Factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT)

Objective

To investigate factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT).

Method

A questionnaire study was conducted among 219 pregnant women in the Netherlands who had declined prenatal screening with NIPT (TRIDENT-2 study). Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non-Western ethnic origin and 64.4% were religious.

Results

Most respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were “I would never terminate my pregnancy” (57.1%) and “every child is welcome” (56.2%). For 16.9% of respondents, the out-of-pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy.

Conclusion

The primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out-of-pocket costs of NIPT hinder equal access for some pregnant women.     

Deriving a bioavailability-based zinc environmental quality standard for France

Environmental Science and Pollution Research - National Environmental Quality Standards (EQS) for zinc used for the assessment of ecological status in freshwaters have been shown to vary by over...     

A second case of intrauterine growth retardation and primary hypospadias associated with a trisomy 22 placenta but with biparental inheritance of chromosome 22 in the fetus

We report a case of severe intrauterine growth retardation (IUGR) and hypospadias in association with trisomy 22 diagnosed following chorionic villus sampling (CVS). Subsequent analysis of amniotic fluid cultures showed a normal male karyotype, 46,XY. As a previous case had been reported with similar abnormalities, in association with maternal uniparental disomy (UPD) 22, molecular studies were also performed. Microsatellite marker studies showed biparental inheritance. Follow-up studies after delivery showed a normal cell line in lymphocytes with the trisomy appearing to be confined to the placenta. The present case concurs with other earlier reports that maternal UPD for chromosome 22 has no impact on the phenotype. The features seen in the fetus are most likely the result of placental dysfunction due to trisomy, tissue-specific mosaicism and/or the effects of local growth restriction. Copyright © 2002 John Wiley & Sons, Ltd.     

Novel resource saving interventions: the case of modelling and storytelling

Climate change communication to the Public is in general presented in a negative fashion and often depicts the resultant costs and impacts as distant. Its substantial gloom together with the less immediate consequences significantly weaken responses. Narratives and stories are potent arbiters of meaningful communication and are an important vehicle for communication in our information-rich lives. Importantly, they reduce jargon, gather and translate information, provide insight, reframe evidence and engage audiences. It has been argued by many observers that stories are potentially useful in driving change; presenting a way to value what is gone, expressing emotions, and helping us assert our determination to salvage something and work towards the future. This paper details the methods utilised by the authors to generate stories and case studies in a community in Ireland over a 4-year research period. The aim of the work was to identify and assess the salience and potency of storytelling – as part of a “co-creation” process – with regard to galvanising local action in the generation of sustainable models of lifestyle practice for residents. In this paper, co-creation includes the planning phase of co-design and the implementation phase of co-production. The demonstration of these sustainable lifestyle practices was a strong driver for the sustainable transition of this community supporting the reduction of its ecological footprint by 28% over 4 years, evidence of which is highlighted in this paper.     

Chemical contaminants in feedlot wastes: concentrations, effects and attenuation

Commercial feedlots for beef cattle finishing are potential sources of a range of trace chemicals which have human health or environmental significance. To ensure adequate protection of human and environmental health from exposure to these chemicals, the application of effective manure and effluent management practices is warranted. The Australian meat and livestock industry has adopted a proactive approach to the identification of best management practices. Accordingly, this review was undertaken to identify key chemical species that may require consideration in the development of guidelines for feedlot manure and effluent management practices in Australia. Important classes of trace chemicals identified include steroidal hormones, antibiotics, ectoparasiticides, mycotoxins, heavy metals and dioxins. These are described in terms of their likely sources, expected concentrations and public health or environmental significance based on international data and research. Androgenic hormones such as testosterone and trenbolone are significantly active in feedlot wastes, but they are poorly understood in terms of fate and environmental implications. The careful management of residues of antibiotics including virginiamycin, tylosin and oxytetracycline appears prudent in terms of minimising the risk of potential public health impacts from resistant strains of bacteria. Good management of ectoparasiticides including synthetic pyrethroids, macrocyclic lactones, fluazuron, and amitraz is important for the prevention of potential ecological implications, particularly towards dung beetles. Very few of these individual chemical contaminants have been thoroughly investigated in terms of concentrations, effects and attenuation in Australian feedlot wastes.     

On the Relationship Between Mean and Variance of Soil Moisture Fields1

Abstract: The objective of this work was to explain an apparent contradiction in the literature related to the relationship between mean and variance (or standard deviation) of soil moisture fields. Some studies found an increase in soil moisture variance with decreasing mean soil moisture, while others showed a decrease. The evidence of maximum variance in the mid‐range of mean soil moisture was also reported in the literature. In this paper, we focus on the effects of spatial variability of soil texture on the relationship between variance and mean of soil moisture during soil dry‐down processes. Soil texture influences soil moisture mean and variance through its direct effects on evaporation and drainage, which are two main factors controlling soil drying. A differential equation describing soil moisture dry down is proposed and studied. Our study shows that as mean soil moisture is greater than a threshold, variance increases with decreasing mean soil moisture. If mean soil moisture is less than the threshold, variance decreases with decreasing mean soil moisture. The threshold depends on soil texture and is between the field capacity and the wilting point. The soil moisture dry‐down equation is also applied to explain the apparent contradiction with regard to the relationship between mean and variance of soil moisture fields reported in the literature.