Sources of attitudes towards parent-child co-sleeping and their effects: A systematic scoping review.

Parent-child co-sleeping is a common practice in many cultures, although in Western countries, families who engage in parent-child co-sleeping can encounter attitudes about co-sleeping that feel critical from the people around them, as it is not commonly accepted and often stigmatized. This systematic scoping review examined and synthesized the available literature on the attitudes about parent-child co-sleeping that people encounter, their origins, and their effect on parents' own attitudes and behaviors. A total of 9796 abstracts were screened, and 33 studies were included. While the scope of the literature on this topic was narrow, this review demonstrated that parents/caregivers mostly encounter encouraging attitudes about co-sleeping from their extended family members and within their culture and discouraging attitudes from healthcare professionals. Findings suggest that encouraging attitudes enhance the likelihood of parents engaging and continuing with co-sleeping behavior, while discouraging attitudes can lead to the avoidance of parents discussing sleep with their healthcare professionals and can cause conflicts with other family members, including partners. Based on these findings, we conclude that further research is needed in several areas related to co-sleeping in Western culture, most specifically in how external attitudes influence the decision to co-sleep, as well as other behaviors and cognitions such as engagement with healthcare professionals, family satisfaction, parental self-efficacy, and overall mental health.

"Please help us with important research": A retrospective analysis examining the impact of research invitation and participation on subsequent blood donor behavior.

BACKGROUND: As over-communication can negatively impact consumer behavior, it is important to understand the impact of research communication on donors' future donation behavior. The aim of this study was to determine the effect of (i) being invited to participate in research, and (ii) participating in that research, on future donation behavior. STUDY DESIGN AND METHODS: A retrospective cohort analysis was conducted with 36,418 donors who were invited to participate in one of 17 research projects, and a matched control group of 36,252 non-invited donors. Poisson regression models were used to examine the associations between invitation or participation in the studies and the likelihood of creating an appointment to donate and attending an appointment at 1, 3, and 6 months. RESULTS: Donors were significantly more likely to create an appointment within 14 days of receiving an invitation compared to controls (RR: 1.91, 95% CI 1.81-2.02), and to return to donate at 1 (RR:1.18, 95% CI 1.13-1.24), 3 (RR:1.10, 95% CI 1.07-1.13) and 6 (RR:1.11, 95% CI 1.09-1.13) months compared to non-invited controls. Donors who participated in the research were more likely to return than control donors at all time points, while donors who were invited but did not participate were also likely to return more at 1 month (RR:1.06, 95% CI 1.00-1.11) and 6 months (RR:1.03, 95% CI 1.00-1.5) than non-invited controls. DISCUSSION: Our findings suggest that research participation is positively associated with future donor behavior and provides reassurance that contacting donors for research does not negatively impact blood collections.

Improving donor retention following a temporary deferral: A cluster randomized controlled trial of deferral educational materials.

BACKGROUND: Providing educational materials to deferred donors has been shown to increase their understanding about their deferral and knowledge about their return. The aim of this study was to determine the effectiveness of educational materials in increasing the retention of deferred donors. STUDY DESIGN AND METHODS: A three-arm cluster randomized controlled trial was conducted, with the following conditions: (a) Incenter Brochure plus Email; (b) Email Only; (c) Control. The Incenter Brochure plus Email condition also included a guided conversation led by staff at the point of deferral. Donors were followed up for 3 months after their deferral had ended to determine if they had attempted to donate. RESULTS: Compared with the Control condition, donors in the Incenter Brochure plus Email condition had increased odds of return at 3 months after their deferral ended (OR: 1.16; 95% CI 1.00-1.33). Subgroup analysis highlighted that novice (OR: 1.38; 95% CI 1.04-1.83) and established donors (OR: 1.36; 95% CI 1.13-1.64) had increased odds of return if they received the incenter materials. Donors who were deferred to maintain their well-being (OR: 1.28; 95% CI 1.03-1.60) and donors with a prior deferral history (OR: 1.55; 95% CI 1.15-1.55) had increased odds of return if they received the incenter materials. No significant differences were found between the Email Only and Control conditions. DISCUSSION: This trial demonstrates the benefits of providing onsite educational materials to donors at the point of deferral. This is a simple, effective strategy to increase the return behavior of donors within 3 months of their deferral ending.

