ThoughtCloud: Exploring the Role of Feedback Technologies in Care Organisations

ThoughtCloud is a lightweight, situated, digital feedback system designed to allow voluntary and community sector care organisations to gather feedback and opinions from those who use their services. In this paper we describe the design and development of ThoughtCloud and its evaluation through a series of deployments with two organisations. Using the system, organisations were able to pose questions about the activities that they provide and gather data in the form of ratings, video or audio messages. We conducted observations of ThoughtCloud in use, analysed feedback received, and conducted interviews with those who 'commissioned' feedback around the value of comments received about their organisation. Our findings highlight how simple, easily deployable digital systems can support new feedback processes within care organisations and provide opportunities for understanding the personal journeys and experiences of vulnerable individuals who use these care services

Exclusion from school in Scotland and across the UK:Contrasts and questions

This article draws on findings from the first cross‐national study of school exclusion in the four jurisdictions of the UK. It casts new light on the crucial aspects of children's education that lead to school exclusion. It investigates the reasons for the UK disparities, as well as the policy and practice in place. The focus of this article is on a detailed analysis of the policy context in Scotland, where official permanent exclusion reduced to an all‐time low of just five cases in 2014/15. This is much lower than in Northern Ireland and Wales and in stark contrast to England, where exclusions have increased substantially since 2012. Our analysis seeks to understand Scotland's success in reducing exclusion and offers new insight into the ways in which national policies and local factors more generally shape schools and their practices and the consequent impacts for children and young people more broadly in the UK

Keeping the focus on children: the challenges of safeguarding children affected by domestic abuse

Safeguarding children affected by domestic abuse is a key responsibility for all professionals working with children and families, but can be difficult to achieve in practice. Despite a policy emphasis on early intervention and child-centred work, limited attention has been paid to how professionals in universal and additional support services address this important area of work. This paper reports findings from qualitative research undertaken in one local authority area in the north of England during 2011 which examines the challenges facing professionals in safeguarding children affected by domestic abuse. Six mixed professional focus groups were held, attended by a total of 23 participants. Discussion focused upon participants’ awareness of domestic abuse, how they assessed and met children and young peoples’ needs, and their views about service provision and safeguarding processes. Data were transcribed and thematic analysis undertaken. The themes presented in this paper – embodied recognition, someone else's job, service gaps, skills deficits, and focusing upon children and young people – illustrate the scope and limitations of professionals’ work with children and young people affected by domestic abuse. Areas for practice improvement are discusse

Independence and effectiveness: Messages from the role of Independent Reviewing Officers in England

This paper draws on research into the role of Independent Reviewing Officers (IROs) in England, exploring the dimensions and challenges of their ‘independence’. IROs are specialist social workers whose function is to review the cases of children in public care and ensure that they have appropriate plans and that these plans are being implemented in a timely manner. IROs are ‘independent’ in the sense that they are not the social worker to whom a child’s case is allocated, and do not have line management responsibility for the case, however they are employed by the same local authority. There are detailed regulations and government guidelines on their role, and high expectations, but what does independence mean in this context? The paper draws on a mixed methods study conducted by the authors in 2012-14, which included a survey of 122 files of children in care from four local authorities; interviews with 54 social workers, 54 IROs, 15 parents, and 15 young people; six focus groups; and nationally-distributed questionnaires for IROs (65), social work managers (46) and children’s guardians (39). The study found five dimensions of independence: professional, operational, perceived, institutional and effective. The IROs and social workers generally took more nuanced and pragmatic approaches to their inter-professional working than prescribed in the policy guidance or the pronouncements of politicians and judges, seeing this as more likely to be effective. IROs are not, and cannot be, the solution to all the problems that exist in services for children in care, and the other professionals involved should not be seen as necessarily any less capable or committed to the best interests of the children. Rather, the IRO is part of an interactive system of checks and balances which, together, may increase the likelihood that professional judgement will be exercised effectively on the child’s behalf

A question of quality: do children from disadvantaged backgrounds receive lower quality early childhood education and care?

This paper examines how the quality of early childhood education and care accessed by three and four year olds in England varies by children’s background. Focusing on the free entitlement to early education, the analysis combines information from three administrative datasets for 2010-11, the Early Years Census, the Schools Census and the Ofsted inspections dataset, to obtain two main indicators of quality: staff qualification levels and Ofsted ratings. These data are combined with child-level indicators of area deprivation (IDACI scores) as a proxy measure of children’s background. The paper finds that children from more disadvantaged areas have access to better qualified staff, largely because they are more likely than children from richer areas to attend maintained nursery classes staffed by teachers, and less likely to attend services in the private, voluntary and independent (PVI) sectors. However, within both maintained and PVI sectors, services catering for more disadvantaged children receive poorer quality ratings from Ofsted, with a higher concentration of children from disadvantaged areas itself appearing to reduce the likelihood of top Ofsted grades. This may be in part because Ofsted ratings reflect levels of child development, and therefore reward settings where children enter at a more advanced starting point, but it may also be that it is genuinely harder to deliver an outstanding service to a more disadvantaged intake. The result point to the need for funding to support better qualified staff in PVI settings in disadvantaged areas

