Thursday, May 16, 2013

Integrated health and social care could help victims of abuse

The conviction of seven men for rape, child prostitution and trafficking in Oxford on Tuesday brings to an end another horrific case of child sexual exploitation.

Social services were again in the firing line for failing to protect the girls and Joanna Simons, the Chief Executive of Oxfordshire County Council, was quick to issue an apology on behalf of the local authority. But social workers alone are not to blame.

The ethnicity and culture of the perpetrators has come under scrutiny, as in similar cases in Derby and Rochdale. The disproportionate number of Asian men in sex-grooming gangs was widely reported. While existing data on perpetrators is patchy and unclear, there does appear to be an over-representation. However, it’s also clear that perpetrators of child sexual exploitation come from all ethnic groups in the UK and not all victims are white British girls.

Stereotyping perpetrators and victims does not help to protect young people. But, without abandoning core professional values, social workers need to be confident about identifying and tackling grooming behaviour without issues of culture or ethnicity obfuscating the risk to the children involved.
Child abuse is a social problem

Child abuse is a significant social problem. Data collected for the NSPCC in 2009 found that about a quarter of young people in the UK reported experiencing abuse or neglect as children.

Since the Baby Peter case in 2007, child protection social work team caseloads have increased exponentially. Cafcass, the organisation that represents children in care cases, witnessed a 62% increase in the number of local authority care applications from 2007-8 to 2011-12.

Children in local authority care also have poorer educational outcomes and a greater prevalence of offending and substance misuse behaviour than the general population. This is likely to be because of vulnerabilities that are already there, but risks from being in the care system can’t be overlooked. It isn’t surprising that the prevalence of emotional distress and mental health problems among looked after children is also high.

Childhood trauma isn’t always resolved just because you grow up. It can contribute to the onset of severe mental health problems for many people. Child physical, sexual and emotional abuse increases the risk for all mental health problems, in particular post-traumatic stress disorder. Long-term separation from a parent before the age of 16 has also been identified as one risk factor for psychosis. The connections between problems in childhood and mental health problems in adulthood are well established.

Parental mental health problems are also a significant risk factor for the neglect and maltreatment of children, but mental health services don’t always consider the needs of children. Similarly, child protection social workers are there to act solely for the child.
Integrated working in mental health is at risk

The government wants more integration between health and social care by 2018.

Bridging the gaps between children’s social care services, provided by local councils, and adult mental health services, provided by the NHS, could help to protect children and meet the mental health needs of their parents.

But competing priorities in the NHS and local authorities are pulling them apart. For example, local authorities are concerned that the social care needs of vulnerable adults are not given enough importance in mental health services.

And in the NHS the introduction of so-called diagnostic-led care clusters, which require mental health workers to assign people to different categories such as “problems associated with hallucinations and delusions”, takes an increasingly medical approach that doesn’t value social issues.

A recent evaluation by the Social Care Institute for Excellence highlighted the barriers and opportunities for agencies to work together. A study I published last month in Child and Family Social Work found that those working in NHS mental health services and children’s social care services thought having joint agreements improved how they worked together.

But as the evidence stacks up that integrated community mental health teams are probably the most effective way to engage and treat people with mental health problems in the community, the pressure to cut the budgets of local authorities is leading some to actually pull out their mental health social workers. This is going in the opposite direction to the idea of integrating health and social care.

It’s against this backdrop of disintegrating community mental health services – though Minister for Care and Support Norman Lamb has not appeared to refer to it – that the government wants greater integration of health and social care. It’s potentially good news for many people with both health and social care needs, but cuts to budgets mean some local authority directors of adult social care services may need some convincing about pooling their cash.

To improve services to meet the needs of both children and adults, we can’t ignore the problems that are already there between those already trying to do this – and with less money.

Friday, April 12, 2013

Dinosaurs may not have revealed their true colours

The accuracy of colour correct dinosaur pictures has been called into question, thanks to a study investigating how fossilisation affects pigment.

The idea of being able to accurately predict colouration is rooted in a project by Jakob Vinther, a molecular palaeobiologist at the University of Bristol. Vinther used analysis of organelles associated with pigment in fossil specimens to work out which colours were displayed as a result.

