Current concepts of Down syndrome screening tests in assisted reproduction twin pregnancies: another double trouble

Assisted reproductive technologies (ART) have increased both the number of pregnancies in women beyond the age of 35 and the incidence of multiple pregnancies. Various methods of screening for Down syndrome (DS) were introduced in clinical practice during the last two decades, and specific problems were encountered when they were applied for twin pregnancies. The current review aims to explore the problematic issue of prenatal DS screening in ART twins. Overall, more women with twin pregnancies (mainly those who conceived via assisted reproduction) are found to be false positive for DS. This is because mid-trimester maternal serum screening is associated with a higher false-positive rate secondary to changes in the feto-placental endocrinologic metabolism, reflected mainly in high human chorionic gonadotrophin (hCG) levels in the ART pregnancies. First-trimester nuchal translucency (NT) measurement in twin pregnancies is not affected by the problems encountered in serum screening. This sonographic screening approach enables a fetus-specific identification of those fetuses at high risk of DS and is associated with a lower false-positive rate than mid-trimester serum screening. DS screening in ART twins presents several challenges in determining the most appropriate screening test modality. Whether there is any significant benefit of adding first-trimester biochemistry or nasal bone scanning in screening ART-conceived twins awaits further investigation. Copyright © 2005 John Wiley & Sons, Ltd.     

LEVEL B WATER RESOURCES PLANNING IN AN URBAN SETTING1

The purpose of this paper is to describe how the Level B Water Resources Planning Process was applied to Long Island Sound and the land area around it, to summarize the major findings and recommendations of the study and to comment on the effectiveness of that process and suggest how it might be made more effective in the future.     

Changing corporate environmental philosophy: Project renewal gets companies started

Project RENEWAL is an innovative new environmental business project taking place in New Jersey. Project RENEWAL stands for Resource Efficiency Network to Eliminate Waste and Liability. The purpose of this project is to investigate and promote the linkages between ecology, technology, and business economics for the benefit of the economy and the environment. This is a collaborative effort, initially focused on equipment and inventory assets, between the business and environmental communities in order to explore new ways to increase business efficiency and profitability and also benefit the environment. Participants in the project include representatives from industry, consulting, local and state government, environmental agencies, trade groups and academia. This article will outline the background and initial framework of Project RENEWAL's initiatives. (The authors are open to comments, suggestions, criticism, and most importantly input from others who share their vision and are willing to cooperatively accelerate the change process).     

EIA training courses organized by the centre for environmental management and planning,University of Aberdeen: An analysis of experience

In 1980, the World Health Organization (Regional Office for Europe) invited The Centre for Environmental Management and Planning (CEMP) to organize a two-week training course on Environmental Impact Assessment (EIA) to provide a comprehensive introduction to EIA with emphasis on methods and techniques for impact identification, prediction and assessment. Not suprisingly the topic of environmental health impact assessment was to be a major focus. Since 1980, the course has been held each year at the University of Aberdeen. An analysis of participation in the course during its first five years yields several impressions about the success of this training effort and the ways in which it might be improved.     

Measuring the wealth of nations

The sustainability of development is closely linked to changes intotal per capita wealth. This paper presents estimates of the wealth of nations for nearly 100 countries, broken down into produced assets, natural resources and human resources. While thelatter is the dominant form of wealth in virtually all countries,in low income natural resource exporters the share of natural resources in total wealth is equal to the share of produced assets. For low income countries in general, cropland forms thevast majority of natural wealth. The analysis suggests the process of development can be viewed as one of portfolio management: sustainable development entails saving the rents fromexhaustible resources, managing renewable resources sustainably,and investing savings in both produced assets and human resources.