Does an educational video for aneuploidy screening improve informed choice among pregnant women? A randomised controlled trial

Background

Poor knowledge and the lack of deliberation have been cited as reasons for women making uninformed choices about aneuploidy screening. Adequate pre-test counselling is of particular importance where non-invasive prenatal screening (NIPS) is being increasingly offered as a primary screening test.

Design

Women attending the antenatal clinic with a singleton pregnancy below 14 weeks were randomised to receive routine counselling or the intervention—a 16-min educational video on aneuploidy screening before their consult. The primary outcome, rate of informed choice, was assessed using an adapted multidimensional measure of informed choice questionnaire, where informed choice was defined as good knowledge and value-consistent behaviour. Secondary outcomes included informed choice with deliberation, decisional conflict and anxiety.

Results

Two hundred and eighty-six women were recruited. 69.8% of women in the intervention group made an informed choice compared with 53.6% in the control group (Risk Ratio [RR] 1.30, p = 0.014). A significantly higher number of women in the intervention group had good knowledge compared to controls (81% vs. 60.9%; RR 1.33, p = 0.001). Decisional conflict did not differ between groups, but women in the intervention group had higher anxiety scores (p < 0.001).

Conclusion

The study intervention was effective in helping women make informed choice. Qualitative studies to determine the reason for increased anxiety are needed.

Trial registration

Trial registry: ClinicalTrials.gov ; Identifier: NCT05492981.     

Preimplantation genetic diagnosis (PGD), a collaborative activity of clinical genetic departments and IVF centres

An Erratum has been published for this article in Prenatal Diagnosis 22 (5) 2002, 451. Preimplantation genetic diagnosis (PGD) requires the combined efforts of geneticists and workers in the field of reproductive medicine. This was studied on the basis of a questionnaire, sent to 35 members of the PGD Consortium of the European Society of Human Reproduction and Embryology (ESHRE). A reply was obtained from 20 centres. They represent the majority of activities in the field of PGD in the world. It is obvious that many of the activities (in vitro fertilisation, embryo culture and biopsy) take place in IVF units while others (counselling and diagnosis) are the responsibility of genetic diagnostic centres. The distances between both units vary considerably. In all but one centre sex determination is offered. Aneuploidy screening is offered in 13 out of 20 centres. PGD of translocations and other structural chromosome abnormalities is offered in all but one centre. The number of monogenic diseases offered varies considerably. In comparison to prenatal diagnosis PGD is more expensive. The majority of these costs are due to the IVF or ICSI procedure. The charges for PGD vary between about € 600 and € 4000. In 16 out of 20 centres the parents to be must sign an informed consent form. Copyright © 2001 John Wiley & Sons, Ltd.     

Changes in the quality of river water before, during and after a major flood event associated with a La Niña cycle and treatment for drinking purposes

The treatment of organics present in the lower reaches of a major river system（the Murray–Darling Basin, Australia） before（March–July 2010）, during（December 2010–May 2011） and after（April–December 2012） a major flood period was investigated. The flood period（over 6 months）occurred during an intense La Nia cycle, leading to rapid and high increases in river flows and organic loads in the river water. Dissolved organic carbon（DOC） increased（2–3 times） to high concentrations（up to 16 mg/L） and was found to correlate with river flow rates. The treatability of organics was studied using conventional jar tests with alum and an enhanced coagulation model（mEnCo）. Predicted mean alum dose rates（per mg DOC） were higher before（9.1 mg alum/mg DOC） and after（8.5 mg alum/mg DOC） than during the flood event（8.0 mg alum/mg DOC）,indicating differences in the character of the organics in raw waters. To assess the character of natural organic matter present in raw and treated waters, high performance size exclusion chromatography with UV and fluorescence detectors were used. During the flood period, high molecular weight UV absorbing compounds（〉2 kDa） were mostly detected in waters collected,but were not evident in waters collected before and afterwards. The relative abundances of humic-like and protein-like compounds during and following the flood period were also investigated and found to be of a higher molecular weight during the flood period. The treatability of the organics was found to vary over the three climate conditions investigated.     

