Social work associate practice programme: a Children's Improvement Board reference document

The Children’s Improvement Board (CIB) have been working to improve performance in children’s services through development of the Social Work Associate Practice Programme (SWAPP), a programme to support frontline managers in practice improvement in safeguarding and children’s care. This 'Reference' document has two main audiences The first of these audiences are frontline managers who will be SWAPPed to provide support between local authorities in order to learn and disseminate best practice in the management of child protection and care services. The second of the two audiences are the more senior managers and other staff who will enable or manage these programmes. Using a systems approach, the SWAPP Reference Document is designed to help local areas improve that process at the frontline. The Reference Document is intended to assist with local thinking and also provide access to further practical resources that can also help to further develop that thinking. Whilst not located in a single model a thread that runs throughout, is the need to recognise complexity and think systemically about the issues local areas face less

Sustainable risk management of emerging contaminants in municipal wastewaters

This article is available open access through the publisher’s website at the link below. Copyright @ 2009 The Royal Society.The presence of emerging contaminants in municipal wastewaters, particularly endocrine-disrupting compounds such as oestrogenic substances, has been the focus of much public concern and scientific attention in recent years. Due to the scientific uncertainty still surrounding their effects, the Precautionary Principle could be invoked for the interim management of potential risks. Therefore, precautionary prevention risk-management measures could be employed to reduce human exposure to the compounds of concern. Steroid oestrogens are generally recognized as the most significant oestrogenically active substances in domestic sewage effluent. As a result, the UK Environment Agency has championed a ‘Demonstration Programme’ to investigate the potential for removal of steroid oestrogens and alkylphenol ethoxylates during sewage treatment. Ecological and human health risks are interdependent, and ecological injuries may result in increased human exposures to contaminants or other stressors. In this context of limiting exposure to potential contaminants, examining the relative contribution of various compounds and pathways should be taken into account when identifying effective risk-management measures. In addition, the explicit use of ecological objectives within the scope of the implementation of the EU Water Framework Directive poses new challenges and necessitates the development of ecosystem-based decision tools. This paper addresses some of these issues and proposes a species sensitivity distribution approach to support the decision-making process related to the need and implications of sewage treatment work upgrade as risk-management measures to the presence of oestrogenic compounds in sewage effluent

Geosynthetic landfill cap stability: comparison of limit equilibrium, computational limit analysis and finite-element analyses

The stability of the veneer cover soil (landfill cap) is an important issue in landfill design. Incorrect design of the landfill cap can lead to failure, which may result in the veneer cover soil sliding on an underlying geosynthetic layer, or in tension failure of the geosynthetic itself. Previous limit equilibrium (LE) analyses of veneer cover layer stability presented in the literature have generally considered whole-slope failure. In this paper, modified LE equations are proposed that (a) encompass more critical cases of localised slope failure for specific cases, and (b) are calibrated against two other methods: 2-D computational limit analysis (CLA) using LimitState:GEO and 2-D elasto-plastic finite-element (FE) analysis using PLAXIS. The scenarios examined encompass a cover of uniform thickness, a buttressed cover, a cover of tapered thickness, the effects of seepage forces, and the effects of construction equipment. It is shown that the LE method provides a reasonable estimate of veneer cover layer stability for most cases examined, although it is in general non-conservative, relative to the CLA and FE analyses. Local failure was found to be critical in the case of the construction equipment, buttress and horizontal seepage scenarios. In the latter case the LE equations previously presented in the literature significantly overestimate stability compared with the LE, CLA and FE analyses considered in this paper

The effectiveness of metal on metal hip resurfacing: a systematic review of the available evidence published before 2002

BACKGROUND: Conventional total hip replacement (THR) may be felt to carry too high a risk of failure over a patient's lifetime, especially in young people. There is increasing interest in metal on metal hip resurfacing arthroplasty (MoM) as this offers a bone-conserving option for treating those patients who are not considered eligible for THR. We aim to evaluate the effectiveness of MoM for treatment of hip disease, and compare it with alternative treatments for hip disease offered within the UK. METHODS: A systematic review was carried out to identify the relevant literature on MoM published before 2002. As watchful waiting and total hip replacement are alternative methods commonly used to alleviate the symptoms of degenerative joint disease of the hip, we compared MoM with these. RESULTS: The data on the effectiveness of MoM are scarce, as it is a relatively new technique and at present only short-term results are available. CONCLUSION: It is not possible to make any firm conclusions about the effectiveness of MoM based on these early results. While the short-term results are promising, it is unclear if such results would be replicated in more rigorous studies, and what the long-term performance might be. Further research is needed which ideally should involve long-term randomised comparisons of MoM with alternative approaches to the clinical management of hip disease

Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) Distinguish Between Cognitive Domains in Healthy Older Adults?