Maria McNamara, also of the University of Bristol, simulated how pigments in bird feathers are affected by fossilisation using an autoclave (a pressurised container generating high temperatures).

She concluded that the organelles, known as melanosomes, shrank and that Vinther's colour predictions may not be accurate as a result. McNamara advises care until colouration is better understood. "These results demonstrate that reconstructions of original plumage colouration in fossils where preserved features of melanosomes are affected by diagenesis should be treated with caution."

However, Vinther disputes the implication, saying that he was aware of the effects of fossilisation on melanosomes and the results don't significantly affect the artist's impressions of the dinosaurs.

"It could have an effect if we [eventually] want to discriminate between a reddish-brown and a slightly less reddish-brown," says Vinther as reported by journal Nature, "but we're not near those sorts of assessments."

Friday, March 22, 2013

'Simple 7' heart health tips

Only one in 1,000 people is truly "heart healthy," according to doctors examining healthy living guidelines.

The American Heart Association has issued a list of seven steps to follow to minimize the chances of suffering cardiovascular disease. Those who meet all the criteria significantly cut their risk of having a heart attack, experts say.

Life's Simple Seven are:

- Not smoking;

- Being physically active;

- Not being overweight;

- Maintaining healthy cholesterol levels;

- Keeping blood pressure down;

- Regulating blood sugar levels;

- And eating healthily.

Jean-Pierre Despres, scientific director of the International Chair on Cardiometabolic Risk, an academic health organization, said the number of people who met all seven criteria was minuscule.

"If you look at those Simple Seven, and you measure what percentage of different populations around the developed world meet those criteria, it's only 0.1 per cent. In terms of having an optimal risk of cardiovascular disease, only one in 1,000 people is healthy," Despres said.

"If you only use the traditional risk factors, like cholesterol and blood pressure, you would probably end up with 15 per cent."

But when exercise, or the lack of it, and diet were taken into consideration, the number who were really healthy was far smaller.

"Exercise and nutrition are the two hardest indicators of cardiovascular health to meet," he said.

Far fewer people got the recommended 150 minutes of weekly exercise than claimed to do so, Despres added.

Although 60 per cent tell interviewers that they reach that target, when properly assessed only a third do.

Despres also said cutting out hidden salt and sugar was difficult, meaning few eat healthily.

He claimed that the health benefit of meeting all seven steps was "amazing."

"Those who meet these criteria just don't have heart attacks before 65," he said.

Two-thirds of adults in Britain are either overweight or obese, making the U.K. the fattest nation in western Europe.

But Despres said Britons should "forget about weight" as an end in itself and instead concentrate on quitting smoking and getting active.

A report last fall indicates that almost a third of Canadians aged five to 17 are overweight or obese, according to Statistics Canada.

"Being physically active is extremely beneficial for your heart health," Despres said.

Among obese people with the same waistline, he added, those who were physically active had half the chance of suffering from heart disease.

A U.S. study has found sticking to the seven steps can halve the chance of getting cancer.

Researchers at Northwestern University in Chicago studied the health of more than 13,000 people for 25 years.

Those who adhered to six or seven of the criteria had a 51 per cent lower chance of getting cancer than those who met none.

Tuesday, February 19, 2013

10 observations from Tigers spring training

Ten notes, thoughts, and items from five days of spring camp at Tigertown:

1. If anything, fans have probably underestimated how much more artillery the Tigers have added to manager Jim Leyland's batting order in 2013. Victor Martinez has replaced Delmon Young. Torii Hunter is wedged between Austin Jackson and Miguel Cabrera in the 1-2-3 spots. Alex Avila is probably your best bet for a bounce-back season. Andy Dirks hit .322 last year. Omar Infante, who was in Detroit for only three months in 2012, is the Tigers' everyday second baseman. It should lead to big innings of the kind Leyland's gang simply couldn't concoct in 2012.

2. I still see a Tigers trade ahead of Opening Day, very likely a multi-player biggie. Rick Porcello isn't going to the bullpen. Drew Smyly isn't going to Toledo. Unless injuries crop up, the Tigers will trade a starter. And that starter will almost certainly be Porcello.

