Second-trimester prenatal screening markers for Down syndrome in women with insulin-dependent diabetes mellitus

Published studies have shown that some serum markers used in screening for Down syndrome tend to be lower among women with insulin-dependent diabetes mellitus (IDDM). On this basis, many screening programmes adjust the marker levels to take account of this difference. Recent studies suggested that the marker levels were not different, and so adjustment may no longer be needed, possibly because of better diabetic control. Data from a prenatal screening programme for Down syndrome were examined to see whether the median values of second-trimester screening markers were still reduced in pregnant women with IDDM. A total of 366 women with IDDM singleton pregnancies without Down syndrome were identified from the screening programme at Barts from 1989 to 2002. After allowing for maternal weight, the median multiples of the median (MoM) for IDDM-unaffected singleton pregnancies were as follows: 0.88 (95% confidence interval 0.84–0.93) for alphafetoprotein (AFP), 0.95 (0.91–0.99) for unconjugated oestriol (uE₃), 0.90 (0.80–1.01) for total human chorionic gonadotrophin (total hCG), 0.98 (0.88–1.08) for free β-hCG, and 0.99 (0.89–1.10) for inhibin-A. The median levels for AFP and uE₃ were statistically significantly lower in pregnant women with IDDM. The other markers were not significantly different in women with and without IDDM. There remains a case for adjusting AFP and uE₃ levels in women with IDDM in prenatal screening programmes for Down syndrome. Copyright © 2004 John Wiley & Sons, Ltd.     

Conservation planning at the landscape scale: A landscape ecology method for regional land trusts

This paper illustrates a landscape ecology approach for land trusts undertaking conservation at the watershed scale. A conservation plan was created for the Grand Traverse Regional Land Conservancy (GTRLC) in the headwaters of Michigan's Manistee River Watershed (USA). Eight conservation drivers were devised to identify Conservation Focus Areas (CFAs) of highest ecological importance. The CFAs were ranked based on ecological importance, feasibility of protection and size. Parcels were ranked, totalling nearly 5000 ha, within the three highest-ranking CFAs in one key county. This approach is useful to land trusts trying to operationalize three distinct goals in conservation planning: to find areas of high ecological importance, to promote the landscape's spatial integrity and to delineate threats to ecological systems and processes.     

Adaptation in Practice: How Managers of Nature Conservation Areas in Eastern England are Responding to Climate Change

Although good general principles for climate change adaptation in conservation have been developed, it is proving a challenge to translate them into more detailed recommendations for action. To improve our understanding of what adaptation might involve in practice, we investigated how the managers of conservation areas in eastern England are considering climate change. We used a written questionnaire and semi-structured interviews to collect information from managers of a range of different conservation areas. Topics investigated include the impacts of climate change perceived to be of the greatest importance; adaptation goals being set; management actions being carried out to achieve these goals; sources of information used; and perceived barriers to taking action. We identified major themes and issues that were apparent across the sites studied. Specifically, we found ways in which adaptation had been informed by past experience; different strategies relating to whether to accept or resist change; approaches for coping with more variable conditions; ways of taking a large-scale approach and managing sites as networks; some practical examples of aspects of adaptive management; and examples of the role that other sectors can play in both constraining and increasing a conservation area’s capacity to adapt. We discuss the relevance of these findings to the growing discussion in conservation about identifying adaptation pathways for different conservation areas and a potential progression from a focus on resilience and incremental change to embracing “transformation.” Though adaptation will be place-specific, we believe these findings provide useful lessons for future action in both England and other countries.     

Why keep lions instead of livestock? Assessing wildlife tourism‐based payment for ecosystem services involving herders in the Maasai Mara,Kenya

This paper examines the effects of wildlife tourism‐based payments for ecosystem services (PES) on poverty, wealth inequality and the livelihoods of herders in the Maasai Mara Ecosystem in south‐western Kenya. It uses the case of Olare Orok Conservancy PES programme in which pastoral landowners have agreed to voluntary resettlement and exclusion of livestock grazing from their sub‐divided lands. These lands are set aside for wildlife tourism, in return for direct monetary payments by a coalition of five commercial tourism operators. Results show that, on the positive side, PES is the most equitable income source that promotes income diversification and buffers households from the livestock income declines during periods of severe drought, such as in 2008‐2009. Without accounting for the opportunity costs, the magnitude of the PES cash transfer to households is, on average, sufficient to close the poverty gap. The co‐benefits of PES implementation include the creation of employment opportunities in the conservancy and provision of social services. There is however a need to mitigate the negative effects of PES, including the widening inequality in income between PES and non‐PES households and the leakages resulting from the displacement of settlements and livestock to currently un‐subdivided pastoral commons.     

Cadmium phytoextraction using short-rotation coppice Salix: the evidence trail

A substantial body of evidence has now accumulated that raises expectations that clean-up of Cd-contaminated land can be achieved through cultivation and harvest of selected clones of short-rotation coppice willow within a realistic crop lifecycle. Cd uptake rates into Salix are high compared to other trace elements and to other plant species. Effective phytoextraction would require (i) careful targeting of hotspots, (ii) repeated harvest prior to leaf fall and (iii) final removal of the root bole.     

