Capturing the scale and pattern of recurrent care proceedings: initial observations from a feasibility study

This article reports the initial findings of a feasibility study that has captured the scale and pattern of recurrent care proceedings. Although frontline professionals have reported long-standing concerns about the repeat clients of public law proceedings, prior to the study we report, the scale of the problem has been unknown. With funding from the Nuffield Foundation and support from the Child and Family Court Advisory Service (CAFCASS) and the President of the Family Division, the research team has arrived at a first estimate of prevalence, confirming that recurrence is a sizeable problem for the English family court. Based on cases that completed during the observational window 2007-2013 (calendar years), 7,143 birth mothers appeared in 15,645 recurrent care applications concerning 22,790 infants and children. Moreover, the study most likely underestimates recurrence, because reliable data concerning completed cases is not available before 2007. Initial observations are that the spacing between recurrent care proceedings is very short, which raises searching questions about prevention. Where episodes of care proceedings follow in swift succession, most likely prompted by the birth of another infant, this affords mothers little opportunity to effect change. Unless, this ‘status quo’ is tackled, it is difficult to envisage how vulnerable birth mothers can exit this cycle. Preliminary recommendations are made in respect of policy and practice change

Information hiding in SOAP messages: A steganographic method for web services

Digital steganography is the art and science of hiding communications; a steganographic system thus embeds secret data in public cover media so as not to arouse an eavesdropper’s suspicion. Hence, it is a kind of covert communication and information security. There are still very limited methods of steganography to be used with communication protocols, which represent unconventional but promising steganography mediums. In this paper, we discuss and analyze a number of steganographic studies in text, XML as well as SOAP messages. Then, we propose a novel steganography method to be used for SOAP messages within Web services environments. The method is based on rearranging the order of specific XML elements according to a secret message. This method has a high imperceptibility; it leaves almost no trail because of using the communication protocol as a cover medium, and since it keeps the structure and size of the SOAP message intact. The method is empirically validated using a feasible scenario so as to indicate its utility and value

The family drug & alcohol court (FDAC) evaluation project

This report presents the findings from the evaluation of the first pilot Family Drug and Alcohol Court (FDAC) in Britain. FDAC is a new approach to care proceedings, in cases where parental substance misuse is a key element in the local authority decision to bring proceedings. It is being piloted at the Inner London Family Proceedings Court in Wells Street. Initially the pilot was to run for three years, to the end of December 2010, but is now to continue until March 2012. The work is co-funded by the Department for Education (formerly the Department for Children, Schools and Families), the Ministry of Justice, the Home Office, the Department of Health and the three pilot authorities (Camden, Islington and Westminster). The evaluation was conducted by a research team at Brunel University, with funding from the Nuffield Foundation and the Home Office. FDAC is a specialist court for a problem that is anything but special. Its potential to help break the inter-generational cycle of harm associated with parental substance misuse goes straight to the heart of public policy and professional practice. Parental substance misuse is a formidable social problem and a key factor in around a third of long-term cases in children’s services in some areas. It is a major risk factor for child maltreatment, family separation and offending in adults, and for poor educational performance and substance misuse by children and young people. The parents’ many difficulties create serious problems for their children and place major demands on health, welfare and criminal justice services. For these reasons, parental substance misuse is a cross-cutting government agenda. FDAC is distinctive because it is a court-based family intervention which aims to improve children’s outcomes by addressing the entrenched difficulties of their parents. It has been adapted to English law and practice from a model of family treatment drug courts that is used widely in the USA and is showing promising results with a higher number of cases where parents and children were able to remain together safely, and with swifter alternative placement decisions for children if parents were unable to address their substance misuse successfully. The catalysts for the FDAC pilot were the encouraging evidence from the USA and concerns about the response to parental substance misuse through ordinary care proceedings in England: poor coordination of adult and children’s services; late interventions to protect children; delays in reaching decisions in court; and soaring costs of proceedings, linked to the cost of expert evidence.The work is co-funded by the Department for Education (formerly the Department for Children, Schools and Families), the Ministry of Justice, the Home Office, the Department of Health and the three pilot authorities (Camden, Islington and Westminster).1 The evaluation was conducted by a research team at Brunel University, with funding from the Nuffield Foundation and the Home Office

Systematic Overview of Hepatitis C Infection in the Middle East and North Africa

AIM: To assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps. METHODS: We conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size \u3e 100. RESULTS: We included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men. CONCLUSION: A substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men

