Patient demands,lack of reciprocity,and burnout: a five‐year longitudinal study among general practitioners

This study among a sample of 207 general practitioners (GPs) uses a five‐year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP–patient relationship, which, in turn, depletes GPs' emotional resources and initiates the burnout syndrome. More specifically, structural equation analyses confirmed that—both at T1 and T2—lack of reciprocity mediates the impact of patient demands on emotional exhaustion. Emotional exhaustion, in turn, evokes negative attitudes toward patients (depersonalization), and toward oneself in relation to the job (reduced personal accomplishment). Moreover, this process model of burnout was confirmed at T2, even after controlling for T1‐scores on each of the model components. Finally, T1 depersonalization predicted the intensity and frequency of T2 patient demands, after controlling for T1 patient demands. This major finding suggests that GPs who attempt to gain emotional distance from their patients as a way of coping with their exhaustion, evoke demanding and threatening patient behaviors themselves. The theoretical and practical implications of these findings are discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

Climate change impacts on the leaching of a heavy metal contamination in a small lowland catchment

The Keersop catchment (43km(2)) in the south of The Netherlands has been contaminated by the emissions of four zinc ore smelters. The objective of this study was to assess the effects of future projected climate change on the hydrology and the leaching of heavy metals (i.e. Cd and Zn) in the catchment. The numerical, quasi-2D, unsaturated zone Soil Water Atmosphere Plant model was used with 100-year simulated daily time series of precipitation and potential evapotranspiration. The time series are representative of stationary climates for the periods 1961-1990 ("baseline") and 2071-2100 ("future"). The time series of future climate were obtained by downscaling the results of eight regional climate model (RCM) experiments, driven by the SRES A2 emissions scenario, using change factors for a series of climate statistics and applying them to stochastic weather generator models. The time series are characterized by increased precipitation in winter, less precipitation in summer, and higher air temperatures (between 2°C and 5°C) throughout the year. Future climate scenarios project higher evapotranspiration rates, more irrigation, less drainage, lower discharge rates and lower groundwater levels, due to increased evapotranspiration and a slowing down of the groundwater system. As a result, lower concentrations of Cd and Zn in surface water are projected. The reduced leaching of heavy metals, due to drying of the catchment, showed a positive impact on a limited aspect of surface water quality.     

Y chromosome detection by Real Time PCR and pyrophosphorolysis-activated polymerisation using free fetal DNA isolated from maternal plasma

Objectives To validate the use of Real Time PCR, a widely used technique that can detect very low levels of Y chromosomal sequence, and to assess the use of a highly sensitive PCR technique, pyrophosphorolysis-activated polymerisation (PAP), for fetal sex determination using free fetal DNA (ffDNA). Methods The fetal sex was determined by Real Time PCR in 58 pregnancies using ffDNA isolated from maternal plasma. In parallel with the Real Time PCR experiments, the presence of Y chromosome sequence was also determined using PAP on 54 isolated ffDNA samples. Results Both techniques detected Y chromosome sequence at very low levels with 98% specificity and 100% sensitivity (Real Time n = 44, PAP n = 54). Furthermore, the PAP technique was shown to be more robust than the Real Time PCR as none of the samples tested failed to meet the acceptance criteria. Combining the two techniques for male fetal sex detection from maternal blood plasma increases the sensitivity and specificity to 100% in this series. Conclusions This study shows that both Real Time PCR and PAP can be used for Y chromosome detection on ffDNA. Furthermore, by using PAP in combination with Real Time PCR more reliable early prenatal sexing can be performed using ffDNA. Copyright © 2007 John Wiley & Sons, Ltd.     

