Interagency practice in children with non‐organic failure to thrive: is there a gap between health and social care?

Failure to thrive is a child protection issue that crosses the boundaries between many professional groups. It is a condition that places children at risk of negative developmental, social, physical and emotional consequences, but it has complex causal roots. Although there are known to be links between neglect, emotional abuse and failure to thrive, health and social care providers have differing responses and interventions with children who are failing to thrive. An examination of recent Scottish statistics supports the argument that there may be a gap between health and social care that some children may be falling through. Evidence from the literature regarding interagency roles and responsibilities is ambiguous, and the different, albeit overlapping, professional constructions of failure to thrive may result in a gap in care for some vulnerable children. It is only by beginning to understand the crucial links between different professions that we can contribute towards effective interagency child protection policy and practice. Copyright © 1999 John Wiley & Sons, Ltd.     

“Know What to Do If You Encounter a Flash Flood”: Mental Models Analysis for Improving Flash Flood Risk Communication and Public Decision Making

Understanding how people view flash flood risks can help improve risk communication, ultimately improving outcomes. This article analyzes data from 26 mental models interviews about flash floods with members of the public in Boulder, Colorado, to understand their perspectives on flash flood risks and mitigation. The analysis includes a comparison between public and professional perspectives by referencing a companion mental models study of Boulder‐area professionals. A mental models approach can help to diagnose what people already know about flash flood risks and responses, as well as any critical gaps in their knowledge that might be addressed through improved risk communication. A few public interviewees mentioned most of the key concepts discussed by professionals as important for flash flood warning decision making. However, most interviewees exhibited some incomplete understandings and misconceptions about aspects of flash flood development and exposure, effects, or mitigation that may lead to ineffective warning decisions when a flash flood threatens. These include important misunderstandings about the rapid evolution of flash floods, the speed of water in flash floods, the locations and times that pose the greatest flash flood risk in Boulder, the value of situational awareness and environmental cues, and the most appropriate responses when a flash flood threatens. The findings point to recommendations for ways to improve risk communication, over the long term and when an event threatens, to help people quickly recognize and understand threats, obtain needed information, and make informed decisions in complex, rapidly evolving extreme weather events such as flash floods.     

On the trimmed mean and minimax-variance L-estimation in Kolmogorov neighbourhoods

We consider the properties of the trimmed mean, as regards minimax-variance L-estimation of a location parameter in a Kolmogorov neighbourhood K() of the normal distribution: We first review some results on the search for an L-minimax estimator in this neighbourhood, i.e. a linear combination of order statistics whose maximum variance in K_t() is a minimum in the class of L-estimators. The natural candidate – the L-estimate which is efficient for that member of K_t,() with minimum Fisher information – is known not to be a saddlepoint solution to the minimax problem. We show here that it is not a solution at all. We do this by showing that a smaller maximum variance is attained by an appropriately trimmed mean. We argue that this trimmed mean, as well as being computationally simple – much simpler than the efficient L-estimate referred to above, and simpler than the minimax M- and R-estimators – is at least “nearly” minimax.     

The paradox of parental participation and legal representation in ‘edge of care’ meetings

This paper assesses the nature of parental participation and legal representation in pre‐proceedings meetings in England and Wales. These are called when a local authority is considering care proceedings on a child. The parent(s) are invited to a meeting to discuss the concerns, and are entitled to attend with a lawyer. The paper draws on findings from a study of the process which included a file survey of over 200 cases, observations of 36 meetings and interviews with more than 90 key informants, including parents. The aim of the process is (usually) to reach an agreement to prevent the case going to court, but the families are usually well known to children's services, and have been through many meetings and agreements before. What then are the possibilities for parental participation and legal representation in the meetings? The study shows that they may help bring a greater degree of clarity to the local authority's proposals, but are not expected to challenge them. Paradoxically, they serve to reinforce the authority's position. The meetings can help divert cases, but it is important to be realistic about the chances of change in these often long‐standing ‘edge of care’ cases.     

Document Delivery as a Supplement or Replacement for Serial Subscriptions

Abstract

Increasing serials costs and shrinking budgets present challenges for academic libraries to continue providing sufficient access to scholarly articles. Rapid document delivery services can serve as an effective means to fill the gap caused by serials cancellations. This column examines several of the existing document delivery service providers and addresses issues involved in their implementation.     

Pathways to adoption for minority ethnic children in England – reasons for entry to care

There have been concerns about the over‐representation of minority ethnic children in care in England for many years. This paper reports on the reasons why a sample of 120 minority ethnic children with adoption recommendations entered care. The study found no evidence that children were being removed unfairly or in a discriminatory way. However, there were significant differences by ethnic group in the characteristics of children and their mothers, in reasons for entry and in age at referral. These differences needed to be better understood, and interventions targeted at improving the circumstances and stresses within families that lead to abuse, neglect or relinquishment are also needed. Simply focusing on reducing the number of minority ethnic children in care will not in itself produce better outcomes for children.     

Health and community services for trafficked women: an exploratory study of policy and practice

The trafficking of women has attracted considerable international and national policy attention, particularly since the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (2000), of which the Australian Government has been a signatory since 2005. The provision of health and community services for trafficked women is a central feature of this Protocol, but in Australia service provision is made difficult by how trafficked women are understood and treated in policy and legal terms. This study aimed to explore the provision of health and community services for trafficked women in the Greater Sydney region through a series of interviews with government and non‐government organisations. The findings reveal that services have been inaccessible as a result of sparse, uncoordinated, and poorly funded provision. The major obstacle to adequate and appropriate service provision has been a national policy approach focusing on ‘border protection’ and criminalisation rather than on trafficked women and their human rights. We conclude that further policy development needs to focus on the practical implications of how such rights can be translated into the delivery of health and community services that trafficked women can access and be supported by more effectively.     

Tracing Stigma in Long-Term Care Insurance in Israel: Stakeholders’ Views of Policy Implementation

A rapidly expanding number of baby boomers provide care to aging parents. This study examines associations between caregiver status and outcomes related to awareness and anticipation of future long-term care (LTC) needs using 2007 Connecticut Long-Term Care Needs Assessment survey data. Baby boomers who were adult child caregivers (n = 353) versus baby boomers who were not (n = 1242) were more likely to anticipate some future LTC needs and to have considered certain financing strategies. Although baby boomer adult child caregivers more readily anticipate some future LTC needs, they are not taking specific actions. It is important to address the need for public education directed toward those who are currently (or have recently completed) caring for aging parents.