74 research outputs found

    Child-centric Information and Communication Technology (ICT) and the fragmentation of child welfare practice in England

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    The ways in which government supports families and protects children are always a fine balance. In recent years, we suggest that this balance can be characterised increasingly as ‘child-centric’, less concerned with families and more focused on individual children and their needs. This article charts the changes in families and government responses over the last 40 years, and the way this is reflected in organisational and administrative arrangements. It notes in particular the impact on everyday practice of the introduction of information and communication technologies. Findings are reported from recent research which shows the struggles faced by practitioners who try to manage systems which separate children from their familial, social and relational contexts. As a consequence, we suggest, the work has become increasingly fragmented and less mindful of children's life within families. While the data and analysis draw on research carried out in England, we suggest that similar changes may be going on in other Western liberal democracies

    Parents’ experiences of health visiting for children with Down syndrome

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    © MA Healthcare Limited.Children with Down syndrome have an increased likelihoodof experiencing serious health conditions. Health visitors canhave an important role in monitoring and promoting healthand development for young children with Down syndrome.This study aimed to explore parents’ experiences of healthvisiting services for children with Down syndrome. Twentyfour parents of children with Down syndrome aged 0–5 yearscompleted a brief questionnaire about the number and natureof visits from health visitors in the previous 12 months andtheir support needs. Some parents commented that otherprofessionals met the needs of their child, whereas others saidthat they would like more advice and support from healthvisitors. A further exploration of broader health serviceprovision, including health visiting, for young children withDown syndrome is needed.Peer reviewedFinal Accepted Versio

    Holocene stable isotope record of insolation and rapid climate change in a stalagmite from the Zagros of Iran

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    We explore Holocene climatic changes recorded by geochemical proxies in a single, well-dated, stalagmite from the northern Zagros Mountains of Iran, a region where stalagmite records have so far only provided short glimpses of Holocene climatic changes. Stalagmite KT-3 from Katalekhor Cave began growing ~9.5 ka under wet early Holocene conditions coincident with the timing of Sapropel 1. At this time d18O values were at or below 9.0‰, stalagmite growth diameter was at its maximum, 234U/238U0 activity values were low and trace element contents indicate flushing of the epikarst. Progressive reduction in winter precipitation amount after 7.0 ka, is recorded by increasing d18O and 234U/238U0 activity values and reduction in trace element contents and growth diameter until ~2.0 ka. These trends follow the reduction in summer insolation and agree with model-simulated changes in total rainfall and rainwater isotopes. Sub-centennial-scale variability is not a feature of the d18O or trace element records; this suggests a stable winter recharge regime, a feature that might militate against KT-3 d18O recording changes in the seasonality of rainfall. KT-3 d13C compositions are enriched relative to lower altitude stalagmites in the Levant, implying low soil CO2 contribution (thin montane soils). However, a broadly decreasing millennial-scale trend in d13C suggests that soil carbon contributions increased with time despite the progressive reduction in winter precipitation amount. The d13C changes probably reflect decreasing summer temperatures and less extreme wintertime coldness, driven by reducing summer and increasing winter-insolation respectively. These combined effects decreased effective evaporation and improved soil-moisture availability favouring vegetation development during the growth season. The d13C values also show ~1.5‰ centennial-scale variability with higher d13C values between 9.0 and 8.7 ka, 8.3 - 7.7 ka, 6.5 - 5.5 ka, 5.4 - 4.5 ka and ~4.3- 2.0 ka: three of these correspond with Rapid Climate Change (RCC) events based on non-seasalt potassium (Kþ) in Greenland ice cores. Higher d13C values indicate poor soil development caused by aridity. The centennial-scale d13C anomaly (8.3-7.7 ka) is in part overprinted by the ~160 year-long, 8.2 ka cold/dry event, but culmination ~7.7 ka corresponds with other records suggesting an intensified Siberian High Pressure system affecting regional climate. The centennial-scale d13C anomaly between 4.3 and 2.0 ka overlaps the 2.65 to 2.50 ka ‘Assyrian megadrought’ evident in stalagmite stable isotope records in northern Iraq. The KT-3 record is key in better understanding Holocene climate change in the central Zagros region, representative of montane ‘fertile crescent’ environments

    Brain-based discourses and early intervention: a critical debate for health visiting

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    Neuroscientific discourses about early brain development and its plasticity have placed considerable importance upon parenting, emotional nurturing and attachment during the first 1001 ‘Critical Days’. This has informed a policy shift towards early intervention in the early years, and is shaping public health practice in this field particularly health visiting. This paper reviews these developments and outlines a critical debate that has been taking place amongst commentators concerned with how these brain based discourses are being applied in policy. Concerns include the policy readiness of the science, the focus upon parenting quality rather than contextual issues such as poverty, and that these developments are creating a new form of governance of families. In contrast these concerns have not been debated within health visiting raising questions about the profession’s engagement with evidence and policy

