Friday, 20 April 2012

rickets death hospital inquiry


Baby's parents demand rickets death hospital inquiry

Rohan Wray and Channa Al-Alas said they felt like one doctor was accusing them of harming their child

A young couple acquitted of murdering their four-month-old son have called for an inquiry into two London hospitals responsible for his care.
Rohan Wray, 22, and Chana Al-Alas, 19, of London, were accused of abusing baby Jayden but his fractures were later found to have been caused by rickets.
They told the BBC that the Great Ormond Street and University College hospitals should have diagnosed the disease.
The hospitals have defended their care of Jayden before his death in 2009.
A University College Hospital spokesman said its clinicians "acted with Jayden's interests at heart".
"We regret that we were unable to reverse his deteriorating condition despite our intensive efforts in the short time he stayed with us. We would like to offer our sincere condolences to Jayden's parents," he said.

Analysis

It is difficult to hear of a more astonishing ordeal than that endured by the parents of baby Jayden.
Accused of murdering their first child who died of natural causes, the couple had to suffer the shock of seeing their second baby taken away in the delivery room and taken into care.
They were acquitted of murder at the Old Bailey last December but have not been able to speak until now due to their family court battle to have their baby daughter Jayda returned to them.
That fight ended successfully on Thursday. For almost three years, they were treated as murder suspects not only by police and medical experts but also strangers in the street who recognised them from newspaper reports.
Both parents want their story told and an inquiry held to help other innocent parents in similar circumstances.
Solicitors and other medical experts say there are many other parents also accused of abuse and murder of children where rickets is later found to be the cause.
Great Ormond Street said the rickets abnormalities had been less obvious to hospital radiologists than at the later autopsy and that it regretted the family's distressing time.
Criminal charges against Jayden's parents were dropped in December 2011, after witnesses were unable to agree on the cause of the boy's death. But civil action was then taken by the local authority, Islington, which said Jayden had died from trauma inflicted on him by his parents.
'Horrible two years' On Thursday, family court judge Mrs Justice Theis cleared Jayden's parents of responsibility for the death of their son and criticised the two hospitals for what she described as sub-optimal care.
Jayden had a fractured skull and died from brain damage and swelling. He had been suffering from severe rickets, a disease caused by vitamin-D deficiency that causes bones to become soft.
In their first broadcast interview, given to BBC Radio 4's Today programme, Jayden's mother and father voiced their anger at Great Ormond Street and University College hospitals.
They described being asked at University College Hospital (UCH) if they knew how Jayden's injuries had occurred.
"I said apart from him rolling over in his cot and hitting his head on the side of the bars I can't think of any other explanation because we haven't dropped him, nothing's dropped on him," Mr Wray said. "The look from them was that simply they didn't believe my explanation."
Baby Jayden Four-month-old baby Jayden died three years ago
The couple said they believed that Jayden would still be alive had his condition been correctly diagnosed at UCH and that they blamed both hospitals for his death.
Ms Al-Alas said they were prevented from seeing Jayden after he was transferred to Great Ormond Street and later learned the hospital had spent four hours getting his injuries scanned.
"He wasn't being treated then. They didn't know his brain readings - they wasn't checking that - they was just concentrating on getting the right pictures and he could've been treated then as well." Lessons needed to be learned, she said.
Mr Wray said it had been a "horrible, horrible two years".
"I really feel that they didn't really know what they were doing and they just pre-judged us way too early," he said. "You should actually be treated as innocent until proven guilty and not guilty until proven innocent."
'Nightmare went on' In a statement, a Great Ormond Street Hospital spokesman said the decision to prosecute Jayden's parents was taken by the Crown Prosecution Service (CPS) after rickets had been diagnosed following Jayden's death.
"It is therefore fair to say that GOSH's radiological opinion was not the determining factor in that decision. Nor would a diagnosis of rickets at GOSH have altered the clinical outcome," he said.
"It is not for the trust to decide legal issues of criminal responsibility. We never took any position on whether any specific person caused these injuries."
A CPS spokesman said: "In bringing this prosecution we considered all of the evidence in detail and our policy on non-accidental head injuries, and were satisfied that there was a realistic prospect of conviction. There was no criticism of the CPS by the judge for bringing this case."
In her High Court ruling, Mrs Justice Theis said she could not be satisfied "on the balance of probabilities" that any of the fractures or the "traumatised fissure" were "as a result of inflicted deliberate harm caused to Jayden by either of these parents".
Mrs Justice Theis concluded that more research was needed on the impact of vitamin D deficiency and rickets on babies aged under six months.
The couple's daughter, who has been in the care of Islington since her birth in October 2010, has now been returned to them.

