A cross-country comparison of pregnant women's decision-making and perspectives when opting for non-invasive prenatal testing in the Netherlands and Belgium

Background

The Netherlands and Belgium have been among the first countries to offer non-invasive prenatal testing (NIPT) as a first-tier screening test. Despite similarities, differences exist in counseling modalities and test uptake. This study explored decision-making and perspectives of pregnant women who opted for NIPT in both countries.

Methods

A questionnaire study was performed among pregnant women in the Netherlands (NL) (n = 587) and Belgium (BE) (n = 444) opting for NIPT, including measures on informed choice, personal and societal perspectives on trisomy 21, 18 and 13 and pregnancy termination.

Results

Differences between Dutch and Belgian women were shown in the level of informed choice (NL: 83% vs. BE: 59%, p < 0.001), intention to terminate the pregnancy in case of confirmed trisomy 21 (NL: 51% vs. BE: 62%, p = 0.003) and trisomy 13/18 (NL: 80% vs. BE: 73%, p = 0.020). More Belgian women considered trisomy 21 a severe condition (NL: 64% vs. BE: 81%, p < 0.001). Belgian women more frequently indicated that they believed parents are judged for having a child with trisomy 21 (BE: 42% vs. NL: 16%, p < 0.001) and were less positive about quality of care and support for children with trisomy 21 (BE: 23% vs. NL: 62%, p < 0.001).

Conclusion

Differences in women's decision-making regarding NIPT and the conditions screened for may be influenced by counseling aspects and country-specific societal and cultural contexts.     

Aggregations and offshore movements as indicators of spawning activity of bonefish (Albula vulpes) in The Bahamas

To identify the timing and location of spawning activity for bonefish (Albula spp.) in the Bahamian archipelago, we used an acoustic telemetry array spanning 44?km² of shallow tidal creeks, flats, and adjacent deeper coastal waters near Cape Eleuthera. In two successive years, we surgically implanted transmitters in male and female bonefish (n?=?60) and examined their movement patterns within the array. Eight bonefish surgically implanted with transmitters as part of an earlier study were also tracked. In 2009, the telemetry information was complemented with snorkeling observations, underwater video, and manual tracking of the same acoustically tagged fish, as well as fish (n?=?3) gastrically implanted with continuous transmitters. During a period of 4?C7?days spanning the full and new moons, primarily between October and May, bonefish moved from their typical shallow flats and aggregated at sites in close proximity to the deep water drop-off of the Exuma Sound. Localized movements of the large schools of bonefish (often?>1,000 fish) at these presumptive pre-spawning aggregation sites included brief trips (<8?h) just after sunset until just prior to sunrise to the abyssal wall at the edge of the Exuma Sound (i.e.,?>1,000?m depth). Tagged bonefish detected at these aggregation sites were subsequently detected back in the tidal creeks and coastal flats shortly after new and full moons and remained at these more typical shallow sites (i.e.,?<2?m depth). Although we did not directly observe spawning events, we did observe ventral nudging and porpoising behaviors, which are potentially associated with courtship. Timing of the observed movements and possible courtship behaviors was coincident with periods when gametes were well developed. Collectively, our study provides the first objective evidence suggesting that the aggregation and seasonal migration of bonefish to deep shelf environments during certain moon phases is for spawning.     

Increasing trend of primary NO2 exhaust emission fraction in Hong Kong

Despite the successful reduction in roadside NO( x ) levels, no such decrease has been detected in roadside NO(2) concentration in Hong Kong. One underlying cause could be the rising primary NO(2) fraction of the total emission of NO( x ). Primary NO(2) can be particularly detrimental to Hong Kong because a large fraction of the population are exposed to the traffic-related primary pollutants in the street canyons formed by congested high-rise buildings. In this study, hourly mean concentration data for roadside nitrogen oxides (NO( x )), nitrogen dioxide (NO(2)), and background ozone (O(3)) were used to estimate the mean primary NO(2) fraction from vehicle exhausts in Hong Kong. An overall increasing trend was observed for the primary NO(2) fraction (f-NO(2)) values in all the three roadside air monitoring sites. The primary NO(2) as a fraction of total NO( x ) (f-NO(2)) increased approximately from 2% in 1998 to 13% in 2008 in Hong Kong. The two particular periods of rising f-NO(2) coincided with the two implementation periods of the diesel retrofit programs for the light-duty vehicles and heavy-duty vehicles. Future vehicle emission control strategies should target not only total NO( x ) but also primary NO(2). Health benefit or disease burden estimates should be taken into account and updated in the process of policy planning and evaluation.     

Multimodel inference and adaptive management

Ecology is an inherently complex science coping with correlated variables, nonlinear interactions and multiple scales of pattern and process, making it difficult for experiments to result in clear, strong inference. Natural resource managers, policy makers, and stakeholders rely on science to provide timely and accurate management recommendations. However, the time necessary to untangle the complexities of interactions within ecosystems is often far greater than the time available to make management decisions. One method of coping with this problem is multimodel inference. Multimodel inference assesses uncertainty by calculating likelihoods among multiple competing hypotheses, but multimodel inference results are often equivocal. Despite this, there may be pressure for ecologists to provide management recommendations regardless of the strength of their study's inference. We reviewed papers in the Journal of Wildlife Management (JWM) and the journal Conservation Biology (CB) to quantify the prevalence of multimodel inference approaches, the resulting inference (weak versus strong), and how authors dealt with the uncertainty. Thirty-eight percent and 14%, respectively, of articles in the JWM and CB used multimodel inference approaches. Strong inference was rarely observed, with only 7% of JWM and 20% of CB articles resulting in strong inference. We found the majority of weak inference papers in both journals (59%) gave specific management recommendations. Model selection uncertainty was ignored in most recommendations for management. We suggest that adaptive management is an ideal method to resolve uncertainty when research results in weak inference.     