It is about who you know (and how you help them): Insights from staff and donors about how to recruit and retain a panel of committed anti-D donors.

BACKGROUND AND OBJECTIVES: Maintaining a panel of committed anti-D donors is crucial for the production of anti-D immunoglobulin to prevent haemolytic disease of the foetus and newborn. Given low numbers of donors in the Australian panel, there is a need to better understand motivators and barriers specific to anti-D donors. MATERIALS AND METHODS: A qualitative approach was used to gather perspectives of staff and current anti-D donors in Australia. Focus groups were held with staff involved with the anti-D programme. An asynchronous online discussion forum and interviews were conducted with donors. All data were coded using deductive and inductive thematic analysis. RESULTS: Staff stressed the importance of recruiting donors who met their own informal criteria as well as the formal selection criteria in order to maximize the chances of donors committing to making regular plasma donations. In contrast, donors were motivated by having a personal connection to anti-D, the recipient group and being eligible to join the programme. Support from staff and understanding the value of their donations also helped donors overcome concerns about the risks of joining the programme and reduced barriers to remaining in the programme. CONCLUSION: Anti-D donors in Australia are motivated by multiple factors, including knowing who the recipient is, and dedicated staff are integral to building donors' commitment through education and support. Findings suggest the current approach to recruitment could be broadened to include all donors who meet formal selection criteria, with retention enhanced by reinforcing and rewarding the motives identified by donors for donating.

Designing and testing an ethnic-ancestry question for Australian blood donors: Acceptability, feasibility, and understanding.

OBJECTIVES: We aimed to evaluate the acceptability, feasibility, and understanding of a donor ethnic-ancestry question with Australian blood donors. BACKGROUND: Ethnic-ancestry assists blood collection agencies to meet the demand for rare blood-types. However, there is no standard ethnicity question used by health/blood services around the world and we do not know how blood donors in Australia will respond to being asked for this information. METHODS/MATERIALS: A survey and ethnic-ancestry question was administered to a sample of donors (n = 506) to evaluate their views on being asked for their ethnic-ancestry, test a comprehensive ethnic-ancestry list, and determine the level of information required by donors. RESULTS: Donors reported being very comfortable providing their ethnic-ancestry and the majority of donors found an ethnic-ancestry option they were happy with (91.3%). Overall donors reported a high level of understanding of why ethnic-ancestry was important to blood donation. However, when provided more information on why ethnic-ancestry is required, donors reported increased understanding. CONCLUSION: The findings from this study demonstrated that it is acceptable and feasible to introduce a comprehensive ethnic-ancestry question for Australian blood donors. We also found that a greater understanding is achieved when a more comprehensive explanation for inclusion of the question is provided.

Examining knowledge translation in blood donor research: A review of vasovagal reaction literature.

BACKGROUND: Knowledge translation focuses on the transfer of research findings into policy and practice. To provide insight into the state of knowledge translation in blood donor research, we undertook a rapid review of a key research area in the field with high potential for translation, vasovagal reactions (VVRs). We examined the number and nature of VVR-related studies to determine the availability of research evidence, and mapped the included articles along the research-to-practice trajectory using the Knowledge to Action framework. STUDY DESIGN AND METHODS: PubMed, PsycINFO, CINAHL, and EMBASE were searched for peer-reviewed journal articles from inception to October 2019 using the terms blood don* AND vasovagal OR faint* OR syncope. RESULTS: A total of 176 articles met our inclusion criteria. Studies relating to VVRs increased substantially from 1942 to 2019, with 84% published in the last 20 years. Articles were predominately observation (non-intervention) studies (117; 66%), followed by intervention (knowledge inquiry) studies (31; 18%) and review (knowledge synthesis) studies (20; 11%). The evidence from intervention research was limited, with 14 strategies tested in 31 studies and often by the same research groups. Only 5 (3%) implementation and evaluation studies were found; all focused on evaluating the effects of a newly introduced intervention on VVR rates through uncontrolled or cross-sectional study designs. DISCUSSION: VVR research is in the early stages of knowledge translation. More intervention research is needed to provide a robust evidence base as well as more published implementation research to share knowledge of translating research into policy and practice.

Notifying donors when their deferral is ending: An effective donor retention strategy.

