‘A Chance to Stand Back’: Parenting Programmes for Parents of Adolescents

Parenting interventions were an important feature of New Labour’s policies to combat social exclusion. This paper critically examines parenting programmes for families with adolescents, assessing national and local policy aims against the perspectives of women who took part in a parenting course, which was the subject of a local evaluation. The paper argues that, while there were important positive outcomes for the participants, the high levels of unmet need which women reported reflect important disparities between the aims of the intervention, the level of service provision, and the needs and concerns of mothers and grandmothers.     

Fetal Alcohol Spectrum Disorder Information Dissemination by Health Care Professions

Fetal alcohol spectrum disorder (FASD) is the leading preventable intellectual and developmental disability. There is no safe level of alcohol consumption at any point during pregnancy. Findings of this study indicate that the information disseminated by health care professionals is not always in keeping with this understanding. Physicians and midwives appeared to be the least consistent in advocating to women that they abstain from alcohol consumption while pregnant. We explore ways in which social workers can support the medical profession to provide more consistent messaging of alcohol abstinence during pregnancy to lower the incidence of FASD.     

Testing the Vision: Preschool Settings as Places for Meeting,Bonding and Bridging

The OECD (2006 Starting Strong II: Early Childhood Education and Care. OECD Publishing: Paris) envisions early childhood education and care settings as meeting places for diverse social groups; places that build social capital. This vision was assessed in a comparison of three preschools types: full‐fee paying, subsidised‐fee and publicly funded. The social composition within each was examined and the connectedness of the children (n = 472) who attended compared. Publicly funded preschools had more socially diverse populations. The quantity of social connectedness did not differ but children in publicly funded preschools described higher quality social relationships. Not all preschool settings are socially diverse but, where they are, the quality of relationships is highest.     

Modeling the Adenoma and Serrated Pathway to Colorectal CAncer (ASCCA)

Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen‐induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma‐carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma‐carcinoma pathway and 13 for the serrated pathway that match the age‐ and sex‐specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one‐time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.