‘Management Standards’ and work-related stress in Great Britain: Progress on their implementation

The aim of this paper is to identify what constituted barriers to progress in the implementation of the Management Standards for preventing and reducing work-related stress nationally, an approach advocated by the Health and Safety Executive in Great Britain. Data were collected from more than 100 public sector organisations through inspector visits and research interviews. Findings show that under supportive contexts, organisations were able to follow the process of a stepwise method for assessing psychosocial risks and implementing interventions using HSE assessment tools and guidance. Main enabling factors included the active and visible support from senior management, human resource departments, and line managers; regular communications on progress, sufficient organisational capability in terms of resources and expertise; departmental/team level assessment as opposed to an overall corporate wide assessment, and involvement of key stakeholders (e.g. Trade Union, employees). Some of the critical barriers across many public sector organisations included in this study were: major or on-going organisational changes; lack of organisational capability; and the resource intensive aspect of the method requiring focus groups in addition to stress survey data. Implications of the findings for policy development are discussed.     

Likely pathogenic variant in the BICD2 gene in fetus presenting with non-immune hydrops

Trio exome sequencing was performed on a fetus presenting with severe hydrops fetalis at 21 + 0 weeks gestation. A novel de novo BICD2 missense variant was identified in the fetus. Pathogenic variants in the BICD2 gene are associated with lower extremity-predominant spinal muscular atrophy. The variant was initially classified as a variant of uncertain clinical significance (VUS) as at the time of analysis and initial report, pathogenic variants in the BICD2 gene specifically had not been associated with fetal hydrops and no other abnormalities had been detected. It was agreed in multidisciplinary team discussions to include the variant in the report as a VUS recommending phenotypic follow-up. The pregnancy was terminated and post-mortem findings were in keeping with a BICD2-pathogenic variant. In addition, a paper was published reporting another case with a pathogenic BICD2 variant presenting with fetal hydrops. The variant classification was then upgraded to class 4 likely pathogenic and reported as consistent with the diagnosis. This case demonstrates the importance of reporting these new gene/phenotypes in enabling others in the classification of variants, staying up-to-date with literature and following up phenotype for class 3 variants of interest.     

Importance of conserving large and old trees to continuity of tree-related microhabitats

Protecting structural features, such as tree-related microhabitats (TreMs), is a cost-effective tool crucial for biodiversity conservation applicable to large forested landscapes. Although the development of TreMs is influenced by tree diameter, species, and vitality, the relationships between tree age and TreM profile remain poorly understood. Using a tree-ring-based approach and a large data set of 8038 trees, we modeled the effects of tree age, diameter, and site characteristics on TreM richness and occurrence across some of the most intact primary temperate forests in Europe, including mixed beech and spruce forests. We observed an overall increase in TreM richness on old and large trees in both forest types. The occurrence of specific TreM groups was variably related to tree age and diameter, but some TreM groups (e.g., epiphytes) had a stronger positive relationship with tree species and elevation. Although many TreM groups were positively associated with tree age and diameter, only two TreM groups in spruce stands reacted exclusively to tree age (insect galleries and exposed sapwood) without responding to diameter. Thus, the retention of trees for conservation purposes based on tree diameter appears to be a generally feasible approach with a rather low risk of underrepresentation of TreMs. Because greater tree age and diameter positively affected TreM development, placing a greater emphasis on conserving large trees and allowing them to reach older ages, for example, through the establishment of conservation reserves, would better maintain the continuity of TreM resource and associated biodiversity. However, this approach may be difficult due to the widespread intensification of forest management and global climate change.     