Risk Factors for Microvascular Complications of Diabetes in a High-Risk Middle East Population

Aims: Much of the diabetes burden is caused by its complications. This cross-sectional study aimed to determine the prevalence and risk factors for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) in a high-risk population. Methods: We collected information via a structured questionnaire and directly from the patient\u27s record on 1034 adult type 2 diabetic patients who were attending outpatient clinics in Qatar. Results: The mean age of the patients was 55 +/- 10 years, and the mean duration of diabetes was 12.4 +/- 8.9 years. Forty-five percent had one or more microvascular complications. Shared risk factors for multiplicity and for individual complications included family history, severity and duration of diabetes, and hypertension, but some risk factors were specific for individual microvascular complications. Early age at onset of diabetes was strongly associated with multiplicity of complications (P = 0.0003). Conclusions: About half the diabetics in this high-risk population had one or more microvascular complications. Several well-established risk factors were associated with multiplicity and individual microvascular complications, but each separate microvascular complication was linked to a somewhat different constellation of risk factors

Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study

Background: Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. Methods: Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. Results: Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% <21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). Conclusion: This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal

Scaling up research on family justice using large-scale administrative data: an invitation to the socio-legal community

This article outlines the value of administrative data for family justice research. Although socio-legal scholars have extended their research beyond purely theoretical or doctrinal analyses, studies using large-scale digital datasets remain few in number. As new opportunities arise to link large-scale administrative datasets across health, education, welfare and justice, it is vital that the community of family justice researchers and analysts are supported to deliver research based on entire service or family court populations. In this context, this article provides a definition of administrative data, before outlining the potential of single, linked or blended administrative data sets for family justice research. The remaining sections of the article speak to questions that are pertinent to this particular academic community, including the distinctive contribution of the socio-legal scholar to interdisciplinary teams and the place of data providers in collaborative research. Drawing on the sociological concept of ‘publics’, the final section considers the multiple interest groups whose social licence must be secured, when personal records are used to understand the relationship between law and family life

Knowledge and Perceptions about Zika Virus in a Middle East Country

BACKGROUND: Zika virus, an emerging serious infectious disease, is a threat to persons living or travelling to regions where it is currently endemic, and also to contacts of infected individuals. The aim of this study was to assess knowledge about this new public health threat to persons residing in a Middle Eastern country. METHODS: We conducted a survey at several international universities in Qatar to assess knowledge and awareness about this disease. An adapted version of the survey was also conducted using online channels from Qatar. RESULTS: The median age of the 446 participants, was 25 years, 280 (63%) were females, and 32% were from Gulf Cooperation Council (GCC) or other Middle East countries. Based upon their knowledge about availability of a vaccine, role of mosquitoes and other modes of transmission, and disease complications, we classified respondent\u27s knowledge as poor (66%), basic (27%) or broad (7%). Forty-five (16%) persons with poor knowledge considered themselves to be well-informed. CONCLUSIONS: This report from a sample of persons associated with Middle East educational complex, reveals inadequate knowledge about Zika virus, a serious emerging infectious disease. Although few cases have been reported from the region, future cases are possible, since this area is a transit hub connecting currently infected regions to North America, Europe and Asia. As a preventive measure, an educational program about Zika virus would be valuable, especially for individuals or family members travelling to afflicted regions

Giving up the ghost: Findings on fathers and social work from a study of pre-birth child protection

This article reports findings from an ethnographic study of pre-birth child protection, conducted in an urban Scottish setting. The study was designed to explore the interactions between practitioners and families in the context of child protection involvement during a pregnancy. This research aimed to understand the activities that constituted pre-birth child protection assessment, and the meaning attached to those activities by social workers and expectant parents. Very different perspectives on fathers and fatherhood emerged through the study. Fathers shared their feelings of familial tenderness in the context of research interviews. Yet social workers often focused on the risks that the fathers posed. This focus on risk led professionals to ignore or exclude fathers in significant ways. Fathers were denied opportunities to take an active role in their families and care planning for their infants, whilst mothers were over-responsibilised. Children meanwhile were potentially denied the relationship, care and identity benefits of involved fatherhood. This article shows how pre-birth child protection processes and practice can function so as to limit the contribution of expectant fathers. The way that fathers and fathering are understood continues to be a wider problem for social work, requiring development through research and practice. This study was not immune to the challenge of involving men in social work research in meaningful ways. Nevertheless, the findings highlight how participation in social work research can create a forum for fathers to share their concerns, and the importance of their perspective for practice