Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Why making children living in care homes leave when they turn 18 needs to change








For most teenagers, turning 18 is a cause for celebration, but for those living in care homes, it means suddenly having to make their own way in the world

By: EhowShare . Jemma Hooper was two years old when she was taken into care. Her parents struggled with addiction and the world she was born into, she says, was one characterised by drugs, chaos and fighting.
By the time she was 17, Jemma was in a children’s home, having already lived in 18 different places. While other kids her age might have looked forward to their 18th as the moment to enjoy their first legal pint, Jemma’s landmark birthday was significant as the date on which she would, for the final time, be thrown out of the place she called home.
There are nearly 70,000 children in care in Britain. The vast majority live with foster families and, owing to a change in law last year, these young people can expect to remain the responsibility of the state until they turn 21, unless they feel ready to move on beforehand.
But for the 6,000 or so young people living in Britain’s children’s homes – who were not affected by new legislation piloted by the previous government and bought into force in 2014 – this is not the case.
Jemma’s removal from residential care came at a time when she was finally beginning to settle, with the help of a brilliant key-worker: “She was ace. There were nothing going wrong when she was around. She listened to what I had to say. She made time for me and we did things together.”
Suddenly having all that pulled from under her was a heavy blow: “For me, it’s like Social Services kicked me out when I needed them the most, when I had nothing and I had no-one.”
The practice of rescinding responsibility for the well-being of young people at an age when many simply aren’t able to cope is the subject of a moving documentary, Kicked Out Kids, which airs Tuesday evening on Channel 4.
Janes Van Vollenstee qualified as a social worker in South Africa before moving to the UK in 1996. Having worked in a local authority until 2012, involved with children in and leaving care, and also child protection, he is now the manager of the Moving On team for the children and families charity Break, which offers transition and mentoring services to young people at this critical juncture. Leaving home is difficult at the best of times, he says: “Now imagine a young person has been in very negative environments, received forms of abuse – with fostering placement breakdowns which have resulted in them moving to a children’s home – it is understandable then that there will be a lot of anxiety and anger, while grappling to understand why they are living differently from their peers...
“For those young people, with everything that has happened in their life, at age of 17 telling them, ‘On your birthday you are going to move on, ready or not...’?”
It is unsurprising, he concludes, that so many are terrified of leaving care and struggle to settle on the outside.
Demornia Cattrill was a baby when he and his twin brother were first taken into care – before being returned to their mother, who remained violent. Years later, when the boys were in Year 9, his brother refused to go home from school one day. Demornia’s response at the time was: “Oh my gosh, it’s happening. Someone’s finally plucked up the courage to say something.”
Though he says it was a relief, he also felt “panicky” because there were also two younger brothers at home, who he now knows went straight into foster care, while the older twins ended up at a children’s home. Now aged 18 and having left full-time care nearly a year ago, Demornia says care was “all right”. “There was a good understanding between staff and kids. You got out what you put in. Even though you could be an arsehole, some of the staff would see that you were still good; finding your feet and that. Obviously there were also a few members of staff who were arseholes, but the staff that cared actually did care a lot.”
He is glad of the opportunities he wouldn’t have got if he’d been living at home. “I got to go to basketball camp on the Isle of Man, twice, and I went on a trip to France.” Mainly, he devoted himself to training in mixed martial arts, first as “something to get my mind off everything”, now with a dream of going pro.
Since leaving care, however – initially to a semi-independent lodging in someone else’s house when he was 17, before moving to full independence – Demornia says he’s been “left in the dark”. “I was almost brought to court because of my council tax. I didn’t have a clue what I was doing. One minute everything’s being done for you, the next you’re out of their hands and you’re all on your own. I have a friend in foster care. He’s 20 and has everything provided. What’s that about?”
After finishing college, where he studied catering, Demornia started looking for work.
“I worked in a warehouse from October to January, getting minimum wage. (At 17, it was £3 something an hour; when I hit 18, it went to £5.13.) In January I got laid off. Since then I’ve had no income whatsoever and nobody’s helped me. I managed to stretch my last week’s pay, then got some overtime before I left. Obviously that’s now run out and I’ve got letters saying bills are due.”

