Isotopic and geochemical data from Barry Lake, Canada: A 900-year record of environmental change.

The data reported here consist of oxygen and hydrogen isotope compositions for 145 modern water samples, and geochemical measurements for gravity cores of sediment, all collected from Barry Lake, a small kettle lake located in Ontario, Canada. The geochemical measurements for the sediment organic matter include organic carbon and total nitrogen isotope compositions, organic carbon and total nitrogen contents and chlorophyll a content. The carbon and oxygen isotope compositions of marl contained in these sediments are also reported, along with the calcite and quartz contents of the sediment sample. Mass accumulation rates of total organic carbon, total nitrogen, chlorophyll a and calcite are reported. Dating of these sediments shows that they span ∼900 years. The stable isotope compositions of the modern waters and marl are useful to researchers studying how effective moisture (the net of water inputs vs outputs) changed in southern Ontario across the last ∼900 years. Proxies derived from the organic fraction of the lake sediments will be of interest to researchers of small Ontario lakes seeking to contextualize recent increases in primary production related to eutrophication. A discussion of these data, and a comparison of these data to other cores in the Great Lakes Region, is available in "A 900-year record of effective moisture in the Great Lakes Region" (Doyle et al., 2021).

Agriculture causes nitrate fertilization of remote alpine lakes.

Humans have altered Earth's nitrogen cycle so dramatically that reactive nitrogen (Nr) has doubled. This has increased Nr in aquatic ecosystems, which can lead to reduced water quality and ecosystem health. Apportioning sources of Nr to specific ecosystems, however, continues to be challenging, despite this knowledge being critical for mitigation and protection of water resources. Here we use Δ(17)O, δ(18)O and δ(15)N from Uinta Mountain (Utah, USA) snow, inflow and lake nitrate in combination with a Bayesian-based stable isotope mixing model, to show that at least 70% of nitrates in aquatic systems are anthropogenic and arrive via the atmosphere. Moreover, agricultural activities, specifically nitrate- and ammonium-based fertilizer use, are contributing most (∼60%) Nr, and data from other North American alpine lakes suggest this is a widespread phenomenon. Our findings offer a pathway towards more effective mitigation, but point to challenges in balancing food production with protection of important water resources.

Challenging hemostasis scenarios in pediatric patients--two case studies.

Pediatric patients differ from adult patients in many clinical situations, and disorders of hemostasis and thrombosis are no exception. The current article presents clinical and laboratory features of two cases in which pediatric patients are evaluated for bleeding disorders. Discussion of the cases focuses on practical considerations for laboratorians. Review of these case studies highlights selected common and esoteric issues in pediatric hemostasis testing.

Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease: prospective study.

BACKGROUND: In the United Kingdom, breast cancer incidence is lower in South Asian and Black women than in White women, but the extent to which this is due to known risk factors is unknown. In a large prospective study, we describe breast cancer incidence by ethnicity, before and after adjustment for known risk factors for the disease. METHODS: Women were recruited into the Million Women Study in 1996-2001, when information on reproductive and lifestyle factors known to influence the risk of breast cancer was obtained. Ethnicity was determined from study questionnaires and hospital admission data. Cox regression models were used to calculate adjusted relative risks (RR) for incident breast cancer in South Asians and Blacks compared with Whites. RESULTS: Analyses included 5877 South Asian, 4919 Black, and 1,038,144 White women in England. The prevalence of 8 out of the 9 risk factors for breast cancer examined, differed substantially by ethnicity (P<0.001 for each), such that South Asian and Black women were at a lower risk of the disease than White women. During 12.2 years of follow-up incident breast cancer occurred in 217 South Asians, 180 Blacks, and 45,191 Whites. As expected, breast cancer incidence was lower in South Asians (RR=0.82, 95% CI 0.72-0.94) and Blacks (RR=0.85, 0.73-0.98) than in Whites when the analyses were adjusted only for age and region of residence. However, after additional adjustment for the known risk factors for the disease, breast cancer incidence was similar to that of Whites, both in South Asians (0.95, 0.83-1.09) and in Blacks (0.91, 0.78-1.05). CONCLUSION: South Asian and Black women in England have lower incidence rates of breast cancer than White women, but this is largely, if not wholly, because of differences in known risk factors for the disease.

