RE: In today's Lancet: from England and other places....

[Guest guest]

I'm really interested in this paper and grateful for Woody's bringing

it to our attention, even though it makes my brain hurt!

It's such difficult stuff to interpret when there are floating

thresholds for referrals to social services/children's services and

varying definitions of what constitutes neglect/abuse. That's before

you raise the issue of missed diagnosis in relation to injuries,

fabricated illness and even some deaths. The deaths where causes

can't be determined have changed and maybe there's more confident

labelling of injuries and deaths as due to maltreatment.

It's good that they look at the wider welfare context for children

and families, but collecting accurate national data on injuries seems

ambitious. Violent child deaths are rare in developed countries

(less so in USA) and much rarer than road traffic deaths.

It's certainly food for thought.

From: Woody<Woody.Caan@...>

Date sent: Fri, 24 Feb 2012 16:07:03 -0500

Subject: In today's Lancet: from England and other

places....

Send reply to:

Recommended Articles

[Guest guest]

Woody, thanks very much for this link and, I agree with , this is an important and complex paper building on the Lancet series from two years ago. It suggests that we need to be cautious about optimistic assessments of reducing rates of death from child maltreatment. For those who cannot access the full paper, I paste the 'key messages' below:Key messages•We

recorded no consistent evidence for a decrease or increase in all types

of indicators of child maltreatment across the six countries or states (Sweden, England, New Zealand, Western Australia, Manitoba [Canada], and

the USA) despite several policy initiatives designed to achieve a reduction.•Large differences between countries in the rate of contacts with child protection agencies contrasted with little variation in rates of maltreatment-related injury or violent death. This discrepancy shows that governments' responses differ.•Overall,

one or more child protection agency indicators (notification, investigation, officially recognised physical abuse or neglect, or out-of-home care) increased in five of six countries and states, particularly in infants, possibly as a result of early intervention policies.•Lower levels of maltreatment indices in Sweden than in the USA are consistent with lower rates of child poverty and parent risk factors and policies providing higher levels of universal support for parenting in Sweden.•High

and rising rates of out-of-home care affect a substantial minority of children, especially those of non-white or Aboriginal origin, despite no

policy advocating this option and little evidence for its effectiveness.•To improve the evidence base for child protection policies, governments should facilitate use of anonymised, linked, population-based data from health-care and child protection services to establish the effect of policy on trends in child maltreatment. Rising placements of children in

out-of-home care demand urgent assessment with randomised controlled trials.best wishesOn 24 Feb 2012, at 21:07, Woody wrote: Recommended Articles Sent By: Woody I thought you would find this useful on ScienceDirect. 1.Child maltreatment: variation in trends and policies in six developed countries Review ArticleThe Lancet, Volume 379, Issue 9817, 25 February–2 March 2012, Pages 758-772Ruth Gilbert, Fluke, O'Donnell, Arturo -Izquierdo, Marni Brownell, ine Gulliver, Staffan Janson, Sidebotham Access the ScienceDirect Info site if you have questions about this message or other features of this service. This email has been sent to you by ScienceDirect, a division of Elsevier B.V., Radarweg 29, 1043 NX Amsterdam, The Netherlands, Tel.+31 20 485 3911. ScienceDirect respects your privacy and does not disclose, rent or sell your personal information to any non-affiliated third parties without your consent, except as may be stated in the ScienceDirect online privacy policy. By using email or alert services, you agree to comply with the ScienceDirect Terms and Conditions. © 2012 ScienceDirect. All rights reserved. Any unauthorized use, reproduction, or transfer of this message or its contents, in any medium, is strictly prohibited. ScienceDirect® is a registered trademark of Elsevier B.V. Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn

[Guest guest]

It strikes me that point 4 is the one which should guide us!CheryllFrom: Cowley <sarahcowley183@...>Reply- < >Date: Sat, 25 Feb 2012 09:04:34 +0000 < >Subject: Re: In today's Lancet: from England and other places....

Woody, thanks very much for this link and, I agree with , this is an important and complex paper building on the Lancet series from two years ago. It suggests that we need to be cautious about optimistic assessments of reducing rates of death from child maltreatment. For those who cannot access the full paper, I paste the 'key messages' below:Key messages•We

recorded no consistent evidence for a decrease or increase in all types

of indicators of child maltreatment across the six countries or states (Sweden, England, New Zealand, Western Australia, Manitoba [Canada], and

the USA) despite several policy initiatives designed to achieve a reduction.•Large differences between countries in the rate of contacts with child protection agencies contrasted with little variation in rates of maltreatment-related injury or violent death. This discrepancy shows that governments' responses differ.•Overall,

one or more child protection agency indicators (notification, investigation, officially recognised physical abuse or neglect, or out-of-home care) increased in five of six countries and states, particularly in infants, possibly as a result of early intervention policies.•Lower levels of maltreatment indices in Sweden than in the USA are consistent with lower rates of child poverty and parent risk factors and policies providing higher levels of universal support for parenting in Sweden.•High