Friday, 30 March 2012


Respect Party candidate George Galloway polled more than 18,000 votes

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Respect Party candidate George Galloway has taken the Bradford West parliamentary seat from Labour, winning the by-election by 10,100 votes.
Mr Galloway, expelled by Labour in 2003, said it was the "most sensational victory" in by-election history. He received 18,341 votes - a 56% share.
He said his victory represented a "total rejection" of the major parties.
At the 2010 General Election, Labour's Marsha Singh, who resigned on health grounds, won with a majority of 5,763 .
The party had held the West Yorkshire seat since 1974, except for a brief period in the 1980s when the sitting MP defected to the SDP.
Labour candidate Imran Hussein came second with 8,201 votes as the party's share of the vote was 20% down on its 2010 figure.
'Bradford spring'
Conservative candidate Jackie Whiteley was third, with 2,746 votes. Jeanette Sunderland, of the Liberal Democrats, secured 1,505 votes.
Mr Galloway, who co-founded the anti-war Respect Party after being expelled by Labour because of comments he made as part of his opposition to the Iraq war, said the result represented the "Bradford 

Tuesday, 27 March 2012

NHS ageism


NHS ageism 'harming elderly care'

Hands of an elderly lady The report calls for better training in the treatment of elderly people
The elderly are being passed around hospitals in England like parcels, often going without treatment because of ageist attitudes, a report suggests.
The King's Fund review said treatable conditions such as incontinence and depression were sometimes ignored.
And even diseases like cancer and heart disease were not always tested for, it suggested.
A Department of Health spokesman said addressing problems with elderly care was a key priority for the NHS.
He added the reforms being introduced in the health service were designed to free staff from the obstacles they were facing to putting patients first.
The report - based on patient surveys and evidence from staff - is the latest in a series of critical reports on elderly care.
The Patients Association and Care Quality Commission have both recently published studies detailing "shocking" standards.
The problem has prompted the Royal College of Nursing to call for minimum staffing levels for elderly care.
'Bed blocker' This study by the King's Fund criticised the whole approach to elderly care, saying the attitudes and language used suggested staff - particularly doctors - were ageist.

“Start Quote

The health and social care system system has failed to keep pace with changing health needs”
End Quote Jocelyn Cornwell Report author
It highlighted the uses of phrases such as "bed blocker" as well as the fact the elderly did not always receive the same assessments and treatments as younger patients.
But the think tank also laid the blame on the system, pointing out the volumes of work and pressure on meeting targets was compromising care.
It said elderly patients, who make up two-thirds of admissions, often found themselves on the wrong wards and passed around "like parcels" because of the rush to admit them.
The King's Fund called for better training for staff, leadership and involvement of patients to ensure the co-ordination of care improved.
Report author Jocelyn Cornwell said: "The health and social care system system has failed to keep pace with changing health needs.
"It needs a radical rethink from top to bottom."
Michelle Mitchell, from Age UK, added: "Health services cannot deliver high-quality services unless older people are treated as individuals and their care is co-ordinated.
"This is what a modern health service needs to deliver."