Pitfalls in special coagulation testing: three illustrative case studies.

Assays in the special coagulation laboratory are affected by numerous factors, including pre-analytical variables, anticoagulant drugs, and abnormalities of the coagulation system other than the analyte specifically being examined. By reviewing special coagulation tests as a group and in concert with clinical information, as well as understanding assay methodologies, interferences can be more easily recognized and incorrect interpretations avoided, preventing possibly unnecessary treatment of patients. Three case studies involving protein S activity, von Willebrand factor analysis, and factor V activity with Bethesda titer will highlight potential pitfalls in the interpretation of special coagulation tests.

Total quality management system: its application in a community hospital research department.

Lehigh Valley Hospital initiated a program of total quality management using the model taught by Philip Crosby Associates. When the training began in the Research Department, we used the application of this model to identify, define and chart the various processes that a research project or study moves through from conception to publication. The resulting charts and process outlines enabled the Research Department personnel to recognize problem areas in the processes, and to chart the progress of a study at any given time. This provided us with both a better understanding of input and output in the research processes, and an opportunity to improve efficiency by correcting problem areas.

Data management of an inflammatory bowel disease registry.

The history and etiology of inflammatory bowel disease which is characterized by two major disease processes: ulcerative colitis and Crohn's disease, remain unknown. Research is focussing on seven major areas of genetic, environmental and physiologic factors that apparently relate to this disease. Based on this background, a population based Inflammatory Bowel Disease Registry was established in 1987 in the Lehigh Valley area of southeastern Pennsylvania. Consent forms, patient data forms and protocols for operation and implementation were developed, and databases were designed to accommodate demographic, basic history, follow-up and relative history data. The databases were correlated with an IBD registry ID number which both enabled relational analyses and ensured confidentiality of data information. The registry continues to grow, providing feedback for both continued medical research and supportive information for IBD patients and their physicians.

Occupational mortality of women aged 15-59 years at death in England and Wales.

STUDY OBJECTIVE: The aim was to analyse occupational mortality differences among women using follow up data from a large nationally representative sample. DESIGN: Occupational information was obtained from the 1971 census records of women in the Longitudinal Study carried out by the Office of Population Censuses and Surveys (OPCS) and related to their subsequent mortality in the period between the 1971 and 1981 censuses. SETTING: In the Longitudinal Study, census, vital statistics, and other OPCS records are linked for a 1% sample of the population of England and Wales. The women studied in this paper were drawn from the 513,071 persons in the 1971 census who were included in the Longitudinal Study and whose entries were traced at the National Health Service Central Register by 1977. PARTICIPANTS: The analysis was based on 77,081 women aged 15-59 years in the Longitudinal Study for whom occupational information was collected in the 1971 census (99% of whom were in paid employment in the week before the census). There were 1553 deaths among these women in the follow up period analysed here. MEASUREMENTS AND MAIN RESULTS: Numbers of deaths in each occupational group at census were compared to those expected on the basis of age specific death rates among all women in the study. "Professional, technical workers, and artists" had significantly low mortality while "Engineering and allied trades workers nec" had significantly high mortality. Among the latter, cancer mortality of electrical production process workers was extremely high. A number of other cause specific associations (which appear to confirm proportionate Decennial Supplement analyses) were suggested by the data; examples include high levels of mortality from ischaemic heart disease among cooks, lung cancer and respiratory disease among charwomen and cleaners, and accidents, poisonings, and violence among several groups of professional and technical workers. CONCLUSIONS: By using prospective follow up from the census, occupational differences in mortality can be identified among women in paid employment. As follow up of this study continues, numbers of deaths available for analysis will increase, allowing increasingly comprehensive analyses to be undertaken.

Inequalities in women's health in England and Wales: mortality among married women according to social circumstances, employment characteristics and life-cycle stage.