Denornia Cantrill, a young man who was brought up in care and now has his own home (Warren Smith)
The long-term prospects for care-leavers are not good. Of  the adult prison population, 27 per cent have been in care at some time. And almost 40 per cent of prisoners under 21 have been in care as children, as have one third of rough sleepers, and 70 per cent of women working in prostitution.
New figures, published last week, revealed the long-term cost in Britain of “picking up the pieces from damaging social problems affecting young people” – totalling around £17bn a year, according to research by the Early Years Foundation charity. Around £5bn of this came directly, it said, from looking after children in care on a yearly basis – but the long-term expense is perhaps more significant. An estimated further £4bn a year – nearly a quarter of the total cost - is currently spent on benefits for 18-24 year olds not in education, employment or training (NEETs), with a further £900m spent helping young people suffering from mental health issues, or battling drug and alcohol problems. Just the sorts of difficulties young people who leave care unsupported are likely to face, as Natasha Finlayson, chief executive of the Who Cares? Trust, points out. “Research consistently shows that leaving care before a young person is ready for independence tends to lead to poor outcomes, with mental health – particularly depression – the biggest factor we see, followed by debt,” she says.
In the coming weeks, the Department for Education will consider the recommendations made in a joint report by the NCB, the Who Cares? Trust and other organisations, which suggests models for rolling out so-called Staying Put arrangements across residential homes, while acknowledging that this is not a straightforward prospect. Not least because of child protection issues: if you mix children and young adults, it requires plenty of legislative and practical frameworks. At an estimated £76m, it won’t come cheap. But considering the long-term financial and emotional burden on services and young people, Enver Soloman of the National Children’s Bureau says this is surely a small price to pay: “If you support a young person properly up to the age of 21, it is much less likely they will fall into difficulty and impose a financial burden on other services and state agencies.”
Another problem, Finlayson suggests, is a deep-rooted culture of children’s homes, which are often “seen as a placement of last resort”. “It is really unhelpful that we have these ideas,” she says. “There are examples from other countries, like those in Scandinavia, which show how really good, constructive work can be done, rather than using children’s homes like a holding pen as we do, with workers who are not well-trained or properly qualified.”
Break’s Van Vollenstee believes the greatest challenge is building a system that allows social workers to invest time in relationship-building rather than constantly filling in forms and assessments. “At the point when they leave care, many young people are still processing what happened to them prior to coming into care, adjusting and learning to be accountable for their actions.” What they really need is continuity and support; people in their lives who will take a parental role in the absence of any other guiding figure. In reality, though, support workers – who are only obliged to see young people once every two months after they’ve turned 18 – often only have time for phone calls or sign-posting to other organisations that offer practical help.
“You can teach young people how to budget or to cook, but no-one can prepare them for what it’s like to be home alone at 9 or 10 at night with no-one to talk to. That is what we hear time and time again – the loneliness – and that’s when they often get tempted to move in with negative circles to reduce the loneliness.”
On leaving care, Jemma moved in with her aunt, her late father’s sister, last year, but that didn’t work out. “There were lots of complications. We didn’t get to know each other well enough. I was there for three or four months, then from there into temporary accommodation, then to another place which was like your own flat but there were staff who came in during the day, which made me feel well uncomfortable – I had more privacy in a kids’ home.” After getting kicked out of there, she ended up in a B&B in Huddersfield, a two-hour walk from her friends in Halifax. Now she is in Halifax in social housing.
On the phone, Jemma is bubbly and upbeat, but over the years, she has tried to take her life several times. “I don’t know; it’s like an issue of not being able to control it sometimes,” she says. “Even though I can speak so openly about things, sometimes I don’t tell the things I need to tell. Sometimes I’ll think I don’t even know who I am. When you’ve been through so many families you aren’t going to know who you are by the end of it.”
In practice, the age of leaving care is often younger than 18, with 31 per cent of the 9,990 care-leavers in 2013 aged just 16 or 17. Moving on at this age to live semi-independently is something that is encouraged by local authorities on the basis that the young person ‘transitions’ at a time when they will still have their rent paid and are entitled to ongoing support.
But some feel that local authorities are often too keen to get young people off their books. Pressures are such that staff often feel they have to prioritise younger charges, Van Vollenstee says, and the older children feel that – and don’t understand why – their needs are no longer of importance: “When a young person leaves care, what they need is someone to say, ‘Let’s talk about what is happening in your life. I’m here, let’s have a coffee and talk.’
“They need to know this is life and it’s full of challenges, that it can be stressful and you need to learn to be resilient and receptive.”
That’s where organisations like his step in, to offer the message: we won’t drop you.
Demornia was just 17 when he moved out of residential care, into semi-independent lodgings. Now that he is no longer entitled to the £55 a week he got when he was living semi-independently, he says his support workers are no longer guardians so much as an advisory service. In that case, he wonders: “Why are you here? If you’re not going to help me in any way, you might as well fuck off.”
Now he is back in college every day on a military preparation course and hopes to join the Marines. “I want to prove to everybody who says I’m just going to be a drug dealer or in prison – I want to prove them wrong and show that just ’cause I had a shit upbringing doesn’t mean I can’t change it.”


Ebola Drug Aids Some in a Study in West Africa

For the first time, a drug is showing promising signs of effectiveness in Ebola patients participating in a study. The medicine, which interferes with the virus’s ability to copy itself, seems to have halved mortality — to 15 percent, from 30 percent — in patients with low to moderate levels of Ebola in their blood, researchers have found. It had no effect in patients with more virus in their blood, who are more likely to die.
The drug, approved as an influenza treatment in Japan last year, was generally well tolerated.
“The results are encouraging in a certain phase of the disease,” Dr. Sakoba Keita, director of disease control for the Guinean Ministry of Health, said in a telephone interview. The drug is being tested in Guinea, one of the three West African countries most affected by the Ebola crisis.
An Ebola treatment center run by the Alliance for International Medical Action has tested the drug favipiravir. Credit Sylvain Cherkaoui/Cosmos for ALIMA
 The details of the early findings have not yet been announced, but they raise questions about which patients, if any, outside the study should be offered treatment with the drug, favipiravir. “These are very difficult, agonizing decisions,” said Susan Ellenberg, a professor of biostatistics at the University of Pennsylvania’s Perelman School of Medicine, who was not involved in the research. She cautioned that early results were sometimes not borne out.


