Meckel–Gruber syndrome: Ultrasonographic diagnosis at 13 weeks' gestational age in an at-risk case

A case of early diagnosis at 13 weeks' gestational age of Meckel–Gruber syndrome by ultrasound is reported in a patient with a 25 percent recurrence risk. The usefulness of genetic counselling and aimed echographic examination is discussed.     

Bicycle helmet effectiveness is not overstated

Objective: The objective of this study was to discuss the challenges in estimating bicycle helmet effectiveness from case–control studies of injured cyclists and to estimate helmet effectiveness from cases and available exposure data.

Methods: Data were extracted from studies of cyclists in Seattle; Victoria and New South Wales, Australia; and The Netherlands. Estimates of helmet use were used as exposure to compute relative risks for Seattle and Victorian data. Cycling distance data are routinely collected in The Netherlands; however, these data cannot be disaggregated by helmet use, which makes it unsuitable for estimating helmet effectiveness. Alternative controls were identified from larger cohorts for the Seattle and New South Wales cases.

Results: Estimates of helmet effectiveness were similar from odds ratios (ORs) using hospital controls or from relative risks (RRs) using helmet use estimates (Seattle: OR = 0.339, RR = 0.444; Victoria: OR = 0.500, RR = 0.353). Additionally, the odds ratios using hospital controls were similar when controls were taken from a larger cohort for head injury of any severity (Seattle: OR = 0.250, alt OR = 0.257; NSW: OR = 0.446, alt OR = 0.411) and for serious head injury (Seattle: OR = 0.135, alt OR = 0.139; NSW: OR = 0.335, alt OR = 0.308). Although relevant exposure data were unavailable for The Netherlands, the odds ratio for helmet effectiveness of those using racing, mountain, or hybrid bikes was similar to other estimates (OR = 0.371).

Conclusions: Despite potential weaknesses with case–control study designs, the best available evidence suggests that helmet use is an effective measure of reducing cycling head injury.     

Road accident fatality risks for “vulnerable” versus “protected” road users in northern Ghana

Background: Road traffic injuries (RTIs) are a serious epidemic that claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low- and middle-income countries. The unfavorable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in northern Ghana to highlight the scale and risk of death among road users.

Objective: The objective of this research was to establish the relative risk of death among road users in northern Ghana.

Methods: Crash data from police reports between 2007 and 2011 were analyzed for the Upper Regions of Ghana. Conditional probabilities and multivariable logistic regression techniques were used to report proportions and adjusted odds ratios (AORs), respectively.

Results: Generally, crashes in northern Ghana were extremely severe; that is, 35% of all injury related collisions were fatal. The proportion of fatal casualties ranged between 21% among victims of sideswipe collisions and 41% among pedestrians and victims of rear-end collisions. Though males were 6 times more likely to die than females overall, females were more likely to die as pedestrians (90% of all female casualty deaths) and males were more likely to die as riders/drivers (78% of all male casualty deaths). Pedestrians were 3 times more likely to die (odds ratio [OR] = 3.1; 95% confidence interval [CI], 2.4 to 4.1) compared with drivers/riders. Compared with drivers, the odds of death among cyclists was about 4 times higher (AOR = 3.6; 95% CI, 2.3 to 5.6) and about 2 times higher among motorcyclists (AOR = 1.6; 95% CI, 1.2 to 2.2). Compared with casualties aged between 30 and 59 years, children under 10 years and those aged 60 years and above were independently 2 times more likely to die in traffic collisions.

Conclusion: Provision of requisite road infrastructure is vital for the safety of VRUs in northern Ghana. Cycle paths and lanes (for cyclists) as well as sidewalks (for pedestrians) in particular will separate VRUs from motorists and improve their safety. Enforcement of traffic laws particularly regarding helmet use, speeding, and alcohol use will be beneficial. Introduction of the demerit points system in the enforcement of traffic regulations may have significant deterrent effects on road users who have the penchant for violating traffic regulations. Road safety education is also required to create responsible road users.     

