Risk communication in emergency response to a simulated extreme flood

Risk communication in flood incident management can be improved through developing hydrometeorological and engineering models used as tools for communicating risk between scientists and emergency management professionals. A range of such models and tools was evaluated by participating flood emergency managers during a 4-day, real-time simulation of an extreme event in the Thamesmead area in the Thames estuary close to London, England. Emergency managers have different communication needs and value new tools differently, but the indications are that a range of new tools could be beneficial in flood incident management. Provided they are communicated large model uncertainties are not necessarily unwelcome among flood emergency managers. Even so they are cautious about sharing the ownership of weather and flood modelling uncertainties.     

Self-leadership and performance outcomes: the mediating influence of self-efficacy

A key foundation of empowering organizations is employee self-leadership. This study examines the effects of self-leadership skills and self-efficacy perceptions on performance. Structural equations modeling determined whether the influence of self-leadership on performance is mediated by self-efficacy perceptions. Results for the sample of 151 respondents indicated self-leadership strategies had a significant effect on self-efficacy evaluations, and self-efficacy directly affected performance. Further, self-efficacy perceptions were found to fully mediate the self-leadership/performance relationship. Theoretical and practical implications are discussed. © 1998 John Wiley & Sons, Ltd.     

Personalized Nutrition and Social Justice: Ethical Considerations Within Four Future Scenarios Applying the Perspective of Nussbaum’s Capabilities Approach

The idea of personalized nutrition (PN) is to give tailored dietary advice based on personal health-related data, i.e. phenotoype, genotype, or lifestyle. PN may be seen as part of a general trend towards personalised health care and currently various types of business models are already offering such services in the market. This paper explores ethical issues of PN by examining how PN services within the contextual environment of four future scenarios about health and nutrition in Europe might affect aspects of social justice according to Martha Nussbaum’s capability approach. The scenarios have been created by a mixed group of stakeholders and experts in three consecutive workshops. This resulted in the definition of four future scenarios within a scenario space consisting of two variables: the ‘logic of health care systems’ and ‘conception of health’. Within each scenario, PN is likely to play a more or less important role in improving health by influencing food consumption patterns in society. Nussbaum’s capability approach implies a concept of social justice as a function of a minimum standard of human dignity. This denotes an account for equality in terms of a minimum of entitlements. However, also the ability of achieving individual objectives is essential for social justice. Personalisation advice in health and food consumption patterns, as aimed for by PN, is therefore acceptable provided a minimum of entitlements is guaranteed to all members of a society, and at the same time freedom concerning personal preferences is respected. Potential variation of how different people might benefit from PN should therefore be consistent with the minimum required as defined by the list of capabilities.     

Prenatal diagnosis of Pompe's disease (type ii glycogenosis) in chorionic villus biopsy using maltose as a substrate

Uncultured trophoblasts obtained from chorionic villus biopsy during the gestation period of 8–12 weeks were assayed for alpha-glucosidase activity using maltose as the substrate. Only one major form of maltase activity with a pH optimum at 4.0 was demonstrated. Using this method, we performed prenatal diagnosis on three pregnancies at risk for the infantile form of type II glycogen storage disease. Two affected fetuses and one unaffected fetus were predicted and the diagnosis was subsequently confirmed. The maltose assay offered a direct, simple, and sensitive method for prenatal diagnosis of Pompe's disease in the first trimester.     

Managing for biodiversity: Emerging ideas for the electric utility industry—summary statement

The conference entitled Managing for Biodiversity: Emerging Ideas for the Electric Utility Industry was held in Williamsburg, Virginia, USA, during 19–20 March 1996. This paper provides an overview of the key points, conclusions, and recommendations from both the presentations/papers and the discussions throughout the conference.     

Risk factors associated with transcervical CVS losses

Factors found to be associated with pregnancy loss after transcervical CVS were race (higher for non-white), history of spontaneous abortion, unplanned pregnancy, history of spotting or bleeding during the pregnancy prior to CVS, and placental position (higher for fundal or lateral locations). Whether the increase in loss risk is due to the factor, per se, or the factor plus the CVS cannot be determined due to the lack of appropriate control data.     

Adverse perinatal outcome in patients screen-positive for neural tube defects and fetal down syndrome

An association between various abnormal mid-trimester maternal serum analyte values and adverse perinatal outcome has been reported. From an original sample of 14 857 women, we observed five women who were ‘screen-positive’ for both neural tube defects [maternal serum alpha-fetoprotein (MSAFP) ≥2·5 multiples of the median] and Down syndrome [risk ≥1/274 using MSAFP, maternal serum unconjugated oestriol (MSuE3), maternal serum human chorionic gonadotropin (MShCG), and maternal age]. The four patients who elected to undergo amniocentesis all demonstrated both normal karyotype and normal amniotic fluid AFP levels. All five cases were associated with intrauterine growth retardation (IUGR) and abnormal pregnancy outcomes. Two cases exhibiting severe IUGR on ultrasound examination were terminated at 19·1 and 21·2 weeks, respectively; the former also exhibited fetal calcifications and positive maternal serology for toxoplasmosis. In another case, fetal demise occurred at 36 weeks' gestation in a patient who had been treated for syphilis in the second trimester. Neither infection was confirmed in fetal tissue studies. Though resulting in live births, the remaining two cases required operative deliveries; emergency Caesarean sections for fetal distress were performed at 38 and 32 weeks, respectively, the latter case being associated with severe pre-eclampsia. We conclude that elevated mid-trimester MSAFP levels concurrent with maternal serum analyte values associated with increased risk for fetal Down syndrome may presage a poor perinatal outcome, particularly IUGR and possibly congenital infection.