Monday, 19 March 2012

Home care for elderly branded 'shocking and disgraceful'

Home care for elderly branded 'shocking and disgraceful'

Which? found cases of missed visits, food left out of reach, medication not given and people being left in soiled beds during its investigation.It concluded too many faced a "constant battle" to just get the basic help.The UK Home Care Association said it was never acceptable for people to experience rushed or inadequate care.Which? said the findings - based on a survey and diaries kept by the elderly - showed the system needed reform.
More than 500,000 people rely on help at home with activities such as washing and dressing.
Elderly personFunding squeeze
These include both people who get council-funded care and those who pay for it themselves.
While Which? said there were some examples of excellent care, it claimed too many were being poorly served.
The group asked 30 people to keep diaries over the course of a week detailing their experiences.One elderly lady was left alone in the dark for hours unable to find food or drink.
Another was left without a walking frame so she was unable to get to the bathroom and one man was not given vital medication for his diabetes.
The poll, of nearly 1,000 people, found one of the most common complaints was missed or rushed visits.
Nearly half of respondents said visits had been missed in the last six months with most not being warned in advance.
One daughter said: "They missed a day just after Christmas. I covered, but mum didn't contact me until early evening by which time she needed a lot of cleaning up.
"You wonder about the elderly with no relatives."
Which? said the situation was only likely to get worse as councils increasingly squeeze funding.
'Real crisis'
This report is just the latest in a series that has highlighted the struggle the elderly are facing.
At the end of last year the Equality and Human Rights Commission said standards were so bad they even breached human rights.
Which? executive director Richard Lloyd said: "Our investigation found some disgraceful examples of care with elderly people given little time or respect.
"The government can no longer claim to be shocked as report after report highlights the pitiful state of care for older people."
And Michelle Mitchell, of Age UK, said the system was putting the "health and dignity of older people at risk".
The UK Home Care Association, which represents the agencies which provide many of the services, said its members were increasingly under pressure to cut the length of visits by councils wanting to save money.
Mike Padgham, the group's chairman, said: "The report supports our growing concern over state-funded homecare.
"People and their families must be confident that they will receive dignified and effective care.
"They must look to government and local councils to place the needs of elderly and disabled people at the forefront in the current economic climate, to avoid the concerning picture described in today's report."
Councillor David Rogers, of the Local Government Association, said: "This research highlights the very real crisis this country is facing in providing care for the elderly and vulnerable.
"We know there isn't enough money in the system and without fundamental reform the situation is only going to get worse and stories like this will sadly become increasingly common."
The government has promised to publish plans this year to overhaul the system in England. One of the aims of the forthcoming changes is to create a fairer and better-funded system.
The other parts of the UK are also looking at their systems.
Even in Scotland, where care is provided free, services are having to be rationed to only those who are the most in need because finances are stretched.


The care worker's story

"I've been in this profession for 10 years. This agency doesn't pay for travelling time so it's rush, rush, rush and the time I spend travelling is taken from each customer."
"Fifteen-minute visits used to be check calls or to give medication. Now they're used to microwave a meal, empty a commode and travel to the next person. It's impossible."

Thursday, 1 March 2012

BBC News... Being compassionate should be as important as being clever


Overhaul in approach to elderly care 'needed'