"Data obtained from follow-up of the Office of Population Censuses and Surveys Longitudinal Study 1971 Census sample have been used to look at women's mortality differentials at ages 15-59 in England and Wales....In this paper we focus on married women and use age of youngest child as a measure of life-cycle stage. We relate this to whether the woman was a housewife, or was in full or part-time paid employment, so as to examine how these affect differences in mortality by social class. We find that socio-economic mortality differences persist irrespective of life-cycle stage.... Housewives married to men in manual occupations experienced death rates over one and a half times as high as those married to men in non-manual occupations. For women in employment the differences by husbands' social class are of a lesser magnitude.... Differences in the mortality of those in full and part-time work depend on the woman's own social class and are greater for non-manual than manual classes." (SUMMARY IN FRE AND ITA)

Inequalities in women's health: looking at mortality differentials using an alternative approach.

Data obtained from follow up of the 1971 census sample in the Office of Population Censuses and Surveys longitudinal study of England and Wales were used to look at women's mortality differentials at ages 15-59. Women were grouped by combining information on marital state, own occupation, husband's occupation (if married), economic activity, and indicators of household wealth (housing tenure and access to a car). Large groups were found with considerable differences in mortality. High mortality was associated with working in manual occupations and living in rented housing with no car in the household. In contrast, low mortality was associated with non-manual occupations and living in owner occupied housing with a car. Among married housewives and single women these extreme groups contributed 44% of expected deaths, the disadvantaged group experiencing death rates two and a half times that of the advantaged group. Smaller differences were found among married women with an occupational class. These findings are further evidence of the "health divide" in England and Wales and show that accurately to reflect the relation between a woman's life circumstances and mortality it is necessary to utilise other measures than those based solely on occupation.

Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples.

Mortality in the period 1981-3 among men in the Office of Population Censuses and Surveys longitudinal study who were seeking work in 1981 was examined to investigate whether the finding of a high mortality rate among a comparable group of men who were followed up from the 1971 Census was repeated despite appreciable changes in the size and structure of the labour force over the intervening years. The pattern of mortality shortly after both censuses suggests that sick unemployed men were not categorised as seeking work, and it is concluded that for both samples the mortality of those who were reported to be seeking work was raised for reasons other than initial poor health. Other findings from the two censuses are also broadly similar. If confirmed after longer follow up this will add considerably to the evidence of the adverse health consequences of unemployment.

Stress and heart disease: evidence of associations between unemployment and heart disease from the OPCS Longitudinal Study.

The OPCS Longitudinal Study has been used to study both overall and cause-specific mortality patterns in 1971-1981 among men and women directly or indirectly affected by unemployment in April 1971. Groups studied included men seeking work in 1971, the wives of men seeking work in 1971 and other women in the same households as a man seeking work in 1971. The findings of this project are summarized here and attention is focused on mortality from circulatory diseases, in particular ischaemic heart disease. The study provides evidence which could be seen as supporting hypotheses about relationships between stress and overall mortality, with a marked excess for suicides. The evidence with respect to ischaemic heart disease is positive but less convincing with excess mortality from this cause principally occurring among younger unemployed men and among the wives of men who were seeking work in 1971. Given the sharp contrasts in the pattern and levels of unemployment between 1971 and 1981 it is difficult to extrapolate from these findings to the present day.

Unemployment and mortality in the OPCS Longitudinal Study.

The mortality of men aged 15-64 who were seeking work in the week before the 1971 census was investigated by means of the OPCS Longitudinal Study, which follows up a 1% sample of the population of England and Wales. In contrast to the current position, only 4% of men of working age in 1971 fell into this category. The mortality of these unemployed men in the period 1971-81 was higher (standardised mortality ratio 136) than would be expected from death rates in all men in the Longitudinal Study. The socioeconomic distribution of the unemployed accounts for some of the raised mortality, but, after allowance for this, a 20-30% excess remains; this excess was apparent both in 1971-75 and in 1976-81. The data offer only limited support for the suggestion that some of this excess resulted from men becoming unemployed because of their ill-health; the trend in overall mortality over time and the pattern by cause of death were not those usually associated with ill-health selection. Previous studies have suggested that stress accompanying unemployment could be associated with raised suicide rates, as were again found here. Moreover, the mortality of women whose husbands were unemployed was higher than that of all married women (standardised mortality ratio 120), and this excess also persisted after allowance for their socioeconomic distribution. The results support findings by others that unemployment is associated with adverse effects on health.