Improving Weight of Evidence Approaches to Chemical Evaluations

Federal and other regulatory agencies often use or claim to use a weight of evidence (WoE) approach in chemical evaluation. Their approaches to the use of WoE, however, differ significantly, rely heavily on subjective professional judgment, and merit improvement. We review uses of WoE approaches in key articles in the peer‐reviewed scientific literature, and find significant variations. We find that a hypothesis‐based WoE approach, developed by Lorenz Rhomberg et al., can provide a stronger scientific basis for chemical assessment while improving transparency and preserving the appropriate scope of professional judgment. Their approach, while still evolving, relies on the explicit specification of the hypothesized basis for using the information at hand to infer the ability of an agent to cause human health impacts or, more broadly, affect other endpoints of concern. We describe and endorse such a hypothesis‐based WoE approach to chemical evaluation.     

The embodied becoming of autism and childhood: a storytelling methodology

In this article I explore a methodology of storytelling as a means of bringing together research around autism and childhood in a new way, as a site of the embodied becoming of autism and childhood. Through reflection on an ethnographic story of embodiment, the body is explored as a site of knowledge production that contests its dominantly storied subjectivation as a ‘disordered’ child. Storytelling is used to experiment with a line of flight from the autistic-child-research assemblage into new spaces of potential and possibility where the becomings of bodies within the collision of autism and childhood can be celebrated.     

Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study

BackgroundSevere perineal tears sustained during childbirth cause significant distress and morbidity amongst women. The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter.MethodsWe used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either straight or curved scissors were used to cut an episiotomy. Other outcomes assessed were pain, length of hospital stay, perineal infection and perineal dehiscence.ResultsOf the 155 patients recruited in the prenatal period, only 20 (12.9%) were eventually randomised at birth. The main reasons for the high loss were that women either did not have a vaginal delivery (38, 24.5%), or they did not need an episiotomy (72, 46.5%). Rates of obstetric anal sphincter injury and other outcomes were similar between groups.DiscussionAnal sphincter injury during childbirth remains an important problem. Although the use of curved scissors provides a theoretical solution, we found that the high attrition rate made feasibility of conducting a suitably powered, randomised trial using the current design untenable. Alternative strategies have been suggested to make any future study more viable.     

War Leaves an Enduring Legacy in Combatants’ Lives

The memory of combat experience endures in World War II veterans. As veterans age, traumatic memory that previously may have been suppressed in the busyness of family and everyday life can re-emerge. Combat stress may affect not only the veterans, but also those people closely associated with them. Interviews were conducted with World War II veteran aircrew, wives, children, grandchildren, siblings, and friends to examine the impact of combat experience on the veterans and the family across the life course from the perspectives of the various participants. The combat experience significantly affected the life course of most.     

Feeding Patterns and Emotional Care in Breastfed Infants

A number of studies have suggested breastfed infants have improved bonding and attachment or cognitive development outcomes. However, mechanisms by which these differences might develop are poorly understood. We used maternal time use data to examine whether exclusively breastfeeding mothers spend more time in close interactive behaviors with their infants than mothers who have commenced or completed weaning. Mothers (188) participating in a time use survey recorded infant feeding activities for 24 h over a 7 day period using an electronic device. Tracking was conducted at 3, 6, and 9 months postpartum. Data was collected for maternal activities including infant feeding and time spent in emotional care. The mothers of exclusively breastfed infants aged 3–6 months fed them frequently and total time spent in breastfeeding averaged around 17 h a week. Maternal time spent in emotional care was also substantial, and found to correlate positively with time spent breastfeeding. Exclusively breastfed infants received greatest amounts of emotional care from their mother, and exclusively formula fed infants the least. Mixed fed infants received more emotional care time than formula fed infants, but less than fully breastfed infants. These findings may help explain the differential cognitive developmental outcomes reported in the medical literature for breastfed and non breastfed infants.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.