and rising rates of out-of-home care affect a substantial minority of children, especially those of non-white or Aboriginal origin, despite no

policy advocating this option and little evidence for its effectiveness.•To improve the evidence base for child protection policies, governments should facilitate use of anonymised, linked, population-based data from health-care and child protection services to establish the effect of policy on trends in child maltreatment. Rising placements of children in

out-of-home care demand urgent assessment with randomised controlled trials.best wishesOn 24 Feb 2012, at 21:07, Woody wrote: Recommended Articles Sent By: Woody I thought you would find this useful on ScienceDirect. 1.Child maltreatment: variation in trends and policies in six developed countries Review ArticleThe Lancet, Volume 379, Issue 9817, 25 February–2 March 2012, Pages 758-772Ruth Gilbert, Fluke, O'Donnell, Arturo -Izquierdo, Marni Brownell, ine Gulliver, Staffan Janson, Sidebotham Access the ScienceDirect Info site if you have questions about this message or other features of this service. This email has been sent to you by ScienceDirect, a division of Elsevier B.V., Radarweg 29, 1043 NX Amsterdam, The Netherlands, Tel.+31 20 485 3911. ScienceDirect respects your privacy and does not disclose, rent or sell your personal information to any non-affiliated third parties without your consent, except as may be stated in the ScienceDirect online privacy policy. By using email or alert services, you agree to comply with the ScienceDirect Terms and Conditions. © 2012 ScienceDirect. All rights reserved. Any unauthorized use, reproduction, or transfer of this message or its contents, in any medium, is strictly prohibited. ScienceDirect® is a registered trademark of Elsevier B.V. Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn

[Guest guest]

Yes, and that is why a one off health promotion to prevent NAHI (shaken baby), such as the hospital based new parents programme, may have some effect but never be the whole answer, given the known risk factors for two thirds of cases such as lower social, mental health, economic and literacy status. From: [mailto: ] On Behalf Of Cheryll Sent: 25 February 2012 10:54 Subject: Re: In today's Lancet: from England and other places.... It strikes me that point 4 is the one which should guide us! Cheryll From: Cowley <sarahcowley183@...>Reply-< >Date: Sat, 25 Feb 2012 09:04:34 +0000< >Subject: Re: In today's Lancet: from England and other places.... Woody, thanks very much for this link and, I agree with , this is an important and complex paper building on the Lancet series from two years ago. It suggests that we need to be cautious about optimistic assessments of reducing rates of death from child maltreatment. For those who cannot access the full paper, I paste the 'key messages' below: Key messages •We recorded no consistent evidence for a decrease or increase in all types of indicators of child maltreatment across the six countries or states (Sweden, England, New Zealand, Western Australia, Manitoba [Canada], and the USA) despite several policy initiatives designed to achieve a reduction.•Large differences between countries in the rate of contacts with child protection agencies contrasted with little variation in rates of maltreatment-related injury or violent death. This discrepancy shows that governments' responses differ.•Overall, one or more child protection agency indicators (notification, investigation, officially recognised physical abuse or neglect, or out-of-home care) increased in five of six countries and states, particularly in infants, possibly as a result of early intervention policies.•Lower levels of maltreatment indices in Sweden than in the USA are consistent with lower rates of child poverty and parent risk factors and policies providing higher levels of universal support for parenting in Sweden.•High and rising rates of out-of-home care affect a substantial minority of children, especially those of non-white or Aboriginal origin, despite no policy advocating this option and little evidence for its effectiveness.•To improve the evidence base for child protection policies, governments should facilitate use of anonymised, linked, population-based data from health-care and child protection services to establish the effect of policy on trends in child maltreatment. Rising placements of children in out-of-home care demand urgent assessment with randomised controlled trials. best wishes On 24 Feb 2012, at 21:07, Woody wrote: Recommended Articles Sent By: Woody I thought you would find this useful on ScienceDirect. 1.Child maltreatment: variation in trends and policies in six developed countries Review ArticleThe Lancet, Volume 379, Issue 9817, 25 February–2 March 2012, Pages 758-772Ruth Gilbert, Fluke, O'Donnell, Arturo -Izquierdo, Marni Brownell, ine Gulliver, Staffan Janson, Sidebotham Access the ScienceDirect Info site if you have questions about this message or other features of this service. This email has been sent to you by ScienceDirect, a division of Elsevier B.V., Radarweg 29, 1043 NX Amsterdam, The Netherlands, Tel.+31 20 485 3911. ScienceDirect respects your privacy and does not disclose, rent or sell your personal information to any non-affiliated third parties without your consent, except as may be stated in the ScienceDirect online privacy policy. By using email or alert services, you agree to comply with the ScienceDirect Terms and Conditions. © 2012 ScienceDirect. All rights reserved. Any unauthorized use, reproduction, or transfer of this message or its contents, in any medium, is strictly prohibited. ScienceDirect® is a registered trademark of Elsevier B.V. Cowleysarahcowley183@...http://myprofile.cos.com/S124021COn