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691.
In recent years, the debate on corporate responsibility has shifted from a focus on environmental management towards a broader concept of corporate social responsibility (CSR). This article examines the chemical industry's approach to CSR from the perspective of two emerging economies: Mexico and South Africa. The global chemical industry was one of the first to respond to public concerns about environmental pollution, toxic waste and human health by adopting an industry‐wide code of practice, known as Responsible Care. This article examines the extent to which the chemical industry has responded to the broader debate on CSR. On the basis of a comparative case study, this article argues that the response to social issues by Mexican and South African chemical companies has tended to be limited to the ‘community awareness and emergency response’ (CAER) or community dialogue component of the international voluntary management framework, Responsible Care. Similarities and differences in regulatory and institutional conditions, as well as different levels of civil society engagement, reveal additional limitations for CSR, beyond that of the Responsible Care framework. This article argues that the socio‐political context influences the extent to which companies embrace CSR, especially in emerging economies, and highlights several challenges for the chemical industry in moving forward on CSR: credibility, stakeholder engagement, value‐chain accountability, disclosure and transparency. Reflecting on these challenges, the authors conclude by recommending a renewed focus on: (1) developing a broader set of CSR management practices beyond Responsible Care; (2) institutionalizing stronger accountability measures, such as reporting and verification; and (3) developing multi‐stakeholder partnerships that complement regulation and build public sector regulatory and guidance capacity.  相似文献   
692.

Objective

Ultrasound assessment of the fetal anatomy and fetal echocardiography are feasible in the first trimester of pregnancy. This study was designed to assess the performance of a comprehensive fetal anatomy assessment in a high-risk population at a tertiary fetal medicine unit.

Methods

A retrospective review of high-risk patients undergoing comprehensive fetal anatomy ultrasound assessment between 11 weeks and 13 + 6 weeks of gestation was conducted. Findings of the early anatomy ultrasound scan were compared with those of the second trimester anatomy scan, and birth outcomes or post-mortem results.

Results

Early anatomy ultrasounds were performed in 765 patients. The sensitivity of the scan for detecting fetal anomalies compared to the birth outcome was 80.5% (95% CI 73.5–86.3) and specificity was 93.1% (95%CI 90.6–95.2). Positive and negative predictive values were 78.5% (95% CI 71.4–84.6) and 93.9% (95% CI 91.4–95.8), respectively. The most missed and overdiagnosed abnormalities were ventricular septal defects. The second trimester ultrasound had sensitivity of 69.0% (95% CI 55.5–80.5) and specificity of 87.5% (95% CI 84.3–90.2).

Conclusions

In a high-risk population, early assessments had similar performance metrics as the second trimester anatomy ultrasound. We advocate for a comprehensive fetal assessment in the care of high-risk pregnancies.  相似文献   
693.
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