Reducing fall risk by improving balance control: development, evaluation and knowledge-translation of new approaches

Problem

Falling is a leading cause of serious injury, loss of independence, and nursing-home admission in older adults. Impaired balance control is a major contributing factor.

Methods

Results from our balance-control studies have been applied in the development of new and improved interventions and assessment tools. Initiatives to facilitate knowledge-translation of this work include setting up a new network of balance clinics, a research-user network and a research-user advisory board.

Results

Our findings support the efficacy of the developed balance-training methods, balance-enhancing footwear, neuro-prosthesis, walker design, handrail-cueing system, and handrail-design recommendations in improving specific aspects of balance control.

Impact on Knowledge Users

A new balance-assessment tool has been implemented in the first new balance clinic, a new balance-enhancing insole is available through pharmacies and other commercial outlets, and handrail design recommendations have been incorporated into 10 Canadian and American building codes. Work in progress is expected to have further impact.     

Status and future of the forest health indicators program of the USA

For two decades, the US Department of Agriculture, Forest Service, has been charged with implementing a nationwide field-based forest health monitoring effort. Given its extensive nature, the monitoring program has been gradually implemented across forest health indicators and inventoried states. Currently, the Forest Service??s Forest Inventory and Analysis program has initiated forest health inventories in all states, and most forest health indicators are being documented in terms of sampling protocols, data management structures, and estimation procedures. Field data from most sample years and indicators are available on-line with numerous analytical examples published both internally and externally. This investment in national forest health monitoring has begun to yield dividends by allowing evaluation of state/regional forest health issues (e.g., pollution and invasive pests) and contributing substantially to national/international reporting efforts (e.g., National Report on Sustainability and US EPA Annual Greenhouse Gas Estimates). With the emerging threat of climate change, full national implementation and remeasurement of a forest health inventory should allow for more robust assessment of forest communities that are undergoing unprecedented changes, aiding future land management and policy decisions.     

Sources and fate of Salmonella and fecal indicator bacteria in an urban creek

This research aimed to understand the sources and fate of Salmonella and fecal bacteria in urban surface waters. An urban creek (San Pedro Creek, California, USA) that had unusually high levels of Salmonella and fecal bacteria relative to other nearby waterbodies was chosen as a model field site. State of the art microbiological methods were used in concert with modeling to investigate Salmonella and fecal bacteria sources, and determine field-relevant dark inactivation and photoinactivation rates. Three along-creek surveys that spanned reaches adjacent to both urban and forested land covers were conducted to measure Salmonella, enterococci, Escherichia coli, and horse- and human-specific Bacteroidales. Salmonella were detected adjacent to and downstream of urban land cover, but not adjacent to forested land cover. No human or horse-specific Bacteroidales fecal markers were detected implicating other urban animal sources of bacteria. Two locations along the creek where Salmonella was consistently detected were sampled hourly for 25 hours and a mass-balance model was applied to determine field-relevant light and dark inactivation rates for Salmonella, enterococci, and E. coli. Sunlight inactivation did not appear to be important in modulating concentrations of Salmonella, but was important in modulating both enterococci and E. coli concentrations. Dark inactivation was important for all three organisms. This is the first study to quantitatively examine the fate of Salmonella within an urban surface water. Although the work is carried out at a single site, the methodologies are extendable to source tracking in other waterbodies. Additionally, the rate constants determined through the modeling will be useful for modeling these organisms in other surface waters, and represent useful benchmarks for comparison to laboratory-derived inactivation rates.     

Comparative toxicity assessment of in situ burn residues to initial and dispersed heavy fuel oil using zebrafish embryos as test organisms

Environmental Science and Pollution Research - In situ burning (ISB) is discussed to be one of the most suitable response strategies to combat oil spills in extreme conditions. After burning, a...     

Spatial separation from family in the mobile young of a biparental fish: risks and dynamics of returning home

In species with extended parental care, mobile dependent young are potentially more vulnerable to predators when they stray and become separated from their parents. We would expect that the likelihood of, and latency time for, a separated young to safely return to its ‘family unit’ (i.e. parents and brood mates) to be, respectively, inversely and positively related to the initial distance of separation and potentially mediated by its age or body size. Using the biparental convict cichlid fish (Amatitlania siquia), we tested these predictions by capturing individual young and displacing them at varying distances from their family unit in both the field and laboratory. As expected, displaced fish were less likely, and took longer, to return to their family with increasing separation distance from the family unit. The body length of displaced young mediated these relationships and their antipredator behaviour; larger young refuged more than smaller ones and were also less likely to be eaten by predators. These results suggest that selection should favour strong affiliative behaviour in mobile young animals towards their brood mates and protective parents because straying from the family unit leads to increased exposure to predation and a reduced likelihood of returning home with increasing separation distance.