Elderly patientNursing standards have been criticised in a series of reports

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Being compassionate should be as important as being clever when it comes to the recruitment of staff to care for the elderly, experts say.
The recommendation was one of a series made by the Commission on Improving Dignity in Care for Older People to improve standards in hospitals and care homes in England.
The group said too many vulnerable people were currently being "let down".
The review comes after a series of critical reports into elderly care.
Cases of neglect have been documented by the likes of the Health Service Ombudsman and Patients Association in the past year.
And so the commission was set up by Age UK, the NHS Confederation and the Local Government Association to set out a blueprint for how the NHS and social care sector should tackle the issue.
Patronising language
In total, the commission published 48 draft recommendations which will be consulted on over the next month before a final action plan is published in the summer.
The measures cover issues such as making dignity a priority at board level, encouraging staff at all levels to challenge bad practice and ensuring patronising language, such as "old dear", is not used.
The report said language which denigrates older people should be as unacceptable as racist or sexist terms.
Another key recommendation involved the role of ward sisters, which the report said should be given the authority by management to take action when standards slip.
But it is the issue of staff training which there will be most focus on. There have been suggestions in the past that nurse training has become too academic.
Some places have started to trial ways of testing the emotional intelligence and bedside manner of students.
The commission said it should become commonplace for universities and professional bodies to take into account compassionate values as much as they do qualifications.
One of the authors of the report, Sir Keith Pearson, told BBC Radio 4's Today programme that dignity was "the essence of proper nursing".
He said: "There are pockets within the NHS and the care home sector where we are seeing excellent care. But you can go to hospitals...and you can see a couple of wards where dignity has broken down."
Sir Keith said there were clearly some nurses and professional carers who held old people "in contempt", adding: "Recruiting for values and then training for skills is enormously important."
He said people considering a career in nursing needed to be aware that 60% of patients in hospitals were over the age of 65 and they needed to be able to show compassion and kindness to elderly patients.
Sir Keith conceded that those nurses and carers who could not adapt to this "root and branch" change to the system would have to go.
But Peter Carter, general secretary of the Royal College of Nursing, suggested the most important factor when it came to standards was ensuring there were enough staff.
"It is absolutely critical that hospitals and care homes employ safe numbers of nurses with the correct skill mix. This is the key challenge that must be met."
Roswyn Hakesley-Brown, of the Patients Association, said the recommendations were a "step forward".
But she added without action on the ground it would be of no comfort to the people "who contact our helpline every day to tell us their loved ones are being left without adequate pain relief, are not being helped to eat and drink or who are left to lie in their own faeces because a nurse says she is too busy to help them to the toilet".
Care services minister Paul Burstow said the commission had made some good recommendations and he would be looking to work with the group to improve standards.

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Monday, 6 February 2012

Bird flu 'censorship'


Bird flu 'censorship' decision

Two scientific research teams have modified influenza strains to create mutant avian influenza viruses that can be transmitted efficiently between mammals. In one case, the virus remained highly pathogenic.A group which advises the US government on biosecurity has explained why it wants two research papers on H5N1 bird flu to be censored.
H5N1 under the microscopeThe US National Science Advisory Board for Biosecurity (NSABB) said publishing the work in full holds significant potential for harm.
The board explains that its main concern was that publishing the experiments in detail could help someone to develop viruses for harmful purposes.
But it acknowledges the work holds "clear benefits" in alerting humanity to the potential H5N1 threat, and that it could lead to greater preparation and potential development of novel strategies for disease control.
The board states that by recommending that the basic results be communicated without methods or details, the benefits to society will be maximised and the risks minimised.
Together with the release of this official statement, the journal Nature has also published a Q&A with the acting chair of the NSABB.
In it, he explains in more detail why they have recommended redaction for the paper in press at Nature even though the modified H5N1 virus that it describes is not highly pathogenic.
A copy of the NSABB Comment can be viewed on the Nature press site, and at: Policy Adaptations of avian flu virus are a cause for concern.
Nature's Q&A article is also on the Nature press site and is available here: Q&A Reasons for proposed redaction of flu paper Nature Nature Publishing Group.

Wednesday, 1 February 2012

school

school
estelle morris
"School effectiveness research



School effectiveness research: a review of criticisms and 
some proposals to address them. 
by Andres Sandoval-Hernandez (A.Sandoval@bath.ac.uk) 
University of Bath, Department of Education
Educate~


Thursday, 26 January 2012

cunfuion over sunlight


Government guidelines recommend some groups, including the under-fives, should take a daily supplement.
However, recent research found that many parents and health professionals were unaware of the advice.
There has been an increase in childhood rickets over the past 15 years.
According to Dr Benjamin Jacobs, from the Royal National Orthopaedic Hospital, links to heart disease and some cancers are also being investigated.

