Contaminants in surface water and sediments around the Tynagh Mine, Galway, Ireland.

A former silver mine in Tynagh, Co. Galway, Ireland is one of the most contaminated mine sites in Europe with maximum concentrations of Zn, As, Pb, Mn, Ni, Cu, and Cd far exceeding guideline values for water and sediment. The aims of this research were to 1) further assess the contamination, particularly metals, in surface water and sediment around the site, and 2) determine if the contamination has increased 10 years after the Environmental Protection Agency Ireland (EPAI) identified off-site contamination. Site pH is alkaline to neutral because CaCO3-rich sediment and rock material buffer the exposed acid generating sulphide-rich ore. When this study was compared to the previous EPAI study conducted 10 years earlier, it appeared that further weathering of exposed surface sediment had increased concentrations of As and other potentially toxic elements. Water samples from the tailings ponds and adjacent Barnacullia Stream had concentrations of Al, Cd, Mn, Zn and Pb above guideline values. Lead and Zn concentrations from the tailings pond sediment were 16 and 5 times higher, respectively, than concentrations reported 10 years earlier. Pb and Zn levels in most sediment samples exceeded the Expert Group (EGS) guidelines of 1000 and 5000 mg/kg, respectively. Arsenic concentrations were as high as 6238 mg/kg in the tailings ponds sediment, which is 62 and 862 times greater than the EGS and Canadian Soil Quality Guidelines (CSQG), respectively. Cadmium, Cu, Fe, Mn, Pb and Zn concentrations in water and sediment were above guideline values downstream of the site. Additionally, Fe, Mn and organic matter (OM) were strongly correlated and correlated to Zn, Pb, As, Cd, Cu and Ni in stream sediment. Therefore, the nearby Barnacullia Stream is also a significant pathway for contaminant transport to downstream areas. Further rehabilitation of the site may decrease the contamination around the area.

Source as a controlling factor on the quality and interpretation of sediment magnetic records from the northern North Atlantic

Magnetic properties of eight particle size ranges from nine locations in Iceland and 26 locations in southern Greenland reveal the importance of source variation for our understanding of paleomagnetic and environmental magnetic records in the marine environment. These terrestrial samples show varying degrees of particle size dependence with all samples showing that the silt fraction possesses greater concentrations of ferrimagnetic minerals than either clay or sand. Fine pseudo-single domain (PSD) size magnetic grains dominate the magnetic assemblage of all Icelandic fractions. In contrast, Greenlandic samples possess greater variation in magnetic grain size; only fine silt and clay are as magnetically fine as the Icelandic PSD grains, while Greenlandic silts and sands are dominated by coarser PSD and multi-domain grains. These observations from potential marine sediment sources suggest that the silt size fraction is a likely driver for much of the concentration-dependent parameters derived from bulk magnetic records and that the magnetic grain size of the silt fraction can be used to discriminate between Icelandic and Greenlandic sources. Using these results to examine magnetic grain size records from marine sediment cores collected across the northern North Atlantic suggests that source, not just transport-controlled physical grain-size, has a significant impact on determining the magnetic grain size at a particular location. Homogeneity of magnetic grain size in Icelandic sediments at least partially explains the consistent quality of paleomagnetic records derived from cores surrounding Iceland and their ability to buffer large environmental changes. © 2013 Elsevier B.V.

Improving the quality of life for patients with angina pectoris: a team approach to disease management.

The evaluation of outcome of management of angina patients is now inextricably linked with an assessment of quality of life. Angina, as a manifestation of coronary heart disease, is a major cause of morbidity and mortality in many countries. Optimal management of patients with angina is of undeniable national and global significance.

This paper attempts to indicate the importance of a team approach and the implications for patients’ quality of life of involving professionals with a variety of different skills. It outlines current guidelines for the management of angina, including aspects of diagnosis, treatment and rehabilitation. Factors of relevance to the management of patients as individuals are discussed. The association of improved quality of life and reduced severity of symptoms with benefit for both the individual and society is considered.

Controls on the contemporary distribution of lake thecamoebians (testate amoebae) in the Greater Toronto Area and their potential as water quality indicators.