‘It's off to work we go!’ Person–environment fit and turnover intentions in managerial and administrative mining personnel

Purpose. Person–environment fit asserts that incompatibility between an employee and aspects of their work environment is more likely to lead to occupational stress. The aim of this study was to investigate the impact that varying levels of person–environment fit had on key criterion outcomes including work engagement, work-related wellbeing and turnover intentions in a unique sample of managerial and administrative mining personnel. Method. An online self-report survey was distributed to an Australian mining organization by the company’s Chief Executive Officer. Anonymous survey links were sent to staff, of which 118 participants responded. The survey consisted of previously validated measures. Results. Hierarchical multiple regression analyses revealed significant relationships between abilities–demand fit, needs–supply fit and work engagement. Additionally, work-related wellbeing was significantly associated with increased person–organization fit and needs–supply fit. However, only needs–supply fit had a significant negative relationship with turnover intentions. Needs–supply fit significantly predicted all criterion variables. Conclusions. This study found that personal need fulfilment through work-related activities had the most significant impact on work-related wellbeing and work engagement. Personal need fulfilment through work also produced the most significant negative relationship with turnover intentions.     

Hand-arm vibration disorder among grass-cutter workers in Malaysia

Introduction. Prolonged exposure to hand-transmitted vibration from grass-cutting machines has been associated with increasing occurrences of symptoms and signs of occupational diseases related to hand–arm vibration syndrome (HAVS). Methods. A cross-sectional study was carried out using an adopted HAVS questionnaire on hand–arm vibration exposure and symptoms distributed to 168 male workers from the grass and turf maintenance industry who use hand-held grass-cutting machines as part of their work. The prevalence ratio and symptom correlation to HAVS between high and low–moderate exposure risk groups were evaluated. Results. There were positive HAVS symptoms relationships between the low–moderate exposure group and the high exposure group among hand-held grass-cutting workers. The prevalence ratio was considered high because there were indicators that fingers turned white and felt numb, 3.63, 95% CI [1.41, 9.39] and 4.24, 95% CI [2.18, 8.27], respectively. Less than 14.3% of workers stated that they were aware of the occupational hand–arm vibration, and it seemed to be related to the finger blanching and numbness. Conclusion. The results suggest that HAVS is under-diagnosed in Malaysia, especially in the agricultural sectors. More information related to safety and health awareness programmes for HAVS exposure is required among hand-held grass-cutting workers.     

Understanding traffic crash under-reporting: Linking police and medical records to individual and crash characteristics

Objective: This study aligns to the body of research dedicated to estimating the underreporting of road crash injuries and adds the perspective of understanding individual and crash factors contributing to the decision to report a crash to the police, the hospital, or both.

Method: This study focuses on road crash injuries that occurred in the province of Funen, Denmark, between 2003 and 2007 and were registered in the police, the hospital, or both authorities. Underreporting rates are computed with the capture–recapture method, and the probability for road crash injuries in police records to appear in hospital records (and vice versa) is estimated with joint binary logit models.

Results: The capture–recapture analysis shows high underreporting rates of road crash injuries in Denmark and the growth of underreporting not only with the decrease in injury severity but also with the involvement of cyclists (reporting rates of about 14% for serious injuries and 7% for slight injuries) and motorcyclists (reporting rates of about 35% for serious injuries and 10% for slight injuries). Model estimates show that the likelihood of appearing in both data sets is positively related to helmet and seat belt use, number of motor vehicles involved, alcohol involvement, higher speed limit, and females being injured.

Conclusions: This study adds significantly to the literature about underreporting by recognizing that understanding the heterogeneity in the reporting rate of road crashes may lead to devising policy measures aimed at increasing the reporting rate by targeting specific road user groups (e.g., males, young road users) or specific situational factors (e.g., slight injuries, arm injuries, leg injuries, weekend).     