The consultant paediatrician told BBC Breakfast that the hospital saw about one severe case a month of rickets - softening of bones through lack of vitamin D in childhood.
He said: "There are many other children who have less severe problems - muscle weakness, delay in walking, bone pains - and research indicates that in many parts of the country the majority of children have a low level of vitamin D."
The Feeding for Life Foundation report, published in October last year, suggested one in four toddlers in the UK is vitamin D deficient.
However, this may be an underestimate as only vitamin D from food was included, and not any vitamin D obtained through sun exposure.
Vitamin D supplements are recommended for all people at risk of a deficiency, including all pregnant and breastfeeding women, children under five years old, people aged over 65, and people at risk of not getting enough exposure to sunlight.
Vitamin D is mainly obtained from sunlight. However, too much sun exposure increases the risk of skin cancer.
According to one recent study, nearly three-quarters of parents and more than half of health professionals are unaware of the recommendations.
The Department of Health has asked the Scientific Advisory Committee on Nutrition to review the issue of current dietary recommendations on vitamin D.
Dame Sally Davies: "We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements.
Free supplements
"Our experts are clear - low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.
"Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.
"It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups."
It has long been known that vitamin D prevents rickets and children were once given food supplements like cod liver oil.
However, this practice was stopped in the 1950s because it was thought unnecessary.
In the last 10 years, doctors have been seeing more cases of vitamin D deficiency, leading to a debate over the use of food supplements and concern that many medical staff are unaware of the problem.

Sunday, 22 January 2012

Thorkil Sonne an extraordinary memory and a remarkable eye for detail.


Four years ago Thorkil Sonne realized that his young autistic son

 possessed an extraordinary memory and a remarkable eye for detail. Those traits are prevalent among people with autism, and Sonne saw an opportunity to help individuals with the disorder find productive employment. As the technical director of a Danish software venture, he knew those qualities were critical in software testers. So he went out on his own and launched Specialisterne, a Copenhagen-based software-testing firm that now has 51 employees, including 37 with autism, and revenues of $2 million.
You started your company to improve the lives of people with autism. Why not just create a nonprofit focused on research or job training?
I wanted to do more than just provide a sheltered workplace for people with a disability. My goal is to create opportunities for people with autism on an international scale. You might find money to support sheltered working environments in Scandinavia but not in Poland or Spain or Brazil. To extend its reach, our organization needs the kind of funding that only a profit-making venture can generate. It must succeed on market terms.
Is it hard to reconcile two missions—serving customers and aiding people with a disability?
We’re constantly asked whether we support customers or a cause. We want to do both, of course, but we’re always fighting against the suspicion that we’re just a charity. Our corporate social responsibility profile might open doors with CEOs, but executives in charge of software testing aren’t evaluated on CSR, only on getting the most for the company’s money. To wipe away their suspicions, we must exceed performance expectations every time.
All our business comes from the private sector. Because Denmark has no tradition of social enterprises, the government doesn’t earmark contracts for companies like ours or give them tax breaks. We have to compete head on.
How does managing autistic workers differ from managing other people?
Most of our consultants with autism have a mild form called Asperger’s and are high functioning. Still, because they’re often hypersensitive to noise, they can be uncomfortable in open-concept office spaces without doors or walls. They also have trouble working in teams and understanding social cues, such as gestures, facial expressions, and tone of voice. You have to be precise and direct with them, be very specific about your expectations, and avoid sarcasm and nonverbal communication. Though we expect employees to do their jobs well, we don’t ask them to excel socially or to interact all the time with others. We just find them the right role. That takes tremendous stress off them. I think normality is whatever the majority decides it will be, and in our company people with autism are the norm.
What about the relationships between customers and your autistic consultants?
About 70% of our work is done at customer sites. The customer appoints a contact—someone who’s good with special people, who will select the right tasks and a comfortable place for them. We also give our clients a short introduction to autism and to our firm’s unique culture. After working with our consultants, the customers start being more direct with their own colleagues and stating their expectations more clearly. That’s helped them improve in an area that many companies struggle with.
In what other ways might firms benefit by adopting your techniques for managing autistic employees?
Companies sometimes unknowingly employ autistic people because the condition often goes undiagnosed. But people with autism aren’t the only employees who don’t thrive in open offices or in the traditional management system, with its emphasis on teamwork and unclear instructions like “Figure out on your own how to deal with this.”
You have to get the most from employees, especially when labor is scarce. Our sector is crying out for manpower, but Specialisterne has many job seekers knocking on the door. The key is to find situations that fit employees’ personalities and ambitions, not force everybody into one mold. That just causes stress, and workplaces already produce too much of that.

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