BACKGROUND: The application of a temporary deferral often leads to donor lapse. Contributing factors may be donors not knowing when their deferral ends or not being contacted and asked to return. The aim of this study was to determine the effectiveness of a reminder message notifying donors that their deferral is coming to an end in increasing donors' postdeferral return rates. We evaluated the optimal time, content, and mode of delivery of the reminder message. STUDY DESIGN AND METHODS: Two studies were conducted with deferred donors. Study 1: donors (n = 1676) were randomized to be sent a reminder message at one of three time points (4 weeks before, 1 week before, and 1 week after their deferral ended) or to a no contact control condition. Study 2: donors (n = 1973) were randomized to three message type conditions (emotive email, nonemotive email, nonemotive SMS). Attempted return behavior was extracted (appointments, attendances) at 1 month. RESULTS: In Study 1, being sent the reminder message increased odds of donors attempting to return within 3 months compared with the control group (OR:2.01). Sending the reminder 1 week before the deferral ended was the most effective time point. In Study 2, the nonemotive message increased the odds of attempting to return compared with the emotive message (OR:1.38). No differences were found between email and SMS messages. DISCUSSION: Sending a reminder message to donors when their deferral is coming to an end is a simple, effective, and cost-effective method to retain donors.

Educating donors about deferrals through the provision of tailored materials: Findings from a survey of deferred donors.

BACKGROUND: Receiving a temporary deferral has been shown to negatively affect donor retention. One contributing factor for low donor return may be poor understanding of why the deferral has occurred. The aim of this study was to determine whether new educational materials-a brochure, guided conversation, and follow-up email-increased deferred donors' knowledge about their donation eligibility, satisfaction with the deferral process, intention to return, and odds of rebooking another appointment. STUDY DESIGN AND METHODS: A three-arm cluster randomised controlled trial was conducted to evaluate the impact of the educational materials compared to business as usual deferral procedures: (a) In-center brochure and follow-up email; (b) Email only; (c) Control. A survey was administered to a random sample of trial participants (n = 847). RESULTS: Compared with the control condition, donors in the in-center brochure and email condition were more knowledgeable about the end date of their deferral, and reported higher satisfaction with the deferral information provided, and had fewer questions and/or concerns about the deferral. Similar findings were observed when comparing the email only condition to the in-center brochure and email condition. No differences were found in intention to return. Donors in the in-center brochure plus email condition had increased odds (OR:1.385) of rebooking their next appointment compared to the combined email only and control conditions. CONCLUSIONS: The application of a deferral is often misunderstood by donors. Providing educational materials to donors can increase their understanding and may lead to increased retention of donors through rebooking of subsequent donations.

Thank you for donating: a survey of Australian donors' and nondonors' orientations toward noncash incentives for blood donation.

BACKGROUND: The aim of this study was to understand Australian donors' and nondonors' orientations toward 13 noncash incentives for blood and plasma donation and the associations between orientations and intention to donate (nondonors) and subsequent donation (donors). STUDY DESIGN AND METHODS: A survey of 1028 donors and 1201 nondonors was conducted online and by telephone. Donors were randomly selected from the Australian Red Cross Lifeblood donor panel; nondonors were selected from randomly generated fixed line and mobile telephone numbers across Australia. Incentives were chosen to reflect a wide array of possible noncash incentives that might be introduced by blood donation organizations (BDOs). Differences between donors and nondonors, as well as other subgroups, were investigated. RESULTS: Orientations toward most types of incentives were positive or neutral. No significant differences were observed between incentive orientations for whole blood versus plasma donations. Many subgroup differences were small but statistically significant. There were mostly small, positive, significant associations between nondonors' intention to donate and orientations toward noncash incentives; there were mostly no significant associations between donors' orientations and subsequent donation behaviors. CONCLUSION: The findings from this study suggest that BDOs that wish to trial noncash incentives in voluntary nonremunerative systems can be confident that neither donors nor potential donors will react negatively. They also indicate that BDOs have some flexibility in deciding which incentives to trial.

A subset of FG-nucleoporins is necessary for efficient Msn5-mediated nuclear protein export.