Thecamoebians were examined from 71 surface sediment samples collected from 21 lakes and ponds in the Greater Toronto Area to (1) elucidate the controls on faunal distribution in modern lake environments; and (2) to consider the utility of thecamoebians in quantitative studies of water quality change. This area was chosen because it includes a high density of kettle and other lakes which are threatened by urban development and where water quality has deteriorated locally as a result of contaminant inputs, particularly nutrients. Fifty-eight samples yielded statistically significant thecamoebian populations. The most diverse faunas (highest Shannon Diversity Index values) were recorded in lakes beyond the limits of urban development, although the faunas of all lakes showed signs of sub-optimal conditions. The assemblages were divided into five clusters using Q-mode cluster analysis, supported by Detrended Correspondence Analysis. Canonical Correspondence Analysis (CCA) was used to examine species-environment relationships and to explain the observed clusterings. Twenty-four measured environmental variables were considered, including water property attributes (e.g., pH, conductivity, dissolved oxygen), substrate characteristics, sediment-based phosphorus (Olsen P) and 11 environmentally available metals. The thecamoebian assemblages showed a strong association with phosphorus, reflecting the eutrophic status of many of the lakes, and locally to elevated conductivity measurements, which appear to reflect road salt inputs associated with winter de-icing operations. Substrate characteristics, total organic carbon and metal contaminants (particularly Cu and Mg) also influenced the faunas of some samples. A series of partial CCAs show that of the measured variables, sedimentary phosphorus has the largest influence on assemblage distribution, explaining 6.98% (P < 0.002) of the total variance. A transfer function was developed for sedimentary phosphorus (Olsen P) using 58 samples from 15 of the studied lakes. The best performing model was based on weighted averaging with inverse deshrinking (WA Inv, r jack 2= 0.33, RMSEP = 102.65 ppm). This model was applied to a small modern thecamoebian dataset from a eutrophic lake in northern Ontario to predict phosphorus and performed satisfactorily. This preliminary study confirms that thecamoebians have considerable potential as quantitative water quality indicators in urbanising regions, particularly in areas influenced by nutrient inputs and road salts.

Quality factor of E-plane periodically loaded waveguide resonators and filter applications

The quality factor of microwave resonators miniaturised by virtue of periodic loading is assessed. Five X-band resonators in E-plane technology with different miniaturisation factors have been designed to resonate at approximately the same frequency. The loaded quality factor is extracted from the fractional bandwidth and subsequently employed to estimate the unloaded quality factor. The study reveals that the unloaded quality factor drops approximately linearly with the miniaturisation. Subsequently design guidelines for E-plane filters with periodically loaded resonators are provided by means of an example involving a fifth-order filter. Full-wave simulated and experimental results are presented to validate the study.

Technical Note: Assessing a 24/7 solution for monitoring water quality loads in small river catchments

Quantifying nutrient and sediment loads in catchments is dif?cult owing to diffuse controls related to storm hydrology. Coarse sampling and interpolation methods are prone to very high uncertainties due to under-representation of high discharge, short duration events. Additionally, important low-?ow processes such as diurnal signals linked to point source impacts are missed. Here we demonstrate a solution based on a time-integrated approach to sampling with a standard 24 bottle autosampler con?gured to take a sample every 7 h over a week according to a Plynlimon design. This is evaluated with a number of other sampling strategies using a two-year dataset of sub-hourly discharge and phosphorus concentration data. The 24/7 solution is shown to be among the least uncertain in estimating load (inter-quartile range: 96% to 110% of actual load in year 1 and 97% to 104% in year 2) due to the increased frequency raising the probability of sampling storm events and point source signals. The 24/7 solution would appear to be most parsimonious in terms of data coverage and certainty, process signal representation, potential laboratory commitment, technology requirements and the ability to be widely deployed in complex catchments.

Testate amoebae (thecamoebians) as water quality indicators in lakes: development of a modern distributional dataset from the Greater Toronto Area