Hydrochemical evaluation of the Voltaian system--the Afram Plains area, Ghana

Inverse geochemical modeling from PHREEQC, and multivariate statistical methods were jointly used to define the genetic origin of chemical parameters of groundwater from the Voltaian aquifers in the Afram Plains area. The study finds, from hierarchical cluster analysis that there are two main hydrochemical facies namely the calcium-sodium-chloride-bicarbonate waters and the magnesium-potassium-sulfate-nitrate waters in the northern and southern sections, respectively, of the Afram Plains area. This facies differentiation is confirmed by the distribution of the SO(4)(2-)/Cl(-) ratio, which associates groundwater from the northern and southern sections to areas influenced by contact with evaporites and seawater, respectively. Principal component analysis (PCA) with varimax rotation using the Kaiser criterion identifies four principal sources of variation in the hydrochemistry. Mineral saturation indices calculated from both major ions and trace elements, indicate saturation-supersaturation with respect to calcite, aragonite, k-mica, chlorite, rhodochrosite, kaolinite, sepiolite, and talc, and undersaturation with respect to albite, anorthite, and gypsum in the area. Inverse geochemical modeling along groundwater flowpaths indicates the dissolution of albite, anorthite and gypsum and the precipitation of kaolinite, k-mica, talc, and quartz. Both the PCA and inverse geochemical modeling identify the incongruent weathering of feldspars as the principal factors controlling the hydrochemistry in the Afram Plains area. General phase transfer equations have been developed to characterize the geochemical evolution of groundwater in the area. A very good relationship has been established between calcite and aragonite saturation indices in the Afram Plains area, with R(2)=1.00.     

Disposal practices for unused medications around the world

Pharmaceuticals have been detected throughout the environment where at least in some cases, they have been shown to have a detrimental effect. Many result from improper patient disposal of unused pharmaceuticals via environmentally-unfriendly routes, such as the sink, toilet or rubbish bin. This review surveys the current peer-reviewed literature on attitudes and practices to medicine disposal methods as reported by patients and the various medication disposal and destruction systems around the world. A literature search was carried out using the keywords 'medicines disposal', 'unused medicines', 'medicines wastage', and 'medication disposal' in the PubMed TM, ISI Web of Knowledge TM, Google Scholar TM, Medline TM, Scopus TM and International Pharmaceuticals Abstracts TM up to the end of May 2010. Twelve peer-reviewed articles with specified sample sizes were selected. The most popular methods for medication disposal were in the garbage, toilet or sink. Liquid medications were more likely to be rinsed down the sink, as opposed to solid tablets and capsules which were more likely deposited in the rubbish bin. Much confusion exists about the 'proper' way of medication disposal as many countries do not have standard medication disposal protocols. Furthermore, some pharmacies around the world refused to accept unused medications or discouraged the practice. Patients with knowledge about the impact of pharmaceuticals in the environment were more likely to return medications for proper disposal and destruction. It is concluded that it is of paramount importance that a formalized protocol for patient disposal and destruction of pharmaceuticals be implemented around the world.     

Disposal practices for unused medications in New Zealand

BackgroundThere is an enhanced international awareness that the improper disposal of unwanted and unused medications may have a detrimental effect on the environment.ObjectivesThe aim of this study was to determine the proportion of unused medications in New Zealand that are not returned to a pharmacy for disposal and are instead disposed of via land fill or water systems. In addition, this study intended to identify why these medications were unused or unwanted.DesignAn online survey was placed on the New Zealand National Poisons Centre website for a period of three months during 2008. This consisted of a series of questions with predefined answer sets and asked about collection of medications, why there may be unused medications, storage of medications and disposal of medications.ResultsThis survey was completed by 452 individuals. 62% of respondents currently had unwanted medications in their house. The most common reason for people to have leftover medication was ‘medical condition improved or resolved’ (n = 307). Depending on formulation type, between 13–24% of unused medications were returned to pharmacies with tablets and capsules being most likely to be returned and liquids most likely to be added to water systems.ConclusionsA significant percentage of unwanted medications are disposed of via routes that have the potential to adversely affect the environment. Reducing excess medications and wastage as well as education of appropriate disposal techniques may minimize their potential impact on the environment.