Issues associated with possible implementation of Non-Invasive Prenatal Testing (NIPT) in first-tier screening: A rapid scoping review

In recent years, as the implementation and use of Non-Invasive Prenatal Testing (NIPT) have increased, the cost of the test has been decreasing. The cost of NIPT is expected to fall further in the upcoming years. As a result of the decreasing cost of NIPT, many jurisdictions may change their prenatal screening policies toward abandoning serum-based screening and instead, implement and support NIPT as the first-tier screening for all women. There are several concerns in replacing first-trimester screening with NIPT. In this scoping review, we aimed to map the existing knowledge about possible issues in the systematic implementation of NIPT as the primary method of first-tier screening and to assess if any jurisdiction has altered its policy and discontinued serum-based prenatal screening in exchange for NIPT. The Medline database (Ovid) and Google Scholar was searched and all the studies discussing, investigating, or reporting on the systematic implementation of NIPT as the primary method of first-tier screening were included. All the studies went through a two-stage screening process and included full-text articles were reviewed. We did not find any articles indicating a country or region that replaced traditional prenatal screening by NIPT. The included articles were charted, and the data about the possible issues in the systematic implementation of NIPT as the primary method of first-tier screening are summarized narratively and presented in tables in four categories. The findings of this scoping review may be informative for stakeholders and policymakers regarding recent changes in NIPT implementation policies around the world and may aid with developing policy for NIPT implementation with a broader perspective.     

Reasons for Child Passenger Nonrestraint in Motor Vehicles

Objective: Although child passenger restraint use in motor vehicles has increased, there is an important minority of children who remain unrestrained. The goal of this study was to identify the frequency of and under what circumstances parents keep their children unrestrained.

Methods: A cross-sectional, online survey was distributed to parents and caregivers of children 10 years old and younger. Survey participants were asked about child restraint practices, including frequency of and reasons for nonuse of restraints. Parents were specifically asked how acceptable it would be to keep their child unrestrained in certain situations.

Results: One thousand two hundred eighty-five parents and guardians responded to the survey and 1,002 completed it; 23.8% (95% confidence interval [CI], 21.3–26.6%) of respondents said they had driven with their child not fully restrained on at least one occasion. Approximately 1 in 5 parents strongly or somewhat agreed that it would be acceptable to keep their child unrestrained in certain situations, including a short drive, in a rush, an inadequate number of restraints, riding in a taxi, if somebody was holding the child, and as a reward for a child. Parents were more likely to agree that it was acceptable to keep their child unrestrained under nearly all circumstances listed if they were male, ages 18–29, with a graduate school education, in the $100,000+ income bracket, or Latino.

Conclusions: There are certain situations for which parents find it acceptable to leave their children unrestrained. This has implications for targeted child passenger safety efforts designed to maximize consistent restraint use.     

Engaging stakeholders in an adaptation process: governance and institutional arrangements in heat-health policy development in Adelaide, Australia

Record breaking heat waves have been recorded in Adelaide, Australia in recent years and climate change would likely increase the frequency, duration and severity of heat waves. This paper describes the governance and institutional arrangements during the development of an adaptation strategy (herein referred to as heat-health policy) for heat waves in Adelaide, Australia. In-depth, semi-structured interviews were conducted between June and August 2011 among 18 stakeholders who were involved in the participatory process during the development of the heat-health policy. Informed consent was obtained and interviews were recorded, transcribed verbatim and the data analysed using framework analysis. Interview data were supplemented by data gathered through a review of documents associated with the process. The results found that the process of developing the heat-health policy was initiated by the state government and comprised of stakeholders from both the state and non-state sectors. There was a high level of leadership and political commitment demonstrated during the process, given that the different players wanted a policy to be in place before any future heat wave. A Steering Committee was established that provided coordination and oversight in addition to the Emergency Management Act within the state which provided the legislative framework during the heat-health policy development process. Although the decision-making authority was controlled by a controlled by a public institution, to a larger extent, there was collaborative decision-making by virtue of the context in which the heat-health policy was developed. An assurance mechanism established during the process was among the factors that ensured accountability during the participatory process. Overall, the development of the heat-health policy in Adelaide was largely successful, attributed to the extent of political commitment from the state government and the sound institutional and legislative framework that facilitated the process. Good governance and institutional arrangements provide the enabling environment, the structures, systems and resources that would facilitate the development of adaptation strategies such as heat-health policies.     