The transport of proteins between the cytoplasm and nucleus requires interactions between soluble transport receptors (karyopherins) and phenylalanine-glycine (FG) repeat domains on nuclear pore complex proteins (nucleoporins). However, the role of specific FG repeat-containing nucleoporins in nuclear protein export has not been carefully investigated. We have developed a novel kinetic assay to investigate the relative export kinetics mediated by the karyopherin Msn5/Kap142 in yeast containing specific FG-Nup mutations. Using the Msn5 substrate Crz1 as a marker for Msn5-mediated protein export, we observe that deletions of NUP100 or NUP2 result in decreased rates of Crz1 export, while nup60Δ and nup42Δ mutants do not vary significantly from wild type. The decreased Msn5 export rate in nup100Δ was confirmed using Mig1-GFP as a transport substrate. A nup100ΔGLFG mutant shows defects in nuclear export kinetics similar to a nup100Δ deletion. Removal of FG-repeats from Nsp1 also decreases export kinetics, while a loss of Nup1 FXFGs does not. To confirm that our export data reflected functional differences in protein localization, we performed Crz1 transcription activation assays using a CDRE::LacZ reporter gene that is upregulated upon increased transcription activation by Crz1 in vivo. We observe that expression from this reporter increases in nup100ΔGLFG and nsp1ΔFGΔFXFG strains that exhibit decreased Crz1 export kinetics but resembles wild-type levels in nup1ΔFXFG strains that do not exhibit export defects. These data provide evidence that the export of Msn5 is likely mediated by a specific subset of FG-Nups and that the GLFG repeat domain of Nup100 is important for Msn5-mediated nuclear protein export.

The health impacts of blood donation: a systematic review of donor and non-donor perceptions.

BACKGROUND: The health and well-being of volunteer donors is of critical concern for blood collection agencies responsible for ensuring a stable supply of blood products. However, lay understandings of the impact of donating blood on health remain poorly understood. As lay perceptions are likely to influence critical decisions about donation, understanding these perceptions is key for informing evidence-based approaches to donor retention and recruitment. As such, we conducted a systematic review of the blood donation literature to identify donors' and non-donors' perceptions of the short and longer-term physiological health effects of whole-blood and/or blood product donation. MATERIALS AND METHODS: This review was conducted in line with PRISMA guidelines. Studies published from January 1995 to February 2021 were included. Perceptions were defined as both experiences and beliefs. Psychological effects were considered outside the scope of the review. RESULTS: A total of 247 studies were included. Most studies (89.5%) had donation-related health perceptions as a background rather than a central (10.5%) focus, and they were only assessed in relation to whole blood donation. More results focused on health-related beliefs than experiences (82 vs 18%), specific rather than general beliefs and experiences (80 vs 20%) and more frequently examined negative than positive beliefs and experiences (83 vs 17%). The most commonly studied and reported specific negative beliefs related to increased risk of infectious disease, reduced vitality, vasovagal reactions and low iron. Most studies examining specific negative beliefs were conducted in Asian countries. DISCUSSION: Findings reinforce that lay perspectives on how donation impacts health are under-researched, and it is difficult to know how important these are in informing critical decisions about donation for donors and non-donors. We suggest that further research with donation-related health beliefs and experiences as the central focus is needed to provide insights to inform communications with donors and the public.

Understanding Mothers' Experiences of Being Ineligible to Donate Their Milk to a Not-for-Profit Milk Bank.

Background: Donor milk banks have strict donor screening criteria to ensure that donor milk is safe for premature or hospitalized babies. Yet little evidence is available to understand how potential donors, who are often breastfeeding their own infants, experience being ineligible ("deferred") to donate their milk to a milk bank. Materials and Methods: Interviews were conducted with 10 mothers who were permanently or temporarily deferred from donating to a large, not-for-profit milk bank in Australia. Interviews focused on becoming a donor and being deferred, meanings of deferral, impact of deferral on feeding own infant, and improving the deferral process. Results: Thematic analysis of interviews identified nine themes: (1) donation as a solution to wasting milk; (2) eligibility questions were acceptable and understandable; (3) more information early on allows self-deferral; (4) deferral is not always clear; (5) deferral is disappointing but does not prevent future donation; (6) deferral did not prevent feeding own infant; (7) early information enables preparation for donation; (8) slow communication disrupts perfect timing to donate; and (9) alternatives to wasting milk. Conclusions: Milk banks have a duty of care to both milk recipients and donors. While mothers who want to donate milk are disappointed by deferrals, clear communication protects their breastfeeding relationships with their own infants. Milk banks can improve their screening processes by providing information up-front and ensuring timely contact with mothers. Mothers can then make informed decisions about donating and not feel as if their milk and resources are "wasted."

