Ethical issues associated with prenatal screening using non-invasive prenatal testing for sex chromosome aneuploidy

Prenatal screening for sex chromosome aneuploidies (SCAs) is increasingly available through expanded non-invasive prenatal testing (NIPT). NIPT for SCAs raises complex ethical issues for clinical providers, prospective parents and future children. This paper discusses the ethical issues that arise around NIPT for SCAs and current guidelines and protocols for management. The first section outlines current practice and the limitations of NIPT for SCAs. It then outlines key guidelines before discussing the ethical issues raised by this use of NIPT. We conclude that while screening for SCAs should be made available for people seeking to use NIPT, its implementation requires careful consideration of what, when and how information is provided to users.     

Mental health outcomes of job stress among Chinese teachers: role of stress resource factors and burnout

This study examined the mental health outcomes of job stress among Chinese teachers in Hong Kong. A total of 269 Chinese teachers participated in Study 1 which provided cross‐sectional data regarding the associations among stress resource factors, burnout, and negative mental health. Study 2 was a six‐month longitudinal study which aimed to establish the direction of the associations among the hypothesized variables across two time points with a separate sample of 61 Chinese secondary school teachers. Results of the structural equation modelling analyses on the cross‐sectional data at T1 showed that stress resource factors of self‐efficacy and proactive attitude were negatively related to burnout, which in turn had a direct effect on negative mental health. Stress resource factors were also directly linked to mental health status of teachers. Results of similar analyses on the longitudinal data at T2 further indicated that burnout at T1 had a direct impact on burnout at T2, which in turn had a direct effect on negative mental health at T2. Findings and limitations of the study were discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

Congenital syphilis: A contemporary update on an ancient disease

Congenital syphilis (CS) rates reached a 20-year high in the United States in 2018. Unlike previous years, most babies diagnosed with CS were born to mothers who received prenatal care, indicative of the need for better provider education and guideline adherence. Current rates suggest that screening for syphilis should be performed at the first prenatal care visit and twice during the third trimester. There are two diagnostic algorithms available for use in the United States (traditional and reverse) and providers must understand how to perform each algorithm. Treatment should be administered according to stage of syphilis per Centers for Disease Control recommendations with best neonatal outcomes seen when treatment is initiated >30 days before delivery. Benzathine Penicillin G remains the only recommended treatment of syphilis during pregnancy. In viable pregnancies, a pretreatment ultrasound is recommended to identify sonographic evidence of fetal infection and treatment should be initiated with continuous fetal monitoring to evaluate for the Jarisch-Herxheimer reaction which can cause preterm labor and fetal distress. After adequate syphilotherapy, a fourfold decline in maternal nontreponemal titers may not be observed by delivery and does not correlate with rates of CS.     