3. National media knew little of Bruce Rondon ahead of spring camp and couldn't believe the Tigers would invade Florida minus a name-brand closer. But now they're catching on. Rondon is Lakeland's hot national story. And as they become acquainted with his arm and with his background, national scribes are picking up on why normally conservative GM Dave Dombrowski is fine with Rondon and his back-end cast.

4. That doesn't mean Rondon will be flying solo, at least immediately. The Tigers are quietly constructing an escape hatch should the pressure build to a scary level for a 22-year-old pitcher. They could choose to pick spots early in Rondon's big-league baptism. They could use Phil Coke, or Octavio Dotel, or Joaquin Benoit in a tight game or two as Rondon gets accustomed to life on the big stage. It's an option, although at the moment, it appears they'll ride with the kid closer.

5. Pitcher Max Scherzer said all the right things the other day. On a personal level, he absolutely would like to stay with the Tigers. But unless his agent, Scott Boras, changes stances and decides on an early contract extension, Boras will take Scherzer to free agency at the end of the 2014 season. Boras always ushers his blue-chip free agents to the open market. And if anyone was aware of his agent's preferences, it was the cerebral businessman, Scherzer.

6. Torii Hunter hasn't disappointed anyone. Everyone said the Tigers would love Hunter — his energy, his personality, his clubhouse spark. Hunter's the best diplomat in a Tigers uniform since Sean Casey. The question: Can a guy who turns 38 this year and who had a freaky good year in 2012 hold up? A personal guess: Yes. He probably won't hit .300, but at .275-.280, with his defense in right field and his vitality in the clubhouse, the Tigers are much better.

7. One reason why Detroit should be fine with Rondon as its closer: The Tigers tend to win with young pitchers. Justin Verlander and Joel Zumaya in 2006 helped take the team to the World Series. Porcello was solid as a 20-year-old starter when he arrived in 2009. Smyly handled the big leagues beautifully when he was promoted last spring. The front office does its homework. It measures skills and emotions. Bad stuff can always happen, but Rondon, for now, has convinced his bosses he has the arm and the head to push for a job. It's not a gamble on their part as much as a conviction.

8. So, who pitches long relief for the Tigers? You'll have your answer six weeks from today. Luke Putkonen is a percentage bet. But it might be Kyle Lobstein, the left-hander the Tigers took in December's Rule 5 draft. Teams grab Rule 5 guys when their rosters have holes or they're convinced a particular guy has a chance to help at a particular place. And the selection of Lobstein, a starter for most of his career, suggests Dombrowski and Co. were thinking of him strongly as a long-relief option when they need all the starters they can muster at Triple A Toledo as support behind Detroit's rotation.

9. Brennan Boesch is Most Likely To Become Spring Camp's Big Surprise. I don't know what his chances are. Probably low, given the pogo-stick nature of his past three years in Detroit. But don't sell him short. Anyone who has slammed pitches as hard as Boesch has hammered them for long stretches might well have figured it out ahead of 2013.

10. Nick Castellanos and Avisail Garcia. Not much chance either rookie makes the team coming out of Florida. But you can bet the disabled list will get its share of Tigers flesh in 2013. And it would be no surprise to see Garcia come aboard early in the season, with Castellanos in line at any point after the All-Star break.

Monday, January 28, 2013

City heat drives warm weather north

Big cities in North America and Asia may generate enough heat to warm areas far to the north of them, according to a new study co-authored by a researcher at Scripps Institution of Oceanography.

The study, published Sunday in the journal Nature Climate Change, suggests that energy consumption in U.S. and Asian cities can alter air circulation, pushing jet streams farther north and heating up parts of Canada and Siberia in the winter.

Its findings, the authors said, could account for unexplained warming in those areas of up to 1.8 degrees Fahrenheit each winter.

“Human activity — light, heat, cooling and transportation — consumes a lot of energy,” said Guang Zhang, a research meteorologist with Scripps Institution of Oceanography. “This energy eventually goes into the atmosphere as waste heat. We were trying to figure out how this excess heat affects climate. To our surprise, we saw that changes for surface temperature are substantial in regions far away from urban areas.”

Meteorologists long have known that cities are warmer than rural areas, as cars and buildings burn energy, and asphalt and roofs absorb heat. That’s called the urban heat island effect, and researchers have long thought that the heat stayed close to the cities.