    Priorities and strategies for improving disabled women's access to maternity services when they are affected by domestic abuse:a multi-method study using concept maps

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    BACKGROUND: Domestic abuse is a significant public health issue. It occurs more frequently among disabled women than those without a disability and evidence suggests that a great deal of domestic abuse begins or worsens during pregnancy. All women and their infants are entitled to equal access to high quality maternity care. However, research has shown that disabled women who experience domestic abuse face numerous barriers to accessing care. The aim of the study was to identify the priority areas for improving access to maternity services for this group of women; develop strategies for improved access and utilisation; and explore the feasibility of implementing the identified strategies. METHODS: This multi-method study was the third and final part of a larger study conducted in the UK between 2012 and 2014. The study used a modified concept mapping approach and was theoretically underpinned by Andersen’s model of healthcare use. Seven focus group interviews were conducted with a range of maternity care professionals (n = 45), incorporating quantitative and qualitative components. Participants ranked perceived barriers to women’s access and utilisation of maternity services in order of priority using a 5-point Likert scale. Quantitative data exploration used descriptive and non-parametric analyses. In the qualitative component of each focus group, participants discussed the barriers and identified potential improvement strategies (and feasibility of implementing these). Qualitative data were analysed inductively using a framework analysis approach. RESULTS: The three most highly ranked barriers to women’s access and utilisation of maternity services identified in the quantitative component were: 1) staff being unaware and not asking about domestic abuse and disability; 2) the impact of domestic abuse on women; 3) women’s fear of disclosure. The top two priority strategies were: providing information about domestic abuse to all women and promoting non-judgemental staff attitude. These were also considered very feasible. The qualitative analysis identified a range of psychosocial and environmental barriers experienced by this group of women in accessing maternity care. Congruent with the quantitative results, the main themes were lack of awareness and fear of disclosure. Key strategies were identified as demystifying disclosure and creating physical spaces to facilitate disclosure. CONCLUSIONS: The study supports findings of previous research regarding the barriers that women face in accessing and utilising maternity services, particularly regarding the issue of disclosure. But the study provides new evidence on the perceived importance and feasibility of strategies to address such barriers. This is an important step in ensuring practice-based acceptability and ease with which improvement strategies might be implemented in maternity care settings

    Coupled stalagmite – Alluvial fan response to the 8.2 ka event and early Holocene palaeoclimate change in Greece

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    We explore the expression of early Holocene climatic change in the terrestrial Mediterranean of southern Greece. A regional palaeoclimate record from stable isotope and trace element geochemical proxies in an early Holocene (~12.4 ka to 6.7 ka) stalagmite is compared to the timing of palaeosol (entisol) development on an early Holocene alluvial fan located <100 km from the stalagmite site. Radiocarbon dated entisol development records fan abandonment surfaces, which can be coupled to the stalagmite climate signal. Variations in δ13C best record the main elements of palaeoclimatic change, more negative values indicating soil carbon input to karst groundwater under wetter conditions. The wettest conditions begin around 10.3 ka, coincident with the start of sapropel 1 deposition in the eastern Mediterranean. The widely documented northern hemisphere ‘8.2 ka event’ of cooler and drier conditions has a muted δ18O climatic signal in common with other stalagmite climate records from the wider Mediterranean. However, less negative δ13C values do record a period of episodic dryness between ~8.8 and ending at 8.2 ka. Wetter conditions re-established after 8.1 ka to the end of the record. The oldest alluvial fan entisols were developing by ~9.5 ka, and a prominent rubified entisol developed ~8.3 to 8.4 ka, indicating pedogenesis within dating error of the 8.2 ka event. The speleothem record of episodic dryness between ~8.8 and 8.2 ka, combined with other regional proxies, is consistent with the notion that precipitation patterns in Greece may have changed from predominantly winter frontal to summer convective during this period. Palaeosol formation on the alluvial fan may have been an allocyclic response to this change. It is plausible that fan-channel incision, driven by temporary development of a ‘flashier’ summer rainfall regime, isolated large areas of the fan surface allowing onset of prolonged pedogenesis there

    The Changing Politics and Practice of Child Protection and Safeguarding in England

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    Rethinking alcohol interventions in health care: a thematic meeting of the International Network on Brief Interventions for Alcohol & Other Drugs (INEBRIA)

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    Regulation and resistance An analysis of the practices of health visitors and women experiencing domestic violence

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