Time-series for river gauging stations are core blue-skies and applied research resources for understanding impacts of climate and anthropogenic change on basin hydrology. River flow archives hold vital information for evidence-based assessment of past hydrological variability, and support hydrological modelling of future changes. River discharge is an integration of basin input, storage and transfer processes to the gauging point. It is important to set basin outlet data in regional to global and long-term contexts: to better understand nested scales of variability; to pinpoint locations and time periods most sensitive to climate and human impacts; to make predictions for ungauged basins; and to inform decision makers on water security issues, and where and when to take measures to mitigate water hazards and stress, including floods and droughts (
Significant improvements in overall quality of life and two specific areas of daily living in people with low vision were found, although the magnitude and clinical significance of the rehabilitation-induced gains were modest. Further investigation in other models of low-vision rehabilitation is needed to optimize quality of life gains in people with low vision.
A large-scale perspective is provided upon the nature of precipitation regimes across Nepal by classifying long-term mean monthly precipitation data for 222 stations. The classification methodology is shown to be a useful tool for identifying underlying spatial structure in precipitation regime shape (seasonal variability) and magnitude (size) in an extreme physical environment where climatological patterns are complex and poorly known. A composite (shape and magnitude) regime classification indicates the key controls upon spatial patterns in Nepalese precipitation to be: length and timing of the summer monsoon (duration decreases east to west with later onset and earlier withdrawal in the west); successively higher altitude, east-west-trending mountain ranges causing rainfall to decline broadly south-north; topographic barriers that induce local rain shadows (lee) and precipitation hotspots (windward side); and westerly weather systems supplying winter precipitation to the northwest mountains. Although general patterns relating to zonal movement of the summer monsoon and physiographic (mountain ranges) controls upon precipitation may be identified, the role of mountainous relief in yielding localized precipitation patterns is significant.
People with vision-threatening diabetic retinopathy are likely to experience enhanced social and emotional strain. Critically, those with both vision-threatening diabetic retinopathy and psychosocial problems may have significantly reduced levels of functioning compared with psychologically healthy counterparts. This can cause inadequate compliance, increased strain on family functioning, worse diabetes control, increased progression of diabetic retinopathy and, consequently, further psychosocial stress resulting in a number of concerning implications for disease management, clinical outcomes and healthcare costs. However, the emotional and social health consequences of diabetic retinopathy have not yet been systematically explored. This information is crucial as it allows for a targeted approach to treatment and prevention and avoidance of the potentially detrimental implications described above. Therefore, this paper reviews the current qualitative and quantitative evidence regarding the social and emotional impact of diabetic retinopathy and identifies directions for future research. Key search terms were applied to the electronic databases Pubmed, ISI Web of Science and Embase and the bibliographies of relevant papers were systematically reviewed for additional references. Overall, the evidence suggests that diabetic retinopathy and associated vision loss have several debilitating effects, including disruption of family functioning, relationships and roles; increased social isolation and dependence; and deterioration of work prospects resulting in increased financial strain. Adverse emotional responses include fear, anxiety, vulnerability, guilt, loss of confidence, anger, stress and self-perception issues. However, the research to date is largely qualitative in nature, with most quantitative studies being small, cross-sectional and somewhat outdated. Similarly, the outcome measures used in many studies to date are suboptimal in terms of content and validity. Therefore, this review identifies the need for improved outcome measures to provide valid, meaningful measurement of the social and emotional impact of diabetic retinopathy and discusses potential directions for future research such as item banking and computer adaptive testing.
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