Factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT)

Objective

To investigate factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT).

Method

A questionnaire study was conducted among 219 pregnant women in the Netherlands who had declined prenatal screening with NIPT (TRIDENT-2 study). Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non-Western ethnic origin and 64.4% were religious.

Results

Most respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were “I would never terminate my pregnancy” (57.1%) and “every child is welcome” (56.2%). For 16.9% of respondents, the out-of-pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy.

Conclusion

The primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out-of-pocket costs of NIPT hinder equal access for some pregnant women.     

Building blocks of economic resilience to climate change: a south east Australian fisheries example

Climate change will impact on ecological, social, and economic elements of fisheries; however, the three are seldom considered in an integrated fashion. We develop a fishery-level assessment of economic resilience to climate change for the Tasmanian rock lobster fishery, a linked social–ecological system. We outline the main climate change forcing influences that link climate change to the fishery via changes in lobster abundance, distribution, and phenology. Using a bottom-up approach, we identify twelve economic attributes strongly related to the fisheries’ economic resilience to climate change. Resilience attributes are grouped according to the level of the economic domain (business, sectoral, and governance). Attributes are then evaluated to determine the overall economic resilience of the rock lobster fishery in the context of the specific nature of predicted climate change effects. We identify areas of low resilience in the economic sub-system for this fishery. Evaluating the economic resilience of regional fisheries using this integrated, interdisciplinary framework provides a practical, parsimonious, and conceptually sound basis for undertaking comprehensive and contextually tailored assessments of climate change impacts and economic vulnerability. The framework can be extended to include a broader range of climate change impacts and the social domain of the human sub-system.     

Levels of PCDD/Fs and trace elements in superficial soils of Pavia Province (Italy)

Trace elements and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were analyzed in soils from rural and light-industrialized sites (n=168) of Province of Pavia (Northern Italy). Most of the trace element values fit in typical ranges of concentrations in soils and are similar to the ones reported for rural sites in Italy or sites with no direct anthropogenic impact. Total concentrations of 2,3,7,8 chlorine substituted PCDD/Fs in superficial soils ranged between 24.4 and 1287 pg g(-1) dw (0.5-28.9 pg WHO(98)-TEQ g(-1) dw). The North Eastern part of the Province presented significantly higher levels (p<0.001) than the rest of the Province for As, Cd, Hg, Pb, Zn and PCDD/Fs. While the existence of a defined heavy metal polluting source for this specific site has been suggested, in the case of PCDD/Fs, profiles were not linked to any specific emission source fingerprint. In the whole extension of Pavia Province, OCDD/F dominated the 2,3,7,8 chlorine substituted congener soil pattern, followed by the 1,2,3,4,6,7,8 hepta-CDD/F congener. Principal Component Analysis (PCA) showed that this profile could not be associated to any described PCDD/F emission source fingerprint and was relatively similar to the baseline deposition of sites with no direct impact of PCDD/F emission sources independently of land use.     

Impacts of 21st‐Century Climate Change on Hydrologic Extremes in the Pacific Northwest Region of North America

Climate change projections for the Pacific Northwest (PNW) region of North America include warmer temperatures (T), reduced precipitation (P) in summer months, and increased P during all other seasons. Using a physically based hydrologic model and an ensemble of statistically downscaled global climate model scenarios produced by the Columbia Basin Climate Change Scenarios Project, we examine the nature of changing hydrologic extremes (floods and low flows) under natural conditions for about 300 river locations in the PNW. The combination of warming, and shifts in seasonal P regimes, results in increased flooding and more intense low flows for most of the basins in the PNW. Flood responses depend on average midwinter T and basin type. Mixed rain and snow basins, with average winter temperatures near freezing, typically show the largest increases in flood risk because of the combined effects of warming (increasing contributing basin area) and more winter P. Decreases in low flows are driven by loss of snowpack, drier summers, and increasing evapotranspiration in the simulations. Energy‐limited basins on the west side of the Cascades show the strongest declines in low flows, whereas more arid, water‐limited basins on the east side of the Cascades show smaller reductions in low flows. A fine‐scale analysis of hydrologic extremes over the Olympic Peninsula echoes the results for the larger rivers discussed above, but provides additional detail about topographic gradients.     

Impact of UV-irradiation on the formation of odorous chloroaldimines in drinking water

In order to explain some of the possible origins of an odor episode which took place in a drinking water supply in the region of Paris (France), the impact of disinfection on the formation of odorous by-products was investigated. We have previously established that very odorous and stable chloroaldimines are formed during amino acid chlorination in conditions relevant to those of drinking water treatment. As chlorination is preceded by a UV-irradiation step, we examined here the impact of this irradiation on the formation of chloroaldimines. Irradiation (30 m W cm(-2)) of various amino acids (glycine, valine, phenylalanine) and peptides (Phe-Gly-Gly-Phe, Phe-Ala) led to a degradation of the compounds but it was negligible at the doses applied in drinking water supplies. As peptides were concerned, contrary to what we previously expected, the degradation did not involve the peptidic bond breaking: irradiation induces therefore no increase in the quantity of free amino acids, precursors of odorous chloroaldimines. However chlorination of peptides (Phe-Ala-Ala-Val, Phe-Gly-Gly-Phe and Ala-Phe) showed that chloroaldimines are also probably formed during combined amino acids chlorination.     

Enabling youth to advocate for workplace safety

Work-related injury rates for Canadian youth (ages 15–24) are alarmingly high compared to adult workers even though youth are less likely to be performing hazardous jobs. This paper reports on a document analysis of youth workplace safety education initiatives sponsored by national and provincial/territorial governmental and non-governmental agencies. Web-based documents were analyzed through the theoretical lens of self-advocacy. The self-advocacy framework highlights how youth can be agentic in altering high-risk workplaces by publicly articulating their own interests, needs, and rights (Test et al., 2005); thus, self-advocacy is a critical component in studying educational programs for youth safety. The analysis revealed that instruction on workplace safety identifies safety issues to workers and tells youth to work safely but does little to promote self-advocacy in young workers.     

A rapid lateral flow immunoassay for the detection of fungal alpha-amylase at the workplace

Fungal alpha-amylase is a flour supplement which is added to improve the quality of bakery products. Various studies have shown that exposure to this enzyme is an important risk factor for the development of bakers' allergy and this allergy is reported to be one of the most frequent causes of occupational asthma. A rapid assay was developed to monitor exposure to occupational allergens directly at the workplace. The sensitivity of the developed assay is 0.32 ng amylase mL(-1) in a buffer system with the commercially available alpha-amylase preparation Fungamyl 1600S as the standard. Initial validation tests (n = 33) were performed with airborne and settled dust from an industrial bakery. The new lateral flow immunoassay detected amylase in 22 of the 26 samples regarded as positive in an enzyme immunoassay, and was negative for all seven enzyme immunoassay-negative samples, while the four lateral flow immunoassay-negative/enzyme immunoassay-positive samples all had levels below 2 ng mL(-1). The sensitivity of 2 ng mL(-1) of the amylase lateral flow immunoassay is sufficient for first screening purposes and, therefore, this simple and rapid assay may allow direct on-site demonstration of work-related hazards of bio-allergen exposure. This would be particularly useful in occupational hygiene practice, especially in traditional or small-scale bakeries which lack the technological skills for testing the exposure to respiratory allergens.