Effects of C60 nanoparticle exposure on earthworms (Lumbricus rubellus) and implications for population dynamics

Effects of C₆₀ nanoparticles (nominal concentrations 0, 15.4 and 154 mg/kg soil) on mortality, growth and reproduction of Lumbricus rubellus earthworms were assessed. C₆₀ exposure had a significant effect on cocoon production, juvenile growth rate and mortality. These endpoints were used to model effects on the population level. This demonstrated reduced population growth rate with increasing C₆₀ concentrations. Furthermore, a shift in stage structure was shown for C₆₀ exposed populations, i.e. a larger proportion of juveniles. This result implies that the lower juvenile growth rate due to exposure to C₆₀ resulted in a larger proportion of juveniles, despite increased mortality among juveniles. Overall, this study indicates that C₆₀ exposure may seriously affect earthworm populations. Furthermore, it was demonstrated that juveniles were more sensitive to C₆₀ exposure than adults.     

Nutritional benefits of filial cannibalism in three-spined sticklebacks (<Emphasis Type="Italic">Gasterosteus aculeatus</Emphasis>)

Although filial cannibalism (eating one’s own offspring) occurs in numerous species, including several teleost fishes, its adaptive value is still not well understood. One often-discussed explanation is that individuals enhance their mass and body condition by consuming part of their eggs. However, evidence for this assumption is scarce thus far. In this study, male three-spined sticklebacks (Gasterosteus aculeatus), a species with paternal care, were allowed to care for a batch of eggs or for an empty nest under food-deprived conditions. All brood-caring males cannibalised at least part of their eggs and thus preserved their initial mass and body condition. Furthermore, mass as well as body condition was significant positively correlated with the number of cannibalised eggs. In contrast, empty-nest males that had no possibility to cannibalise eggs significantly lost mass and body condition. This is, to our knowledge, the first experimentally documented evidence that mass as well as body condition were preserved by filial cannibalism.     

Measuring bioavailability: from a scientific approach to standard methods

Biological effects are not related to the total concentration of a contaminant in the soil and soil-like materials. Organisms respond only to the fraction that is biologically available. The bioavailable fractions of contaminants are dependent on soil properties and various processes varying with time and on the behavior or the target organism. Bioavailability may be assessed in two complementary ways: (i) by chemical methods (e.g., extraction methods), which determine a defined available fraction of a well defined class of contaminants; and (ii) by biological methods, which expose organisms to soil or soil eluates to monitor effects. Although there is scientific discussion on the concept of bioavailability, the literature gives enough evidence to recognize bioavailability as a promising tool in risk assessment. A large number of methods are available. Under regulatory aspects of soil protection, a risk assessment should be based on the same common concept of determination and assessment of exposure and measuring and assessment of effects. A harmonized framework on bioavailability is necessary to promote the development and introduction of workable (international) standard methods to be used in soil and site assessment. The working group 'Bioavailability' of ISO/TC190-Soil Quality has developed a guidance document for development and selection of methods to assess bioavailability for different target species with regard to several classes of contaminants. The way to this standard, on the border of science and regulation, is described in this article.     

Utilisation of a coastal grassland by geese after managed re-alignment

In this study we evaluate the effect of coastal re-alignment on the utilisation of coastal grasslands by staging geese. We assessed vegetation change and utilisation by geese using repeated mapping and regular dropping counts in both the restored marsh and adjacent reference sites. All measurements were started well before the actual re-alignment. In addition, we studied the effects of livestock grazing on vegetation and geese, using exclosures. The vegetation transformed from fresh grassland into salt-marsh vegetation. A relatively large proportion of the de-embanked area became covered with secondary pioneer vegetation, and the overall cover of potential food plants for geese declined. Goose utilisation had initially dropped to low levels, both in autumn and in spring, but it recovered to a level comparable to the reference marsh after ten years. Exclosure experiments revealed that livestock grazing prevented the establishment of closed swards of grass in the poorly drained lower area of the restored marsh, and thereby negatively affected goose utilisation of these areas during spring staging. Goose grazing in the restored marsh during spring showed a positive numerical response to grass cover found during the preceding growing season. (1) The value of restored salt marsh as foraging habitat for geese initially decreased after managed re-alignment but recovered after ten years. (2) Our findings support the idea that the value of foraging habitats depends largely on the cover of forage plants and that this can be manipulated by adjusting both grazing and drainage.