A new inventory for two-wheel vehicle emissions in West Africa for 2002

Rather surprisingly, urban atmospheric particulate levels in West Africa compare with measured concentrations in Europe and Asia megacities (Liousse, C., Galy-Lacaux, C., Assamoi, E.-M., Ndiaye, A., Diop, B., Cachier, H., Doumbia, T., Gueye, P., Yoboue, V., Lacaux, J.-P., Guinot, B., Guillaume, B., Rosset, R., Castera, P., Gardrat, E., Zouiten, C., Jambert, C., Diouf, A., Koita, O., Baeza, A., Annesi-Maesano, I., Didier, A., Audry, S., Konare, A., 2009. Integrated Focus on West African Cities (Cotonou, Bamako, Dakar, Ouagadougou, Abidjan, Niamey): Emissions, Air Quality and Health Impacts of Gases and Aerosols. Third International AMMA Conference on Predictability of the West African Moosoon Weather, Climate and Impacts. Ouagadougou, Burkina Faso. July 20–24). This pollution mainly derives from road traffic emissions with, in some capitals (e.g. Cotonou), the strong contribution of two-wheel vehicles. Two key questions arise: are presently available emission inventories (e.g. Junker, C., Liousse, C., 2008. A global emission inventory of carbonaceous aerosol from historic records of fossil fuel and biofuel consumption for the period 1860–1997. Atmospheric Chemistry Physics, 8, 1–13; Bond, T.C., Streets, D.G., Yarber, K.F., Nelson, S.M., Woo, J.H., Klimont, Z., 2004. A technology-based global inventory of black and organic carbon emissions from combustion. Journal of Geophysical Research, 1009, D14203, DOI:10.1029/2003JD003697) able to account for these emissions? And, if not, how can we remedy this? The aim of this paper is to develop a methodology to estimate emissions produced by two-wheel vehicles in West Africa for 2002 in a context where reliable information is hardly available. Fuel consumption ratios between two-wheel engines (in this work) and all vehicles issued from UN database (http://data.un.org/Data.aspx?d=EDATA&f=cmID%3aMO%3btrID%3a1221) are as high as 169%, 264% and 628%, for Burkina Faso, Mali and Chad respectively, indicating that this global database does not properly account for regional specificities. Moreover, emission factors for black carbon (BC) and primary organic carbon (OCp) have been measured for two-stroke engines in Benin (Guinot, B., Liousse, C., Cachier, H., Guillaume, B., et al. New emission factor estimates for biofuels and mobile sources. Atmospheric Environment, in press.), giving significantly higher values than in Europe. This is particularly true for OCp, and consequently the calculated emissions for two-stroke engines are also significantly larger than total road traffic previously estimated in global inventories (Junker and Liousse (2008) with United Nations database for 2002; Bond et al., 2004). The ensuing discussion illustrates the importance of two-stroke engines in the West Africa transport sector and the strong need for inventory updating.     

Climate change mitigation policy paradigms—national objectives and alignments

The aim of this paper is to assess how policy goals in relation to the promotion of green growth, energy security, pollution control and greenhouse gas (GHG) emissions reductions have been aligned in policies that have been implemented in selected countries during the last decades as a basis for discussing how a multi objective policy paradigm can contribute to future climate change mitigation. The paper includes country case studies from Brazil, Canada, China, the European Union (EU), India, Japan, Mexico, Nigeria, South Africa, South Korea and the United States covering renewable energy options, industry, transportation, the residential sector and cross-sectoral policies. These countries and regions together contribute more than two thirds of global GHG emissions. The paper finds that policies that are nationally driven and that have multiple objectives, including climate-change mitigation, have been widely applied for decades in both developing countries and industrialised countries. Many of these policies have a long history, and adjustments have taken place based on experience and cost effectiveness concerns. Various energy and climate-change policy goals have worked together in these countries, and in practice a mix of policies reflecting specific priorities and contexts have been pursued. In this way, climate-change mitigation has been aligned with other policy objectives and integrated into broader policy packages, though in many cases specific attention has not been given to the achievement of large GHG emission reductions. Based on these experiences with policy implementation, the paper highlights a number of key coordination and design issues that are pertinent to the successful joint implementation of several energy and climate-change policy goals.     

Impacts of experimental trampling on tall alpine herbfields and subalpine grasslands in the Australian Alps

The Australian Alps, which are of high conservation value, are popular summer bushwalking destinations. Experimental trampling trials using a standardized methodology were conducted to determine the resistance and resilience of the two common vegetation types: tall alpine herbfield and subalpine grasslands. Vegetation parameters were measured in lanes subject to control (no trampling), 30, 100, 200, 500 and 700 passes at five sites prior to trampling, immediately post trampling, 2 weeks, 6 weeks and 1 year post trampling. Vegetation height, cover of graminoids and herbs, as well as net species richness all declined with trampling, while litter cover increased. Thresholds for damage varied between the two communities and among the different vegetation parameters. The resistance indices for the two communities (number of passes resulting in 50% reduction in vegetation cover), however, were similar at around 440–450 passes indicating that these two communities are among the most resistant of the 19 alpine–subalpine communities that have been tested around the world, but only of moderate resistance compared to non-alpine communities. The two communities showed limited recovery with damage still evident 1 year post trampling. This indicates that they have only moderate tolerance to damage due to moderate resistance, but low resilience.