Risk factors for adverse perinatal outcomes in imprisoned pregnant women: a systematic review

BACKGROUND: Imprisoned pregnant women constitute an important obstetric group about whom relatively little is known. This systematic review was conducted to identify the risk factors associated with adverse pregnancy outcome present in this group of women. METHODS: The review was conducted according to a prespecified protocol. Studies of any design were included if they described information on any of the pre-specified risk factors. We calculated the results as summary percentages or odds ratios where data was available on both cases and population controls. RESULTS: The search strategy identified 27 relevant papers of which 13 met the inclusion criteria, involving 1504 imprisoned pregnant women and 4571 population control women. Imprisoned women are more likely to be single, from an ethnic minority, and not to have completed high school. They are more likely to have a medical problem which could affect the pregnancy outcome and yet less likely to receive adequate antenatal care. They are also more likely to smoke, drink alcohol to excess and take illegal drugs. CONCLUSION: Imprisoned women are clearly a high risk obstetric group. These findings have important implications for the provision of care to this important group of women

Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study

<p>Abstract</p> <p>Background</p> <p>Higher risks of preterm birth and small for gestational age babies have been reported in teenagers. The aim of this study was to investigate the relationship between first and second teenage pregnancies and preterm birth, birthweight and small for gestational age (SGA).</p> <p>Methods</p> <p>All women aged 14 to 29 yrs who gave birth to live singletons in the North Western Region of England between January 1st 2004 and December 31st 2006 were identified. Women were classified in three groups; 14-17 yrs, 18-19 yrs and 20-29 yrs (reference group). The outcome measures were preterm birth, very preterm birth, birthweight, SGA (< 5^thpercentile), very SGA (VSGA< 3^rdpercentile). We compared these outcome measures in teenagers' first and second pregnancies with those of mothers aged 20 to 29 yrs.</p> <p>Results</p> <p>The risk of preterm birth was increased in first (OR = 1.21, [95% CI: 1.01-1.45]) and second (OR = 1.93, [95% CI: 1.38-2.69]) time mothers aged 14-17 yrs compared to the reference group. Birthweight was reduced in the first (mean difference = -24 g; [95% CI: -40, -7]) and second (mean difference = -80 g; [95% CI: -115, -46]) time mothers aged 14-17 yrs compared to the reference group. There was some evidence of a protective effect against VSGA in 14-17 yr old first time mothers (OR = 0.79, [95% CI: 0.63-0.99]).</p> <p>Conclusions</p> <p>Teenage mothers are at increased risk of preterm birth compared to adult mothers and this risk is further increased in second time teen pregnancies. This study highlights the importance of ensuring pregnant teenagers have appropriate antenatal care. A first pregnancy may be the first and only time a pregnant teenager interacts with health services and this opportunity for health education and the promotion of contraception should not be overlooked.</p

A hidden HIV epidemic among women in Vietnam

<p>Abstract</p> <p>Background</p> <p>The HIV epidemic in Vietnam is still concentrated among high risk populations, including IDU and FSW. The response of the government has focused on the recognized high risk populations, mainly young male drug users. This concentration on one high risk population may leave other populations under-protected or unprepared for the risk and the consequences of HIV infection. In particular, attention to women's risks of exposure and needs for care may not receive sufficient attention as long as the perception persists that the epidemic is predominantly among young males. Without more knowledge of the epidemic among women, policy makers and planners cannot ensure that programs will also serve women's needs.</p> <p>Methods</p> <p>More than 300 documents appearing in the period 1990 to 2005 were gathered and reviewed to build an understanding of HIV infection and related risk behaviors among women and of the changes over time that may suggest needed policy changes.</p> <p>Results</p> <p>It appears that the risk of HIV transmission among women in Vietnam has been underestimated; the reported data may represent as little as 16% of the real number. Although modeling predicted that there would be 98,500 cases of HIV-infected women in 2005, only 15,633 were accounted for in reports from the health system. That could mean that in 2005, up to 83,000 women infected with HIV have not been detected by the health care system, for a number of possible reasons. For both detection and prevention, these women can be divided into sub-groups with different risk characteristics. They can be infected by sharing needles and syringes with IDU partners, or by having unsafe sex with clients, husbands or lovers. However, most new infections among women can be traced to sexual relations with young male injecting drug users engaged in extramarital sex. Each of these groups may need different interventions to increase the detection rate and thus ensure that the women receive the care they need.</p> <p>Conclusion</p> <p>Women in Vietnam are increasingly at risk of HIV transmission but that risk is under-reported and under-recognized. The reasons are that women are not getting tested, are not aware of risks, do not protect themselves and are not being protected by men. Based on this information, policy-makers and planners can develop better prevention and care programs that not only address women's needs but also reduce further spread of the infection among the general population.</p