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Climate changes over the past two millennia in the central part of the Gulf of St. Lawrence are documented in this paper with the aim of determining and understanding the natural climate variability and the impact of anthropogenic forcing at a regional scale. The palynological content (dinocysts, pollen, and spores) of the composite marine sediment core MSM46-03 collected in the Laurentian Channel was used to reconstruct oceanographic and climatic changes with a multidecadal temporal resolution. Sea-surface conditions, including summer salinity and temperature, sea-ice cover, and primary productivity, were reconstructed from dinocyst assemblages. Results revealed a remarkable cooling trend of about 4°C after 1230 cal yr BP (720 CE) and a culmination with a cold pulse dated to 170-40 cal yr BP (1780-1910 CE), which likely corresponds to the regional signal of the Little Ice Age. This cold interval was followed by a rapid warming of about 3°C. In the pollen assemblages, the decrease of Pinus abundance over the past 1700 yr suggests changes in wind regimes, likely resulting from increased southerly incursions of cold and dry Arctic air masses into southeastern Canada. [ABSTRACT FROM AUTHOR]

Purpose: We assessed the prevalence and variables associated with haloperidol use for delirium in ICU patients and explored any associations of haloperidol use with 90-day mortality., Methods: All acutely admitted, adult ICU patients were screened during a 2-week inception period. We followed the patient throughout their ICU stay and assessed 90-day mortality. We assessed patients and their variables in the first 24 and 72 h in ICU and studied their association together with that of ICU characteristics with haloperidol use., Results: We included 1260 patients from 99 ICUs in 13 countries. Delirium occurred in 314/1260 patients [25% (95% confidence interval 23-27)] of whom 145 received haloperidol [46% (41-52)]. Other interventions for delirium were benzodiazepines in 36% (31-42), dexmedetomidine in 21% (17-26), quetiapine in 19% (14-23) and olanzapine in 9% (6-12) of the patients with delirium. In the first 24 h in the ICU, all subtypes of delirium [hyperactive, adjusted odds ratio (aOR) 29.7 (12.9-74.5); mixed 10.0 (5.0-20.2); hypoactive 3.0 (1.2-6.7)] and circulatory support 2.7 (1.7-4.3) were associated with haloperidol use. At 72 h after ICU admission, circulatory support remained associated with subsequent use of haloperidol, aOR 2.6 (1.1-6.9). Haloperidol use within 0-24 h and within 0-72 h of ICU admission was not associated with 90-day mortality [aOR 1.2 (0.5-2.5); p = 0.66] and [aOR 1.9 (1.0-3.9); p = 0.07], respectively., Conclusions: In our study, haloperidol was the main pharmacological agent used for delirium in adult patients regardless of delirium subtype. Benzodiazepines, other anti-psychotics and dexmedetomidine were other frequently used agents. Haloperidol use was not statistically significantly associated with increased 90-day mortality.