Ecological knowledge and North Sea environmental policies

In an analysis of North Sea eutrophication science and policies, focusing on the period 1980–2005, it was investigated how scientific information was used in policy-making. The analysis focused on the central assumptions of the rational policy-making model, i.e. that scientific information can be used to formulate decisions, based upon objective scientific information (rational decision-making), and secondly, can support implementing these decisions (rational management). In general terms, the following was concluded:

• •More knowledge has increased rather than reduced uncertainty;
• •In order to handle the problem of dealing with complexity and uncertainty at the political level, a simplification of facts has occurred, in this case focusing on nutrients as the main cause of the problem, at the same time excluding other possible causes;
• •Both the limited scientific view (i.e. the nutrient view) and the exaggeration of the seriousness of the problem (impacts, scope) have been used as an authoritative basis for the justification of political decisions. Both were not supported by the majority of the scientific community;
• •New scientific knowledge, not in support of existing policies, has been excluded from the policy process;
• •The science–policy interface, mainly consisting of “civil-servant scientists”, that emerged and increased its influence over the period of investigation, has been the central element in the simplification and exclusion process.

The main lesson learned is that work at the interface of science and policy must be subject to democratic principles, i.e. be transparent and involving all parties with a stake in the issue under consideration.     

Application of chemometric analysis based on physicochemical and chromatographic data for the differentiation origin of plant protection products containing chlorpyrifos

The aim of this study was to investigate the similarities and dissimilarities between the pesticide samples in form of emulsifiable concentrates (EC) formulation containing chlorpyrifos as active ingredient coming from different sources (i.e., shops and wholesales) and also belonging to various series. The results obtained by the Headspace Gas Chromatography–Mass Spectrometry method and also some selected physicochemical properties of examined pesticides including pH, density, stability, active ingredient and water content in pesticides tested were compared using two chemometric methods. Applicability of simple cluster analysis and also principal component analysis of obtained data in differentiation of examined plant protection products coming from different sources was confirmed. It would be advantageous in the routine control of originality and also in the detection of counterfeit pesticides, respectively, among commercially available pesticides containing chlorpyrifos as an active ingredient.     

How the DPSIR framework can be used for structuring problems and facilitating empirical research in coastal systems

As pressures on coastal zones mount, there is a growing need for frameworks that can be used to conceptualize complex sustainability challenges and help organize research that increases understand about interacting ecological and societal processes, predicts change, and supports the management, persistence, and resilience of coastal systems. The Driver–Pressure–State–Impact–Response (DPSIR) framework is one such approach that has been adopted in some coastal zones around the world. Although the application of the DPSIR framework has considerable potential to bridge the gap between scientific disciplines and link science to coastal policy and management, current applications of DPSIR in coastal environments have been limited and new innovations in the application of the DPSIR model are needed. We conducted a structured review of literature on the DPSIR framework as applied to the function, process and components of complex coastal systems. Our specific focus was on how the DPSIR framework has been used as a tool to organize sophisticated empirical scientific research, support transdisciplinary knowledge at a level appropriate for building understanding about coastal systems, and how adopting a DPSIR approach can help stakeholders to articulate and structure challenges in coastal systems and use the framework to support policy and management outcomes. The review revealed that DPSIR models of coastal systems have been largely used to support and develop conceptual understanding of coastal social–ecological systems and to identify drivers and pressures in the coastal realm. A limited number of studies have used DPSIR as a starting point for semi-quantitative or quantitative analyses, although our review highlights the continued need for, and potential of, transformative quantitative analyses and transdisciplinary applications of the DPSIR framework. The DPSIR models we reviewed were predominantly single sector, encompassing ecological or biophysical factors or focusing primarily on socio-cultural dimensions rather than full integration of both types of information. Only in eight of 24 shortlisted articles did researchers actively engage decision-makers or citizens in their research: given the potential opportunity for using DPSIR as a tool to successfully engage policy-makers and stakeholders, it appears that the DPSIR framework has been under-utilized in this regard.     

Silver-Russell syndrome as a cause for early intrauterine growth restriction

The diagnosis of Silver–Russell syndrome is based on the characteristic growth restriction and the presence of typical dysmorphic features. We present the prenatal and postnatal findings of a case that was treated at our perinatal center. The suspected diagnosis Silver–Russell syndrome was confirmed after delivery by our medical genetic and neonatology services. The authors want to point out that SRS should be considered in the differential diagnosis of early asymmetric intrauterine growth restriction. Copyright © 2005 John Wiley & Sons, Ltd.