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.     

What Cruising Infants Understand about Support for Locomotion

“Cruising” infants can only walk using external support to augment their balance. We examined cruisers' understanding of support for upright locomotion under four conditions: cruising over a wooden handrail at chest height, a large gap in the handrail, a wobbly unstable handrail, and an ill‐positioned low handrail. Infants distinguished among the support properties of the handrails with differential attempts to cruise and handrail‐specific forms of haptic exploration and gait modifications. They consistently attempted the wood handrail, rarely attempted the gap, and occasionally attempted the low and wobbly handrails. On the wood and gap handrails, attempt rates matched the probability of cruising successfully, but on the low and wobbly handrails, attempt rates under‐ and overestimated the probability of success, respectively. Haptic exploration was most frequent and varied on the wobbly handrail, and gait modifications—including previously undocumented “knee cruising”—were most frequent and effective on the low handrail. Results are discussed in terms of developmental changes in the meaning of support.