Maximizing the phylogenetic diversity of seed banks

Ex situ conservation efforts such as those of zoos, botanical gardens, and seed banks will form a vital complement to in situ conservation actions over the coming decades. It is therefore necessary to pay the same attention to the biological diversity represented in ex situ conservation facilities as is often paid to protected‐area networks. Building the phylogenetic diversity of ex situ collections will strengthen our capacity to respond to biodiversity loss. Since 2000, the Millennium Seed Bank Partnership has banked seed from 14% of the world's plant species. We assessed the taxonomic, geographic, and phylogenetic diversity of the Millennium Seed Bank collection of legumes (Leguminosae). We compared the collection with all known legume genera, their known geographic range (at country and regional levels), and a genus‐level phylogeny of the legume family constructed for this study. Over half the phylogenetic diversity of legumes at the genus level was represented in the Millennium Seed Bank. However, pragmatic prioritization of species of economic importance and endangerment has led to the banking of a less‐than‐optimal phylogenetic diversity and prioritization of range‐restricted species risks an underdispersed collection. The current state of the phylogenetic diversity of legumes in the Millennium Seed Bank could be substantially improved through the strategic banking of relatively few additional taxa. Our method draws on tools that are widely applied to in situ conservation planning, and it can be used to evaluate and improve the phylogenetic diversity of ex situ collections. Maximizar la Riqueza Filogenética de los Bancos de Semillas     

Characterising components of liquid crystal displays to facilitate disassembly

Liquid Crystal Display (LCD) technology has evolved and developed over the past decades to replace Cathode Ray Tube (CRT) display technology as the market leader. This is evident, with global market figures for liquid crystal displays surpassing $75 Billion in 2008.Current End-of-Life (EoL) disposal for LCD screens is typically landfill or incineration, this form of disposal restricts the ability to recover potentially reusable materials from waste LCD screens e.g. steel, aluminium, copper etc. Thus to conserve raw materials and to protect the environment it is essential to replace the traditional flow of products from manufacturer to landfill with a recycle and recover approach.While the recycling methods for CRTs are well established, however those of LCDs are as yet in their infancy. However to reduce consumption of natural resources and reduce quantities of waste going to landfill, recycling process must be encouraged and developed.This paper aims to address the challenges facing EoL treatment of LCD units by analysing LCD build types, structures and component material to establish traits which may make EoL treatment less of a challenge. Analysing this data will lay the foundation to developing a balanced recovery system meeting the needs of economic viability and environmental conservation in future work.     

A cost-effectiveness analysis of alternative air quality control strategies

A number of linear programming models purport to minimize the costs of emission control to achieve ambient air quality standards. Many of the simulations incorporate the simplifying assumption that improvements in ambient air quality are proportional to reductions in regional emissions. This approach minimizes the cost of mass emission reduction, but not the cost to achieve a prescribed ambient air quality. The costs of this emissions least-cost strategy are compared to an ambient least-cost strategy which does achieve prescribed ambient air quality at minimum cost. The cost saving achieved by this strategy relative to the emissions least-cost strategy is as much as 50670. In addition, both are compared to a strategy typical of those currently used by the states, which is found to be as much as ten times as expensive as the ambient least-cost strategy.     

Herbicides: A new threat to the Great Barrier Reef

The runoff of pesticides (insecticides, herbicides and fungicides) from agricultural lands is a key concern for the health of the iconic Great Barrier Reef, Australia. Relatively low levels of herbicide residues can reduce the productivity of marine plants and corals. However, the risk of these residues to Great Barrier Reef ecosystems has been poorly quantified due to a lack of large-scale datasets. Here we present results of a study tracing pesticide residues from rivers and creeks in three catchment regions to the adjacent marine environment. Several pesticides (mainly herbicides) were detected in both freshwater and coastal marine waters and were attributed to specific land uses in the catchment. Elevated herbicide concentrations were particularly associated with sugar cane cultivation in the adjacent catchment. We demonstrate that herbicides reach the Great Barrier Reef lagoon and may disturb sensitive marine ecosystems already affected by other pressures such as climate change.