Incorporation of spatial and economic analyses of human-use data in the design of marine protected areas.

Social, economic, and ecological criteria contribute to the successful design, implementation, and management of marine protected areas (MPAs). In the context of California's Marine Life Protection Act Initiative, we developed a set of methods for collecting, compiling, and analyzing data about the spatial extent and relative economic importance of commercial and recreational fishing. We interviewed 174 commercial fishers who represented the major fisheries in the initiative's north-central coast region, which extends from Point Arena south to Pigeon Point. These fishers provided data that we used to map the extent of each of the fishing grounds, to weight the relative importance of areas within the grounds, to characterize the operating costs of each fishery, and to analyze the potential economic losses associated with proposed marine protected areas. A regional stakeholder group used the maps and impact analyses in conjunction with other data sets to iteratively identify economic and ecological trade-offs in designations of different areas as MPAs at regional, port, and fishery extents. Their final proposed MPA network designated 20% of state waters as MPAs. Potential net economic loss ranged from 1.7% to 14.2% in the first round of network design and totaled 6.3% in the final round of design. This process is a case study in the application of spatial analysis to validate and integrate local stakeholder knowledge in marine planning.

Extending electromagnetic methods to map coastal pore water salinities.

The feasibility of mapping pore water salinity based on surface electromagnetic (EM) methods over land and shallow marine water is examined in a coastal wetland on Tampa Bay, Florida. Forward models predict that useful information on seabed conductivity can be obtained through <1.5 m of saline water, using floating EM-31 and EM-34 instruments from Geonics Ltd. The EM-31 functioned as predicted when compared against resistivity soundings and pore water samples and proved valuable for profiling in otherwise inaccessible terrain due to its relatively small size. Experiments with the EM-34 in marine water, however, did not reproduce the theoretical instrument response. The most effective technique for predicting pore water conductivities based on EM data entailed (1) computing formation factors from resistivity surveys and pore water samples at representative sites and (2) combining these formation factors with onshore and offshore EM-31 readings for broader spatial coverage. This method proved successful for imaging zones of elevated pore water conductivities/salinities associated with mangrove forests, presumably caused by salt water exclusion by mangrove roots. These zones extend 5 to 10 m seaward from mangrove trunks fringing Tampa Bay. Modeling indicates that EM-31 measurements lack the resolution necessary to image the subtle pore water conductivity variations expected in association with diffuse submarine ground water discharge of fresher water in the marine water of Tampa Bay. The technique has potential for locating high-contrast zones and other pore water salinity anomalies in areas not accessible to conventional marine- or land-based resistivity arrays and hence may be useful for studies of coastal-wetland ecosystems.

Considerations in evaluating potential socioeconomic impacts of offshore platform decommissioning in California.

The 27 oil and gas platforms offshore southern California will eventually reach the end of their useful lifetimes (estimated between 2015 and 2030) and will be decommissioned. Current state and federal laws and regulations allow for alternative uses in lieu of the complete removal required in existing leases. Any decommissioning pathway will create a complex mix of costs, benefits, opportunities, and constraints for multiple user groups. To assist the California Natural Resources Agency in understanding these issues, we evaluated the potential socioeconomic impacts of the 2 most likely options: complete removal and partial removal of the structure to 85 feet below the waterline with the remaining structure left in place as an artificial reef-generally defined as a manmade structure with some properties that mimic a natural reef. We estimated impacts on commercial fishing, commercial shipping, recreational fishing, nonconsumptive boating, and nonconsumptive SCUBA diving. Available data supported quantitative estimates for some impacts, semiquantitative estimates for others, and only qualitative approximations of the direction of impact for still others. Even qualitative estimates of the direction of impacts and of user groups' likely preferred options have been useful to the public and decision makers and provided valuable input to the project's integrative decision model. Uncertainty surrounds even qualitative estimates of the likely direction of impact where interactions between multiple impacts could occur or where user groups include subsets that would experience the same option differently. In addition, we were unable to quantify effects on ecosystem value and on the larger regional ecosystem, because of data gaps on the population sizes and dynamics of key species and the uncertainty surrounding the contribution of platforms to available hard substrate and related natural populations offshore southern California.

Drug Safety and the Cost of Monitoring: The Role of REMS in Risk Management.

