Precession-band variance missing from East Asian monsoon runoff.

Speleothem CaCO3 δ18O is a commonly employed paleomonsoon proxy. However, inferring local rainfall amount from speleothem δ18O can be complicated due to changing source water δ18O, temperature effects, and rainout over the moisture transport path. These complications are addressed using δ18O of planktonic foraminiferal CaCO3, offshore from the Yangtze River Valley (YRV). The advantage is that the effects of global seawater δ18O and local temperature changes can be quantitatively removed, yielding a record of local seawater δ18O, a proxy that responds primarily to dilution by local precipitation and runoff. Whereas YRV speleothem δ18O is dominated by precession-band (23 ky) cyclicity, local seawater δ18O is dominated by eccentricity (100 ky) and obliquity (41 ky) cycles, with almost no precession-scale variance. These results, consistent with records outside the YRV, suggest that East Asian monsoon rainfall is more sensitive to greenhouse gas and high-latitude ice sheet forcing than to direct insolation forcing.

Oxygen prescribing practice at Waikato Hospital does not meet guideline recommendations.

BACKGROUND: It is the recommendation of the British Thoracic Society oxygen guidelines and the Waikato Hospital prescribing policy that all supplemental oxygen should be prescribed. AIMS: The aim of this audit was to evaluate the current oxygen prescribing practices on different specialty wards in the Waikato Hospital. The secondary aim was to evaluate potential harm from oxygen toxicity of the patients whose oxygen was not prescribed appropriately. METHODS: One hundred and twenty inpatients receiving oxygen therapy were randomly selected between December 2012 and April 2013. Forty patients were selected from each of the respiratory, surgical and other medical subspecialty wards. Their medication charts, clinical records and laboratory results were reviewed regarding their oxygen prescription, smoking history, diagnoses of chronic respiratory diseases and previous documentation of type 2 respiratory failure. RESULTS: In total, 51.7% of all the patients audited had correct oxygen prescriptions: 77.5% of respiratory, 52.5% of surgical and 25% of other medical specialities. Among the 50 patients whose oxygen was not prescribed, many were classified as having high risk of potential complications of oxygen toxicity: 44% having known chronic respiratory disease, 70% having smoking history and 16% having previous type 2 respiratory failure. CONCLUSION: Current oxygen prescription rates and practices in Waikato Hospital are not satisfactory and can in turn put patients at risk of oxygen toxicity. There is a significant discrepancy in prescribing practices between specialities. Better education of oxygen prescription is required to raise the awareness and to improve the prescribing practice across the hospital.