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.     

The Aversion to Tampering with Nature (ATN) Scale: Individual Differences in (Dis)comfort with Altering the Natural World

People differ in their comfort with tampering with the natural world. Although some see altering nature as a sign of human progress, others see it as dangerous or hubristic. Across four studies, we investigate discomfort with tampering with the natural world. To do so, we develop the Aversion to Tampering with Nature (ATN) Scale, a short scale that is the first to directly measure this discomfort. We identify six activities that people believe tamper with nature (geoengineering, genetically modified organisms, pesticides, cloning, gene therapy, and nanoparticles) and show that ATN scores are associated with opposition to these activities. Furthermore, the ATN Scale predicts actual behavior: donations to an anti-tampering cause. We demonstrate that ATN is related to previously identified constructs including trust in technology, naturalness bias, purity values, disgust sensitivity, aversion to playing God, and environmental beliefs and values. By illuminating who is concerned about tampering with nature and what predicts these beliefs, the ATN Scale provides opportunities to better understand public opposition to technological innovations, consumer preferences for “natural” products, and strategies for science communication.     

Power and dependence perspectives on outsourcing decisions

Since the 1980s outsourcing has been a major topic in both economic and management literature. Economic literature tends to focus on the transaction cost perspective. In management literature the core competence approach prevails. An emerging alternative view on outsourcing is the power and dependence perspective. Aspects of power and dependence become visible in four case studies involving the maintenance of capital assets. In each instance both the buyer and supplier sides of the dyad are examined. The paper concludes with managerial implications and research opportunities.     

Young people negotiating and maintaining boundaries in youth work relationships: findings from an ethnographic study of youth clubs

‘Professional boundaries’ set limits on appropriate behaviours in the relationship between the service users and practitioners. The professional literature often assumes boundaries are maintained by the practitioners, occupational bodies, or organisational policy. However in youth work this is under-researched. An ethnographic study of four youth clubs in the North East of England into ethical practice revealed that young people were surprisingly adept at maintaining boundaries with the youth workers. These boundaries were negotiated and maintained through the young people's use of space, their willingness to interact with the workers, the way they shared information with the workers, and their inclusion of youth workers into their social networking. Young people also showed a sophisticated awareness of the organisational boundaries youth workers were operating within, and often cooperated in maintaining them with the worker. The article concludes by arguing youth workers should take seriously young people's ability and willingness to set and work within boundaries, and see their negotiation and maintenance as a mutual endeavour. However, this may provide a challenge to organisations with rigid policy-defined boundaries.     

“Egg Donor Wanted”: Social Work with Women Looking for an Egg Donor

Abstract

Women seeking fertility treatment using donor eggs can face challenges associated with recruiting suitable egg donors and negotiating the role that the donor may play in the life of the child. Social work in infertility clinics is an emerging area of practice and social work counsellors have an important role to play with parties involved in the egg donation process. This paper seeks to raise awareness of social work practice with women seeking egg donors, providing an overview of issues for social work practice. Findings from a small practice research project are also presented to highlight the experiences of women advertising for egg donors and to illustrate an empowerment approach to social work practice with these women. It was found that with the support of the social work counsellor, newspaper advertising can be an effective method to recruit egg donors for fertility treatment that allows women control over the process.     

Final report of the Color Additive Scientific Review Panel

The Color Additives Scientific Review Panel considered whether there was information sufficient to perform a carcinogenic risk assessment on the colors D&C Red No. 19 (R-19), D&C Red No. 37 (R-37), D&C Orange No. 17 (O-17), D&C Red No. 9 (R-9), D&C Red No. 8 (R-8) and FD&C Red No. 3 (R-3) and to evaluate the assessments sent to FDA as part of the petitions for use of the colors for drug and external uses by the Cosmetic, Toiletry and Fragrance Association (CTFA). There is a lack of human data concerning the colors for making a human health assessment, so the assessments are based upon the extrapolation of animal data. The risk assessments are determined for exposure to single chemicals. Excluded from consideration are possible effects from exposure to multiple chemicals, such as co-carcinogenesis, promotion, synergism, antagonism, etc. In the light of recent efforts in establishing a consensus in risk assessment, the Panel has determined that the CTFA assessments for R-10, O-17, and R-9 are consistent with present acceptable usages, although it questions some of the assumptions used in the assessments. The Panel identified a number of general assumptions made, and discusses their validity, their impact on total uncertainty, and the potential options to address the gaps in understanding that necessitate the assumption. The Panel also derived revised risk estimates using more "reasonable" assumptions than "worst-case" situations, for 90th percentile and average exposure. For those assumptions that are easily quantifiable, the Panel's estimates are less than an order of magnitude lower than the CTFA risk estimates, indicating that the underestimates and overestimates of the CTFA risk estimates tend to balance each other. The impact of most of the assumptions is not quantifiable. The assessment for R-3 is complicated by the fact that there is no good skin penetrance study for this color. It was assumed that the penetrance is similar to that of another water-soluble xanthene color, R-19. It is expected that the absorption of the color is not likely to exceed that of the smaller molecule, R-19. Therefore, the risk estimates are similar to the CTFA estimates, but with different reasoning. The estimates for R-8 and R-37 are different from the others in that there is a lack of any exposure or toxicological information on these colors.(ABSTRACT TRUNCATED AT 400 WORDS)