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Thermal regimes in rivers and streams are fundamentally important to aquatic ecosystems and are expected to change in response to climate forcing as the Earth's temperature warms. Description and attribution of stream temperature changes are key to understanding how these ecosystems may be affected by climate change, but difficult given the rarity of long-term monitoring data. We assembled 18 temperature time-series from sites on regulated and unregulated streams in the northwest U.S. to describe historical trends from 1980-2009 and assess thermal consistency between these stream categories. Statistically significant temperature trends were detected across seven sites on unregulated streams during all seasons of the year, with a cooling trend apparent during the spring and warming trends during the summer, fall, and winter. The amount of warming more than compensated for spring cooling to cause a net temperature increase, and rates of warming were highest during the summer (raw trend = 0.17°C/decade; reconstructed trend = 0.22°C/decade). Air temperature was the dominant factor explaining long-term stream temperature trends (82-94% of trends) and inter-annual variability (48-86% of variability), except during the summer when discharge accounted for approximately half (52%) of the inter-annual variation in stream temperatures. Seasonal temperature trends at eleven sites on regulated streams were qualitatively similar to those at unregulated sites if two sites managed to reduce summer and fall temperatures were excluded from the analysis. However, these trends were never statistically significant due to greater variation among sites that resulted from local water management policies and effects of upstream reservoirs. Despite serious deficiencies in the stream temperature monitoring record, our results suggest many streams in the northwest U.S. are exhibiting a regionally coherent response to climate forcing. More extensive monitoring efforts are needed as are techniques for short-term sensitivity analysis and reconstructing historical temperature trends so that spatial and temporal patterns of warming can be better understood. Continuation of warming trends this century will increasingly stress important regional salmon and trout resources and hamper efforts to recover these species, so comprehensive vulnerability assessments are needed to provide strategic frameworks for prioritizing conservation efforts. [ABSTRACT FROM AUTHOR]

The worst mistake any attorney or physician involved in a case of medical negligence can make is to underestimate the opponent. The expert witness may know a lot more about a certain field than the physician, or at least a lot more about what the basic standard of care is for a particular case. This article discusses the importance of the deposition and delineates four aspects of the deposition that are of utmost importance in a medical negligence case.

From a plaintiff's perspective, a jury trial and verdict are prepared for in every case. Experienced trial lawyers know, however, that it is preferable for both sides to reach an equitable compromise as to the value of a case, rather than risk the unknowns involved in a jury determination of a verdict. There are legal elements that require an independent analysis to determine whether a trial, settlement, or some form of arbitration is the appropriate strategy for a plaintiff to pursue.

The most important initial step a physician can take in a malpractice case is to secure the best possible representation for his or her defense. This article enumerates the criteria for obtaining quality representation. Among other points, the author cautions the physician to consider the motivation of those who are defending him or her and explains how to determine if an attorney has one's best interests in mind.

Violence against women is a common phenomenon worldwide. Effects can be severe and life-long. As physicians who treat women exclusively, the obstetrician-gynecologist has a medical and ethical obligation to recognize and intervene on behalf of their abused patients. At the same time, because of the special nature of the patient-physician relationship, the obstetrician-gynecologist is in a unique position to provide such assistance. This article presents an overview of violence against women and its consequences, highlights responses to the problem, and details the activities of the American College of Obstetricians and Gynecologists to educate its members on domestic violence. ACOG activities may serve as a model of response to domestic violence for similar organizations.

That living will, or natural death, legislation--which is currently being pushed in state assemblies nationwide--is unnecessary and may actually inhibit physicians in providing the best of care to dying patients is evident from an analysis of the statutes that have been passed. Whether the motivation behind such legislation is to take a step toward legalizing euthanasia is an open question.

HEW funding for research involving in vitro fertilization would support acts that are ethically inappropriate and of questionable legality.

Nearly a dozen years ago, the McGrath Thesis stimulated controversy about Catholic corporations as property owners. Though no court has ever ruled that a charitable corporation's control is vested in the general public, institutions should understand state and federal laws that affect both property ownership and its dissolution.