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a semiautomated computer interface for assessing cognitive function. We examined whether CANTAB tests measured specific cognitive functions, using established neuropsychological tests as a reference point. A sample of 500 healthy older (M = 60.28 years, SD = 6.75) participants in the Tasmanian Healthy Brain Project completed battery of CANTAB subtests and standard paper-based neuropsychological tests. Confirmatory factor analysis identified four factors: processing speed, verbal ability, episodic memory, and working memory. However, CANTAB tests did not consistently load onto the cognitive domain factors derived from traditional measures of the same function. These results indicate that five of the six CANTAB subtests examined did not load onto single cognitive functions. These CANTAB tests may lack the sensitivity to measure discrete cognitive functions in healthy populations or may measure other cognitive domains not included in the traditional neuropsychological battery

Diagnosing uncertainty, producing neonatal abstinence syndrome

The use of alcohol and other drugs during pregnancy is understood to be an important public health problem. One way in which this problem is expressed and responded to is via the identification and treatment of neonatal abstinence syndrome (NAS). In this article, we demonstrate how the processes of anticipating, identifying and responding to NAS are characterised by significant uncertainty among parents and health and social care practitioners. We draw on interviews with 16 parents who had recently had a baby at risk of NAS, and multidisciplinary focus groups with 27 health and social care professionals, held in Scotland, UK. NAS, and drug use in pregnancy, is a fraught and complex arena. Parents in the UK who use opioids risk losing custody of children, and must navigate a high degree of surveillance, governance and marginalisation. We suggest that considering NAS as a social diagnosis, further informed by Mol's political ontology of ‘multiple’ bodies/diseases, may help to produce clinical and social responses to uncertainty which avoid, rather than promote, further marginalisation of parents who use drugs. One such response is to develop a culture of relationship‐based care which empowers both service providers and service users to challenge existing practice and decision‐making.Output Status: Forthcoming/Available Onlin

REHABILITATION DESIGN METHODOLOGY FOR HAUL ROADS ASSOCIATED WITH A WIND FARM DEVELOPMENT IN SOUTHWESTERN ONTARIO

ABSTRACT This paper describes the impact of very heavy vehicles carrying wind turbine components on haul roads and the rehabilitation design methodology that was used for the haul roads located in the Town of Lakeshore in Southwestern Ontario. A wind farm consisting of 72 turbines was constructed in the Town. For the construction of the wind farm, number of turbine components were hauled on a network of rural low-volume roads. The original design and construction of these low-volume roads did not take in to consideration the large wheel loads that would be applied by the wind farm haul traffic. Therefore, the Town of Lakeshore commissioned a study to accomplish the following: • Establish baseline conditions of the roads along the proposed haul route; • Evaluate the pavement condition of the roads after the passage of the haul traffic; • Comparison of the baseline and post-haul pavement condition; and • Rehabilitation recommendations for the roads along the haul route. Pavement condition is typically classified based on four criteria: visual distresses; structural capacity; safety (typically skid resistance); and roughness. For the purpose of this investigation only the first two criteria were used to characterize the condition of the pavement. A pavement condition survey was done for the roads along the haul route both before and after the haul traffic. The pavement structural condition was evaluated by carrying out Falling Weight Deflectometer (FWD) load/deflection testing. The FWD testing was carried out to determine the baseline structural capacity of the roads and subsequently to quantitatively determine the potential loss in structural capacity due to the haul traffic. FWD data was analyzed to determine the normalized deflection and pavement surface modulus. The normalized deflections were then utilized to determine the remaining life of the pavement. Rehabilitation recommendations were provided for each section of roads along the haul route by combining visual distress observations and comparison of the baseline and post-haul pavement structural condition. The study found that although some of the haul roads experienced significant deterioration after the haul period, still others were found to have adequate bearing capacity and no significant development of visual distresses after the haul period had been completed

Insights into social disparities in smoking prevalence using Mosaic, a novel measure of socioeconomic status: an analysis using a large primary care dataset

<p>Abstract</p> <p>Background</p> <p>There are well-established socio-economic differences in the prevalence of smoking in the UK, but conventional socio-economic measures may not capture the range and degree of these associations. We have used a commercial geodemographic profiling system, Mosaic, to explore associations with smoking prevalence in a large primary care dataset and to establish whether this tool provides new insights into socio-economic determinants of smoking.</p> <p>Methods</p> <p>We analysed anonymised data on over 2 million patients from The Health Improvement Network (THIN) database, linked via patients' postcodes to Mosaic classifications (11 groups and 61 types) and quintiles of Townsend Index of Multiple Deprivation. Patients' current smoking status was identified using Read Codes, and logistic regression was used to explore the associations between the available measures of socioeconomic status and smoking prevalence.</p> <p>Results</p> <p>As anticipated, smoking prevalence increased with increasing deprivation according to the Townsend Index (age and sex adjusted OR for highest vs lowest quintile 2.96, 95% CI 2.92-2.99). There were more marked differences in prevalence across Mosaic groups (OR for group G vs group A 4.41, 95% CI 4.33-4.49). Across the 61 Mosaic types, smoking prevalence varied from 8.6% to 42.7%. Mosaic types with high smoking prevalence were characterised by relative deprivation, but also more specifically by single-parent households living in public rented accommodation in areas with little community support, having no access to a car, few qualifications and high TV viewing behaviour.</p> <p>Conclusion</p> <p>Conventional socio-economic measures may underplay social disparities in smoking prevalence. Newer classification systems, such as Mosaic, encompass a wider range of demographic, lifestyle and behaviour data, and are valuable in identifying characteristics of groups of heavy smokers which might be used to tailor cessation interventions.</p