Simulating solute transport in a structured field soil: uncertainty in parameter identification and predictions

Dual-permeability models have been developed to account for the significant effects of macropore flow on contaminant transport, but their use is hampered by difficulties in estimating the additional parameters required. Therefore, our objective was to evaluate data requirements for parameter identification for predictive modeling with the dual-permeability model MACRO. Two different approaches were compared: sequential uncertainty fitting (SUFI) and generalized likelihood uncertainty estimation (GLUE). We investigated six parameters controlling macropore flow and pesticide sorption and degradation, applying MACRO to a comprehensive field data set of bromide andbentazone [3-isopropyl-1H-2,1,3-benzothiadiazin-4(3H)-one-2,2dioxide] transport in a structured soil. The GLUE analyses of parameter conditioning for different combinations of observations showed that both resident and flux concentrations were needed to obtain highly conditioned and unbiased parameters and that observations of tracer transport generally improved the conditioning of macropore flow parameters. The GLUE "behavioral" parameter sets covered wider parameter ranges than the SUFI posterior uncertainty domains. Nevertheless, estimation uncertainty ranges defined by the 5th and 95th percentiles were similar and many simulations randomly sampled from the SUFI posterior uncertainty domains had negative model efficiencies (minimum of -3.2). This is because parameter correlations are neglected in SUFI and the posterior uncertainty domains were not always determined correctly. For the same reasons, uncertainty ranges for predictions of bentazone losses through drainflow for good agricultural practice in southern Sweden were 27% larger for SUFI compared with GLUE. Although SUFI proved to be an efficient parameter estimation tool, GLUE seems better suited as a method of uncertainty estimation for predictions.     

WATER SHORTAGES,DEVELOPMENT, AND DROUGHT IN ROCKLAND COUNTY,NEW YORK1

Knowledge of the historical variability of regional climate is an essential element of successful water resource planning. Lacking such perspective, planners and managers can be deceived as to the severity of a recent climate extreme, such as drought, and place a disproportionate blame on the climate, not the integrity of the supply system should water restrictions become necessary to avoid shortages. Presented here is a vivid example of how development, a lack of adequate planning, and climate variability have converged to produce three water emergencies in Rockland County, New York, since 1995. An examination of climate data over the past century indicates that the severity of the recent droughts was well within the range of past variability. Rather than climate alone, the recent water emergencies have highlighted a significant mismatch between supply and demand that has been developing in Rockland County over the past three decades. Substantial development, largely in the form of single‐family homes, has not been matched with a corresponding enhancement of the county's water system. Realistic plans for meeting current water demand will require cooperation among all stakeholders, beginning with an acknowledgement that climate variations are inevitable, not the sole source of blame when water shortages arise.     

Field investigation of child restraints in side impact crashes

OBJECTIVE: Various test procedures have been suggested for assessing the protection afforded by child restraints (CRS) in lateral collisions. Analyses of real world crashes can be used to identify relevant characteristics of the child, restraint, collision, and injury mechanisms that should be incorporated into the design of the test procedures as well as in the design of related ATDs and injury metrics. The objective of this work is to use in-depth crash investigations of children restrained in CRS in side impacts to elucidate specific sources and mechanisms of injuries and explore the role of crash severity variables such as magnitude and location of intrusion and specific impact angle. METHODS: Real world crashes involving children restrained in forward facing CRS in side impacts were analyzed from Partners for Child Passenger Safety, an on-going child specific crash surveillance system in which insurance claims are used to identify cases. In-depth crash investigations using standardized protocols were used to calculate the crash severity and determine the mechanisms and sources of the injuries sustained. RESULTS: Cases of 32 children restrained in CRS in 30 side impact crashes were examined. Twenty-five percent sustained AIS 2+ injuries. The most common injuries sustained by children restrained in CRS in side impact crashes were to the face, head, and lower extremity. Characteristics of the crashes that appeared related to injury were intrusion that entered the child's occupant space or caused an interior part of the vehicle to enter the child's occupant space, forward component of the crash, and the rotation of the CRS, restrained by a seat belt, towards the side of the impact. CONCLUSIONS: The ability to assess the injury potential in a laboratory setting for the body regions of common injury, the head, face, and lower extremity, must be explored. Characteristics of a regulatory-based test procedure to assess injury risk should include a frontal component to the crash and intrusion into the occupant's seating position. Design enhancements of the CRS should address rotation during lateral impacts. These results provide guidance to current efforts to design and regulate these restraints for the safety of child passengers in side impacts.     

In Defence of Humanitarianism

The humanitarian crisis which followed in the wake of the genocidal regime in Rwanda in 1994 generated massive media attention and an unprecedented outpouring of international public and private assistance. In late 1997, the Rwanda refugee population in Zaire was subjected to a disaster of similarly epic proportions as a result of military action. Yet this crisis went relatively under-reported and failed to attract substantial aid funds, particularly from official donors. This paper seeks to document and account for the demise of the humanitarian imperative. It confronts a number of the criticisms of humanitarian action, concluding that, rather than being flawed, traditional humanitarian values remain valid and should be defended wherever there are situations of conflict.