Quantitative reconstructions are made of Holocene changes in climatic and environmental conditions from analyses of pollen, chironomids and diatoms in identical stratigraphic levels of a sediment core from Vuoskkujavri (68'20'43 N, 19'06'00 E, 348 m as.l.) near Abisko in northern Sweden (Lapland). Transfer functions, based on regional calibration sets, are applied to reconstruct Holocene patterns in mean July air temperature (using all three indicators), mean Januaiy air temperature (pollen), annual precipitation (pollen) and lakewater pH (diatoms).During periods with 'good' fit to the modern calibration sets all mean July air-temperature inferences based on the three proxy indicators reveal a general trend of decreasing temperature: pollen-inferred mean July air temperature shows a decrease of c. 1.10C since 7500 cal. yrs BP; the chironomids show a decrease of c. 1.20C since the early Holocene; whereas the diatoms show a decrease of C. 1.50C since 6000 cal. yrs BP. Pollen-inferred mean January air temperature indicates that winters may have been warmer by c. 3.0WC during the early Holocene, followed by a gradual cooling until 8500 cal. yrs BP (c. I .0'C warmer than today) and a subsequent warming until 7000 cal. yrs BP (c. 2.0'C warmer than today). Since 7000 cal. yrs BP, a gradual cooling towards the present-day values is inferred. According to the pollen, annual precipitation may have been considerably higher during the early Holocene than today (c. +150 mm) and increased until 7000 cal. yrs BP (c. +320 mm). Since 7000 cal. yrs BP, annual precipitation decreased continuously towards present-day values. Diatom-inferred pH trends show that natural acidification of c. 0.5 pH units followed deglaciation; present-day values were reached c. 5000 cal. yrs BP. The early Holocene is identified as a problematic time period for the application of modern calibration sets, as diatoms show 'poor' fit to the calibration set from 10 600 to 6000 cal. yrs BP, pollen from 10 600 to 7500 cal. yrs BP, and chironomids from 10 250 to 10 000 cal. yrs BP. Compared with estimates from the COHMAP GCM model, mean July air-temperature inferences based on biological proxies at Vuoskkujdvri suggest a more moderate decrease in temperature over the past 9000 years.

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Introduction With the growing burden of chronic diseases, surveillance will play an essential role in improving their prevention and control. The Institut national de santé publique du Québec has developed an innovative chronic disease surveillance system, the Quebec Integrated Chronic Disease Surveillance System (QICDSS). We discuss the primary features, strengths and limitations of this system in this report. Methodology The QICDSS was created by linking five health administrative databases. Updated annually, it currently covers the period from January 1, 1996, to March 31, 2012. The operational model comprises three steps: (1) extraction and linkage of health administrative data according to specific selection criteria; (2) analysis (validation of case definitions essentially) and production of surveillance measures; and (3) data interpretation, submission and dissemination of information. The QICDSS allows the surveillance of the following chronic diseases: diabetes, cardiovascular diseases, respiratory diseases, osteoporosis, osteoarticular diseases, mental disorders, Alzheimer's disease and related disorders. The system also lends itself to the analysis of multimorbidity and polypharmacy. Results For 2011–2012, the QICDSS contained information on 7 995 963 Quebecers with an average age of 40.8 years. Of these, 95.3% met at least one selection criterion allowing the application of case definitions for chronic disease surveillance. The actual proportion varied with age, from 90.1% for those aged 19 years or less to 99.3% for those aged 65 years or over. Conclusion The QICDSS provides a way of producing population-based data on the chronic disease burden, health services and prescription drug uses. The system facilitates the integrated study of several diseases in combination, an approach rarely implemented until now in the context of population surveillance. The QICDSS possesses all the essential features of a surveillance system and supports the dissemination of information to public health decision-makers for future actions.