BACKGROUND: The mission of the US Food and Drug Administration (FDA) can be viewed as a pendulum that swings between protecting public health and patient safety and promoting the public health through the drug review and approval process. Two decades of legislation have by and large provided the FDA with additional resources under the successive reauthorizations of the Prescription Drug User Fee Acts (PDUFA) to provide a necessary infusion of funds to hire medical experts, scientists, and epidemiologists, among other disciplines, to expedite review of new drug and biologic applications. However, a renewed attention to potential adverse drug experiences, culminating in the Vioxx withdrawal, has resulted in the passage of the Food and Drug Administration Amendments Act of 2007 (FDAAA). Under this act, the FDA was authorized to impose postapproval requirements on the biopharmaceutical industry through the imposition of risk evaluation and mitigation strategies (REMS) and postmarketing trial (PMT) requirements to improve drug safety. Despite the extensive dialogue between stakeholders and lawmakers in the development of the FDAAA, there remains some uncertainty as to the exact impact of REMS on not only operational costs for both industry and health care professionals but also product sales and prescribing habits in the 5 years since its implementation. METHODS: Recognizing that in the past 2 years, the use of REMS has shifted markedly, we sought to provide greater clarity on the duration of REMS requirements and impact of REMS on drug sales. RESULTS: While in absolute terms, the use of REMS may be declining, the REMS experience has provided an important, perhaps even critical, step in the development of current risk management strategies aimed at improving patient safety.

Not all salmon are created equal: life cycle assessment (LCA) of global salmon farming systems.

We present a global-scale life cycle assessment of a major food commodity, farmed salmon. Specifically, we report the cumulative energy use, biotic resource use, and greenhouse gas, acidifying, and eutrophying emissions associated with producing farmed salmon in Norway, the UK, British Columbia (Canada), and Chile, as well as a production-weighted global average. We found marked differences in the nature and quantity of material/energy resource use and associated emissions per unit production across regions. This suggests significant scope for improved environmental performance in the industry as a whole. We identify key leverage points for improving performance, most notably the critical importance of least-environmental cost feed sourcing patterns and continued improvements in feed conversion efficiency. Overall, impacts were lowest for Norwegian production in most impact categories, and highest for UK farmed salmon. Our results are of direct relevance to industry, policy makers, eco-labeling programs, and consumers seeking to further sustainability objectives in salmon aquaculture.

Geochemical and geophysical examination of submarine groundwater discharge and associated nutrient loading estimates into Lynch Cove, Hood Canal, WA.

Geochemical tracer data (i.e., 222Rn and four naturally occurring Ra isotopes), electromagnetic (EM) seepage meter results, and high-resolution, stationary electrical resistivity images were used to examine the bi-directional (i.e., submarine groundwater discharge and recharge) exchange of a coastal aquifer with seawater. Our study site for these experiments was Lynch Cove, the terminus of Hood Canal, WA, where fjord-like conditions dramatically limit water column circulation that can lead to recurring summer-time hypoxic events. In such a system a precise nutrient budget may be particularly sensitive to groundwater-derived nutrient loading. Shore-perpendicular time-series subsurface resistivity profiles show clear, decimeter-scale tidal modulation of the coastal aquifer in response to large, regional hydraulic gradients, hydrologically transmissive glacial terrain, and large (4-5 m) tidal amplitudes. A 5-day 222Rn time-series shows a strong inverse covariance between 222Rn activities (0.5-29 dpm L(-1)) and water level fluctuations, and provides compelling evidence for tidally modulated exchange of groundwater across the sediment/water interface. Mean Rn-derived submarine groundwater discharge (SGD) rates of 85 +/- 84 cm d(-1) agree closely in the timing and magnitude with EM seepage meter results that showed discharge during low tide and recharge during high tide events. To evaluate the importance of fresh versus saline SGD, Rn-derived SGD rates (as a proxy of total SGD) were compared to excess 226Ra-derived SGD rates (as a proxy for the saline contribution of SGD). The calculated SGD rates, which include a significant (>80%) component of recycled seawater, are used to estimate associated nutrient (NH4+, Si, PO4(3-), NO3 + NO2, TDN) loads to Lynch Cove. The dissolved inorganic nitrogen (DIN = NH4 + NO2 + NO3) SGD loading estimate of 5.9 x 10(4) mol d(-1) is 1-2 orders of magnitude larger than similar estimates derived from atmospheric deposition and surface water runoff, respectively.