But the study, based on a computer model, now suggests the heat does something else, albeit indirectly. It travels about half a mile up into the air and then its energy changes the high-altitude currents in the atmosphere that dictate prevailing weather.

The study adds to the evolving body of data examining how human activity affects climate. While scientists have said that carbon dioxide and other greenhouse gases are responsible for warming trends, recent studies, including one published earlier this month, suggest that black soot — from coal or wood fires — plays a greater role than previously thought.

Research on the effect of urban heat on global weather systems might fill in another part in that puzzle, but researchers acknowledge that there are more questions to answer.

Several outside scientists said they were surprised by the study results, calling the work “intriguing” and “clever.” But they said it would have to be shown in more than one computer model and in repeated experiments before they could accept this theory.

“It’s an interesting and rationally carried out study,” said David Parker, climate monitoring chief of the United Kingdom meteorology office. “We must be cautious until other models are used to test their hypothesis.”

Warming trends aren’t uniform around the globe, but instead are more pronounced over high-latitude land areas than elsewhere, said study co-author Ming Cai, a professor with the Department of Earth, Ocean, and Atmospheric Science at Florida State University. Until now, scientists struggled to explain that difference, and climate models couldn’t account for it, he said.

That extra heat could indicate a flaw in the model, natural temperature variability, or some other factor that forces northern areas to warm up in winter, Cai said. When he and his research partners factored urban heat in the model, the equation added up, with 95 percent confidence.

“By adding that heat into the model, this accounts for a substantial part of the missing warming that the models were unable to account for,” Xhang said.

The heat generated in cities doesn’t just warm the immediate area, however, the authors said, but instead may supercharge weather systems that move across the globe.

“The heat perturbs the jet stream,” Xhang said. “It modifies the air circulation pattern and forces heat northward. Basically it pushes the jet stream further up north.”

Urban heat involved represents a tiny fraction of the energy that the sun adds to the climate, Xhang said. So its role is not so much fueling — but rather rearranging — climate patterns. Consequently some parts of the Pacific Northwest and Europe may be a little chillier in winter, he said. And portions of North America and Asia may be cooler in fall.

Global energy use is almost 16 trillion watts, the study stated. Eighty-six cities, including New York, Los Angeles and Tokyo and other metropolitan giants, consume about 42 percent of that amount. The study only looked at that subset of cities, and only studied those through 2006, Xhang said, so future studies should include a more comprehensive estimate of energy use.

Thursday, December 20, 2012

Spaced out: NASA denies world's end as queries skyrocket

If there's one US government body really looking forward to December 22, it's NASA. The space agency said it had been flooded with calls and emails from people asking about the purported end of the world - which, as the doomsday myth goes, is apparently set to take place on December 21.

The myth may have originated with the Mayan calendar, but in the age of the internet and social media it proliferated online, raising questions and concerns among people around the world who turned to NASA for answers.

An agency spokesman, Dwayne Brown, said NASA usually received about 90 calls or emails a week with questions from the public. But in recent weeks the number had rocketed, and between 200 and 300 people a day had been contacting NASA to ask about the end of the world. ''Who's the first agency you would call?'' he said. ''You're going to call NASA.''

The questions range from myth (Will a rogue planet crash into Earth? Is the sun going to explode? Will there be three days of darkness?) to the macabre (Some people ''embrace it so much'' they want to hurt themselves). So, Brown said, NASA decided to do ''everything in our power'' to set the facts straight.
The effort included interviews with scientists posted online and a web page that Brown said had already drawn more than 4.6 million views.

NASA has put out a video called Why the World Didn't End Yesterday. Although the title implies a December 22 release date, Brown said NASA posted the four-minute clip last week to help spread its message.

NASA suspected it might have to create such a campaign when the idea of the world ending began ''festering'', he said. The apocalyptic action movie 2012, released in 2009, did not help.

''We kind of look ahead - we're a look-ahead agency - and we said, 'You know what? People are going to probably want to come to us','' Brown explained. ''We're doing all we can to let the world know that as far as NASA and science goes, December 21 will be just another day.''

NASA has handled many high-profile events before, Brown said, including the Venus transit this year, but nothing this big. ''It's been a very, very busy week,'' he said.