Intermittent absent and reversed umbilical artery flows in appropriately grown monochorionic diamniotic twins in relation to proximate cord insertion: A harmful combination?

Objective

To compare the prevalence of intermittent absent or reversed end-diastolic flow (iAREDF) in the umbilical artery in appropriately grown monochorionic diamniotic (MCDA) pregnancies with and without proximate cord insertion (PCI), and to evaluate pregnancy outcome.

Methods

The prevalence of iAREDF in MCDA pregnancies with PCI (n = 11) was compared with a control group without PCI (n = 33). PCI was defined as a distance between the cord insertions below the fifth percentile. Placental sharing, number, and diameter of anastomoses were assessed by placental examination. Pregnancy outcome was evaluated.

Results

iAREDF was present in 7/11 PCI pregnancies, compared with 0/33 in the control group (P ≤ .01). All PCI pregnancies and 94% of controls had arterioarterial (AA)-anastomoses (P = .56), the diameter was larger in the PCI group, respectively 3.3 vs 2.1 mm (P = .03). Three cases with iAREDF had adverse outcome, two resulted in fetal death of which one with brain damage in the co-twin, another underwent early premature emergency section for fetal distress.

Conclusion

iAREDF occurs in a large proportion of MCDA pregnancies with PCI and is related to the diameter of the AA anastomosis. We hypothesize that iAREDF in appropriately grown MCDA twin pregnancies reflects an unstable hemodynamic balance with an increased risk for fetal deterioration. Whether outcome in these pregnancies can be improved by altered management requires further investigation.

     

Future waste disposal in The Netherlands

This paper sets out a few results of research on waste prevention, recycling and disposal in The Netherlands. First, an outline is given of the actual waste disposal. Secondly, a projection is made of the different waste categories as a result of independent developments for the year 2000. Finally, a scenario is presented in which recent Dutch policy on the prevention and recycling of waste, as well as incineration, play important roles. The waste policy will be based on the long-term objective of sustainable development, as mentioned in the Brundtland Commission report. Results are given concerning space, costs and emissions.     

Fetoscopic myelomeningocoele closure: Is the scientific evidence enough to challenge the gold standard for prenatal surgery?

Since the completion of the Management of Myelomeningocoele Study, maternal-fetal surgery for spina bifida has become a valid option for expecting parents. More recently, multiple groups are exploring a minimally invasive approach and recent outcomes have addressed many of the initial concerns with this approach. Based on a previously published framework, we attempt to delineate the developmental stage of the surgical techniques. Furthermore, we discuss the barriers of performing randomized controlled trials comparing two surgical interventions and suggest that data collection through registries is an alternative method to gather high-grade evidence.     

Promoting Good Environmental Management: Lessons from BS 5750

This paper evaluates the adoption of standards as proof of and an incentive for sound environmental practice in business and industry. The paper outlines the origins of environmental management and the development of the first environmental management standard BS 7750. The background to quality management is outlined to provide a context for these developments. The paper then goes on to examine the likely success of BS 7750 in actually improving the environmental performance of organizations in the light of experience in the field of quality. Finally, alternative approaches are looked at as ways of achieving environmental improvement.     

How do transformational leaders foster positive employee outcomes? A self‐determination‐based analysis of employees' needs as mediating links

Although followers' needs are a central aspect of transformational leadership theory, little is known about their role as mediating mechanisms for this leadership style. The present research thus seeks to integrate and extend theorizing on transformational leadership and self‐determination. In particular, we propose that the satisfaction of followers' basic needs (autonomy, competence, and relatedness) mediates the relationship between transformational leadership and employee outcomes (job satisfaction, self‐efficacy, and commitment to the leader). We tested this model in two studies involving employees from a broad spectrum of organizations in Germany (N = 410) and in Switzerland (N = 442). Results revealed largely consistent patterns across both studies. The need for competence fulfillment solely mediated the link between transformational leadership and occupational self‐efficacy; the need for relatedness fulfillment solely mediated the link between transformational leadership and commitment to the leader. The mediating pattern for the link between transformational leadership and job satisfaction varied slightly across studies. In Study 1, only the need for autonomy fulfillment was a significant mediator, whereas in Study 2, all three needs mediated this relationship. Taken together, our study integrates theorizing on transformational leadership and self‐determination by corroborating that need fulfillment indeed is a central mechanism behind transformational leadership. Copyright © 2012 John Wiley & Sons, Ltd.     

Consequences of shell-species preferences for female reproductive success in the hermit crab Pagurus bernhardus

Littoral hermit crabs, Pagurus bernhardus, show a strong preference for Littorina obtusata shells rather than those of Gibbula species. The fitness consequences, in terms of fecundity, for this shell preference is examined for female crabs. Females in the preferred species produced eggs earlier in the season, produced more eggs in the first brood, and produced a second brood more often than did females in the less preferred species. The smaller brood for Gibbula spp. was not a consequence of egg loss from the pleopods due to an unfavourable shape of shell, but rather reflected lower egg production. It is not clear, however, if this differential reproduction is due to direct costs of carrying an unfavourable shell, i.e. the shell impedes reproduction, or whether crabs compete aggressively for favoured shells so that only crabs of low quality inhabit lowquality shells.     

Physiological stress responses in the edible crab, <Emphasis Type="Italic">Cancer pagurus</Emphasis>, to the fishery practice of de-clawing

We examined physiological stress responses in the edible crab, Cancer pagurus, subjected to the commercial fishery practice of manual de-clawing. We measured haemolymph glucose and lactate, plus muscular glycogen and glycogen mobilisation, in three experiments where the crabs had one claw removed. In the first, crabs showed physiological stress responses when ‘de-clawed’ as compared to ‘handled only’ over the short term of 1–10 min. In the second, de-clawing and the presence of a conspecific both increased the physiological stress responses over the longer term of 24 h. In the third, de-clawing was shown to be more stressful than ‘induced autotomy’ of claws. Further, the former practice caused larger wounds to the body and significantly higher mortality than the latter. Since the fishery practice is to remove both claws, the stress response observed and mortality data reported are conservative.     

Work–family conflicts of women in the Air Force: their influence on mental health and functioning

This paper examined the effects of work and family stressors and conflicts on Air Force women's mental health and functioning. We analyzed data from a 1993 survey of representative stratified samples of 525 Air Force women from the active duty reserve and guard forces. The analyses of the data are guided by the comprehensive model of work–family conflict that has been tested by Frone, Russell, and Cooper (1992) using a large representative community sample. Structural equation modeling analyses provided support for the work–family conflict model. The analyses also provided support for an extension of the model, which included the separate effects of marital and parental roles on mental health. The extended model demonstrated that job and parental stresses had direct effects on work–family conflicts and that job and marital distress and family–work conflict had an independent adverse effect on mental health. Whereas job and parental involvement had a beneficial effect on distress, they had an adverse effect on work–family conflicts. Copyright © 1999 John Wiley & Sons, Ltd.