moisture supply from the MDS. Nevertheless, no linear relationship is found between the intensity and peak values (annual, summer) of drought episodes and anomalies in the moisture contribution from the MDS.
PDF