Book reviews

Making Cities Work: the role of local government in the urban environment. Richard Gilbert, Don Stevenson, Herbert Girardet &; Richard Stren, 1996, London, Earthscan, 203pp. ISBN 1 85383 354 1, £13.95 pbk

Environmental Policy in an International Context, Vols 1–3: Perspectives, Conflicts and Prospects. P. Glasbergen &; A. Blowers (Series Eds) London, Arnold

Rhetoric and Reality in Environmental Policy. M. Wintle &; R. Reeve (Eds), 1994, Aldershot, Avebury Studies in Green Research, 154 pp. ISBN 1 85628 927 3

FutureNatural: Nature, Science, Culture. G. Roberston et al. (Eds) 1996, London, Routledge, ISBN 0415 070139, £40.00 hbk

Environmental Policy with Political Integration: the European Union and the United States. New horizons in environmental economics. John B. Braden, Henk Folmer &; Thomas S. Ulen (Eds), 1996, Cheltenham, Elgar Publishing, 477 pp. ISBN 1 85898 217 0     

Fate of atrazine and chlorpyrifos during solid state fermentation—examination of processes

Abstract

Solid state fermentation (SSF) was investigated as a means to dispose of two commonly used pesticides, chlorpyrifos (O, O‐diethyl O‐(3,5,6‐trichloro‐2‐pyridyl) phosphorothioate) and atrazine (2‐chloro‐4‐ethylamino‐6‐isopropylamino‐1,3,5‐triazine). SSF experiments were carried out in bench‐scale bioreaetors (equipped with CO₂ and volatile organic traps) containing a mixture of lignocellulosic materials and a radiolabeled pesticide. Ethyl acetate‐extractable, alkali soluble, and alkali insoluble fractions were evaluated for radioactivity following a 60‐d incubation period at 40°C. The majority of the [2, 6‐pyridyl‐¹⁴C]chlorpyrifos was associated with the ethyl acetate extract (about 74%), 17% was trapped as organic volatiles by polyurethane foam traps and < 0.5% of the chlorpyrifos was mineralized to CO². Only small amounts of the radioactivity were associated with alkali soluble (0.0003%) and alkali insoluble (0.3%) fractions. In the [¹⁴C‐U‐ring] atrazine bioreactors, very little of the radioactivity volatilized (<0.5%) and less than 0.5% was mineralized to CO₂. Approximately 57% of the applied radioactivity was associated with the ethyl acetate extract while 9% and 24% of the radioactivity was associated with the alkali soluble (humic and fulvic acids) and alkali insoluble fractions, respectively. Possible reaction mechanisms by which covalent bonds could be formed between atrazine (or metabolites) and humic substances were investigated. The issue of bound atrazine residue (alkali soluble fraction) was at least partially resolved. Oxidative coupling experiments revealed that formation of covalent bond linkages between amino substituent groups of atrazine residue and humic substances is highly unlikely.     