Thecamoebians were examined from 123 surface sediment samples collected from 45 lakes in the Greater Toronto Area (GTA) and the surrounding region to i) elucidate the controls on faunal distribution in modern lake environments; and ii) to consider the utility of thecamoebians in quantitative studies of water quality change. This area was chosen because it includes a high density of lakes that are threatened by urban development and where water quality has deteriorated locally as a result of contaminant inputs, particularly nutrients. Canonical Correspondence analysis (CCA) and a series of partial CCAs were used to examine species-environment relationships. Twenty-four environmental variables were considered, including water properties (e.g. pH, DO, conductivity), substrate characteristics, nutrient loading, and environmentally available metals. The thecamoebian assemblages showed a strong association with Olsen's Phosphorus, reflecting the eutrophic status of many of the lakes, and locally to elevated conductivity measurements, which appear to reflect road salt inputs associated with winter de-icing operations. A transfer function was developed for Olsen P using this training set based on weighted averaging with inverse deshrinking (WA Inv). The model was applied to infer past changes in Phosphorus enrichment in core samples from several lakes, including eutrophic Haynes Lake within the GTA. Thecamoebian-inferred changes in sedimentary Phosphorus from a 210Pb dated core from Haynes Lake are related to i) widespread introduction of chemical fertilizers to agricultural land in the post WWII era; ii) a steep decline in Phosphorous with a change in agricultural practices in the late 1970s; and iii) the construction of a golf course in close proximity to the lake in the early 1990s. This preliminary study confirms that thecamoebians have considerable potential as indicators of eutrophication in lakes and can provide an estimate of baseline conditions.

The Quality of Reporting of Diagnostic Accuracy Studies of Optical Coherence Tomography in Glaucoma

Objective: To evaluate the quality of reporting of diagnostic accuracy studies using optical coherence tomography (OCT) in glaucoma. Design: Descriptive series of published studies. Participants: Published studies reporting a measure of the diagnostic accuracy of OCT for glaucoma. Methods: Review of English language papers reporting measures of diagnostic accuracy of OCT for glaucoma. Papers were identified from a Medline literature search performed in June 2006. Articles were appraised using the 25 items provided by the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. Each item was recorded as full, partially, or not reported. Main Outcome Measures: Degree of compliance with the STARD guidelines. Results: Thirty papers were appraised. Eight papers (26.7%) fully reported more than half of the STARD items. The lowest number of fully reported items in a study was 5 and the highest was 17. Descriptions of key aspects of methodology frequently were missing. For example, details of participant sampling (e.g., consecutive or random selection) were described in only 8 (26.7%) of 30 publications. Measures of statistical uncertainty were reported in 18 (60%) of 30 publications. No single STARD item was fully reported by all the papers. Conclusions: The standard of reporting of diagnostic accuracy studies in glaucoma using OCT was suboptimal. It is hoped that adoption of the STARD guidelines will lead to an improvement in reporting of diagnostic accuracy studies, enabling clearer evidence to be produced for the usefulness of OCT for the diagnosis of glaucoma. © 2007 American Academy of Ophthalmology.

Guidelines and considerations for conducting experiments using tissue microarrays

Tissue microarrays (TMAs) represent a powerful method for undertaking large-scale tissue-based biomarker studies. While TMAs offer several advantages, there are a number of issues specific to their use which need to be considered when employing this method. Given the investment in TMA-based research, guidance on design and execution of experiments will be of benefit and should help researchers new to TMA-based studies to avoid known pitfalls. Furthermore, a consensus on quality standards for TMA-based experiments should improve the robustness and reproducibility of studies, thereby increasing the likelihood of identifying clinically useful biomarkers. In order to address these issues, the National Cancer Research Institute Biomarker and Imaging Clinical Studies Group organized a 1-day TMA workshop held in Nottingham in May 2012. The document herein summarizes the conclusions from the workshop. It includes guidance and considerations on all aspects of TMA-based research, including the pre-analytical stages of experimental design, the analytical stages of data acquisition, and the postanalytical stages of data analysis. A checklist is presented which can be used both for planning a TMA experiment and interpreting the results of such an experiment. For studies of cancer biomarkers, this checklist could be used as a supplement to the REMARK guidelines.

Predicting critical source areas of sediment in headwater catchments

Mitigation of diffuse nutrient and sediment delivery to streams requires successful identification andmanagement of critical source areas within catchments. Approaches to predicting high risk areas forsediment loss have typically relied on structural drivers of connectivity and risk, with little considera-tion given to process driven water quality responses. To assess the applicability of structural metrics topredict critical source areas, geochemical tracing of land use sources was conducted in three headwateragricultural catchments in Co. Down and Co. Louth, Ireland, within a Monte Carlo framework. Outputswere applied to the inverse optimisation of a connectivity model, based on LiDAR DEM data, to assess theefficacy of land use risk weightings to predict sediment source contributions over the 18 month studyperiod in the Louth Upper, Louth Lower and Down catchments. Results of the study indicated sedimentproportions over the study period varied from 6 to 10%, 84 to 87%, 4%, and 2 to 3% for the Down Catch-ment, 79 to 85%, 9 to 17%, 1 to 3% and 2 to 3% in the Louth Upper and 2 to 3%, 79 to 85%, 10 to 17%and 2 to 3% in the Louth Lower for arable, channel bank, grassland, and woodland sources, respectively.Optimised land use risk weightings for each sampling period showed that at the larger catchment scale,no variation in median land use weightings were required to predict land use contributions. However,for the two smaller study catchments, variation in median risk weightings was considerable, which mayindicate the importance of functional connectivity processes at this spatial scale. In all instances, arableland consistently generated the highest risk of sediment loss across all catchments and sampling times.This study documents some of the first data on sediment provenance in Ireland and indicates the needfor cautious consideration of land use as a tool to predict critical source areas at the headwater scale

