International perspectives on the implementation of reproductive carrier screening

Reproductive carrier screening started in some countries in the 1970s for hemoglobinopathies and Tay-Sachs disease. Cystic fibrosis carrier screening became possible in the late 1980s and with technical advances, screening of an ever increasing number of genes has become possible. The goal of carrier screening is to inform people about their risk of having children with autosomal recessive and X-linked recessive disorders, to allow for informed decision making about reproductive options. The consequence may be a decrease in the birth prevalence of these conditions, which has occurred in several countries for some conditions. Different programs target different groups (high school, premarital, couples before conception, couples attending fertility clinics, and pregnant women) as does the governance structure (public health initiative and user pays). Ancestry-based offers of screening are being replaced by expanded carrier screening panels with multiple genes that is independent of ancestry. This review describes screening in Australia, Cyprus, Israel, Italy, Malaysia, the Netherlands, Saudi Arabia, the United Kingdom, and the United States. It provides an insight into the enormous variability in how reproductive carrier screening is offered across the globe. This largely relates to geographical variation in carrier frequencies of genetic conditions and local health care, financial, cultural, and religious factors.     

Regional planning and sustainability: limits and potentials of South Africa's integrated development plans

This paper considers whether South Africa's Integrated Development Plans provide an adequate framework for achieving sustainable regional development, particularly for peripheral regions of developing countries. It examines the case of Integrated Development Planning in the Ugu District Municipality, which has been acclaimed for its emphasis on incorporating principles of sustainable development into its planning processes. While the emphasis on integration and the multi‐sectoral approach are strengths, greater attention needs to be given to environmental aspects, and the form of planning needs to be adapted to the context, and its social, economic and political dynamics.     

Improving the contingent valuation method: A psychological perspective

Results of research on the social psychology of human decision making that offer direction for improving the contingent valuation method are reviewed. The paper focuses on the findings of that literature related to (1) limitations of human information processing and judgment-making abilities, (2) the influence of elicitation stimuli and expectations, and (3) quality of decision making in the face of too much or too little stress. Within the context of this literature, specific research directions are recommended that can improve the validity and reliability of the results of contingent valuation studies. More multidisciplinary studies are encouraged.