Spatial analysis of a large magnitude erosion event following a Sierran wildfire

High intensity wildfire due to long-term fire suppression and heavy fuels buildup can render watersheds highly susceptible to wind and water erosion. The 2002 "Gondola" wildfire, located just southeast of Lake Tahoe, NV-CA, was followed 2 wk later by a severe hail and rainfall event that deposited 7.6 to 15.2 mm of precipitation over a 3 to 5 h time period. This resulted in a substantive upland ash and sediment flow with subsequent down-gradient riparian zone deposition. Point measurements and ESRI ArcView were applied to spatially assess source area contributions and the extent of ash and sediment flow deposition in the riparian zone. A deposition mass of 380 Mg of ash and sediment over 0.82 ha and pre-wildfire surface bulk density measurements were used in conjunction with two source area assessments to generate an estimation of 10.1 mm as the average depth of surface material eroded from the upland source area. Compared to previous measurements of erosion during rainfall simulation studies, the erosion of 1800 to 6700 g m(-2) mm(-1) determined from this study was as much as four orders of magnitude larger. Wildfire, followed by the single event documented in this investigation, enhanced soil water repellency and contributed 17 to 67% of the reported 15 to 60 mm ky(-1) of non-glacial, baseline erosion rates occurring in mountainous, granitic terrain sites in the Sierra Nevada. High fuel loads now common to the Lake Tahoe Basin increase the risk that similar erosion events will become more commonplace, potentially contributing to the accelerated degradation of Lake Tahoe's water clarity.     

Phosphorus and other soil components in a dairy effluent sprayfield within the central Florida Ridge

There is concern that P from dairy effluent sprayfields will leach into groundwater beneath Suwannee River basins in northern Florida. Our purpose was to describe the effects of dairy effluent irrigation on the movement of soil P and other nutrients within the upper soil profile of a sprayfield over three 12-mo cycles (April 1998-March 2001). Effluent P rates of 70, 110, and 165 kg ha(-1) cycle(-1) were applied to forages that were grown year-round. The soil is a deep, excessively drained sand (thermic, uncoated Typic Quartzipsamment). Mean P concentration in soil water below the rooting zone (152-cm depth) was < or = 0.1 mg L(-1) during 11 3-mo periods. Mehlich-1-extractable (M1) P, Al, and Ca in the topsoil increased over time but did not change in subsoil depths of 25 to 51, 51 to 71, 71 to 97, and 97 to 122 cm. Topsoil Ca increased as effluent rate increased. High Ca levels were found in dairy effluent (avg.: 305 mg L(-1)) and supplemental irrigation water (avg.: 145 mg L(-1)) which likely played a role in retaining P in the topsoil. An effect of effluent rate on P and Al concentrations in the topsoil was not detected, probably due to large and variable quantities present at project initiation. The P retention capacity (i.e., Al plus Fe) increased in the topsoil because Al increased. Dairy effluent contained Al (avg.: 31 mg L(-1)). Phosphorus saturation ratio (PSR) increased over time in the topsoil but not in subsoil layers. Regardless of effluent rate, the P retention capacity and PSR of subsoil, which contained 119 to 229 mg kg(-1) of Al, should be taken into account when assessing the risk of P moving below the rooting zone of most forage crops.     

Inorganic nitrogen and phosphorus in Sierran forest O horizon leachate

High in situ concentrations of inorganic N and P have been reported in overland/litter interflow from Sierran forests, indicating that these nutrients are derived from the forest floor O horizons. To test this hypothesis, forest floor monoliths consisting of the combined O(e) and O(i) horizons were collected near the South Shore of Lake Tahoe, Nevada, for leaching experiments. Three monoliths were left intact, and three were hand-separated according to horizon for a total of three treatments (combined O(e)+O(i), O(e) only, and O(i) only) by three replications. Samples were randomized and placed into lined leaching bins. Initial leaching consisted of misting to simulate typical early fall precipitation. This was followed by daily snow applications and a final misting to simulate spring precipitation. Leachate was collected, analyzed for NH(4)(+)-N, NO(3)(-)-N, and PO(4)(3-)-P, and a nutrient balance was computed. There was a net retention of NH(4)(+)-N, but a net release of both NO(3)(-)-N and PO(4)(3-)-P, and a net release of inorganic N and P overall. Total contributions (mg) of N and P were highest from the O(e) and O(e)+O(i) combined treatments, but when expressed as per unit mass, significantly (p < 0.05) higher amounts of NO(3)(-)-N and PO(4)(3-)-P were derived from the O(i) materials. The nutrients in forest floor leachate are a potential source of biologically available N and P to adjacent surface waters. Transport of these nutrients from the terrestrial to the aquatic system in the Lake Tahoe basin may therefore play a part in the already deteriorating clarity of the lake.