Diagnosis and management of hyponatraemia: AGREEing the guidelines

Hyponatraemia is a common electrolyte disorder associated with significant complications and controversies regarding its optimal management. Clinical practice guidelines and consensus statements have attempted to provide clinicians with evidence-based diagnostic and treatment strategies for hyponatraemia. Recently published guidance documents differ in their methods employed to review the quality of available evidence. Nagler et al. used the Appraisal of Guideline for Research and Evaluation (AGREE II) instrument in a systematic review of guidelines and consensus statements for the diagnosis and management of hyponatraemia. Nagler and colleagues highlighted the variability in methodological rigour applied to guideline development and inconsistencies between publications in relation to management of hyponatraemia (including the recommended rate of correction of a low serum sodium concentration). These differences could cause confusion for practising physicians managing patients with hyponatraemia.

Psychosocial interventions to improve quality of life and emotional wellbeing in newly diagnosed cancer patients

Title
Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients.

Background
Despite clear guidelines recommending the provision of emotional support for cancer patients, we do not know how best to address psychological distress in this group.

Aim
To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress newly diagnosed cancer patients.

Methods
We searched electronic sources for RCTs of psychosocial interventions or ‘talking therapies’ with individual newly diagnosed cancer patients. Only trials measuring QoL and general psychological distress were included. Meta-analyses examined subgroups by outcome measurement, mode of delivery and discipline of trained helper.

Results
Thirty trials met the criteria. No significant effects were observed for QoL at 6-months (SMD 0.11; 95% CI -0.00 to 0.22) except when using cancer-specific measures (SMD 0.16; 95% CI 0.02 to 0.30). Sub-group analyses revealed that psycho-educational, nurse-delivered interventions improved QoL (SMD 0.23; 95% CI 0.04 to 0.43). General psychological distress as assessed by ‘mood measures’ improved (SMD - 0.81; 95% CI -1.44 to -0.18), but heterogeneity was a factor.

Discussion and conclusion
Psychosocial interventions vary in format and content, raising concerns about heterogeneity, despite appearing to have a beneficial impact on cancer-specific QoL and mood. Future research should concentrate on screening for emotional support needs and identifying common elements within interventions that are of value. Authors should carefully select outcome measures that are appropriately sensitive to change.

Psychosocial interventions to improve quality of life and emotional wellbeing in newly diagnosed cancer patients

Title
Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients.

Background
Despite clear guidelines recommending the provision of emotional support for cancer patients, we do not know how best to address psychological distress in this group.

Aim
To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress newly diagnosed cancer patients.

Methods
We searched electronic sources for RCTs of psychosocial interventions or ‘talking therapies’ with individual newly diagnosed cancer patients. Only trials measuring QoL and general psychological distress were included. Meta-analyses examined subgroups by outcome measurement, mode of delivery and discipline of trained helper.

Results
Thirty trials met the criteria. No significant effects were observed for QoL at 6-months (SMD 0.11; 95% CI -0.00 to 0.22) except when using cancer-specific measures (SMD 0.16; 95% CI 0.02 to 0.30). Sub-group analyses revealed that psycho-educational, nurse-delivered interventions improved QoL (SMD 0.23; 95% CI 0.04 to 0.43). General psychological distress as assessed by ‘mood measures’ improved (SMD - 0.81; 95% CI -1.44 to -0.18), but heterogeneity was a factor.

Discussion and conclusion
Psychosocial interventions vary in format and content, raising concerns about heterogeneity, despite appearing to have a beneficial impact on cancer-specific QoL and mood. Future research should concentrate on screening for emotional support needs and identifying common elements within interventions that are of value. Authors should carefully select outcome measures that are appropriately sensitive to change.