The drug has been provided on an emergency basis to Ebola patients in European countries, but not in Africa. The Japanese maker of the drug announced in October that it had 20,000 courses of treatment in stock. The epidemic is now ebbing but is not over. The World Health Organization on Wednesday reported 124 new cases in Guinea, Sierra Leone and Liberia in the week that ended on Sunday, warning of an increased geographical spread in Guinea and a rise in new cases in all three countries for the first time this year.
Early reports of the interim results of the drug trial have created unanticipated complications, delaying the testing of at least one other therapy as researchers reconsidered plans and some doctors pressed to make favipiravir more widely available.
Researchers and health authorities have been quietly debating whether and when to release the preliminary results of the study. The dilemmas they face echo those from the early years of the AIDS epidemic. Because mortality was so high in a disease with no proven treatment, there was demand to provide experimental therapies to everyone.

The results for the drug favipiravir are based on an analysis of 69 patients older than 14 who have received it at two sites in Guinea since December. The survival rates of those with low to moderate levels of virus in their blood were significantly better than those of patients previously treated at a center run by Doctors Without Borders in Guéckédou, Guinea.
Caroline Guele, 31, a rice farmer who lost two children and her husband to Ebola, received the drug in January at the site run by the Alliance for International Medical Action soon after she developed symptoms. She said she believed it contributed to her survival. “When I heard I could take the medicine, I actually prayed to God it would help me,” she said in a telephone interview Wednesday.

In a typical drug study, participants would be randomly assigned to take the drug or not, and the outcomes would be compared to see if the drug made a difference. However, because Ebola is so deadly and there is no known treatment aside from supportive care, all patients in the study were provided with the treatment. Fluctuating death rates during the current epidemic have complicated researchers’ efforts to assess whether the new drug should be credited with the reduced mortality.
The drug was expected to be most effective in patients receiving it within two to three days of showing symptoms, similar to antiviral treatments for influenza. However, most study participants arrived at the Ebola treatment units later in their illnesses, a median of five days after their symptoms began, so results were analyzed instead in terms of the approximate levels of virus in the blood.
Independent boards charged with monitoring the drug trial detected the encouraging findings and recommended that they be made public. Results were submitted for review to the Conference on Retroviruses and Opportunistic Infection, which will take place in Seattle at the end of the month. A draft of an abstract of the findings was reviewed by The New York Times.
“With Ebola, there’s precious little good news,” said Dr. Susan Shepherd, who served as medical coordinator at a treatment unit run by the Alliance for International Medical Action, one of two sites where the drug was tested. (The other was a facility run by Doctors Without Borders.)
Dr. Shepherd added, “There will, I think, be an enormous pressure and desire to offer the treatment more broadly.”
 
A patient is treated at the ALIMA ebola treatment center in Nzerekore, Guinea. Credit Sylvain Cherkaoui/Cosmos for ALIMA
 
The trial is sponsored by the French public research institute Inserm, with support from the European Union, and is run by a consortium of organizations and the Guinean government. After a briefing with the president of Inserm, President François Hollande of France issued a statement on Wednesday welcoming the findings and calling them an important step. The drug, also known by the trade name Avigan, was developed by the Japanese company Toyama Chemical, part of Fujifilm Group, and approved for influenza treatment in that country last March after safety testing.
The company has said it would produce more doses of the drug in anticipation of the trial. It has also provided the tablets on an emergency basis to several Ebola patients in Europe, according to a company spokeswoman, Kana Matsumoto. She said that the drug had never been provided on that basis to patients in any African country, and that the company had no comment as to whether it would do so in the future given the new findings.
“With a medication that seems to be safe, you really don’t have a leg to stand on in terms of this person gets it and this person doesn’t,” Dr. Shepherd said. “The problem we seem to have is it doesn’t help at all for people who have high viral loads.”
Researchers hope that some patients’ lives might be saved by bolstering the immune system, including through transfusions of serum extracted from the blood of Ebola survivors, which contains virus-fighting antibodies.
However, expectations around favipiravir have contributed to a delay in a trial of serum transfusions, also known as convalescent plasma therapy, in Guinea’s capital, according to Roeland Scholtalbers, the head of communications for the Institute of Tropical Medicine in Antwerp, Belgium, the study’s sponsor.
If patients getting the serum transfusions also get favipiravir, as some doctors have urged, it would probably be more difficult to discern whether the serum had an effect. Mr. Scholtalbers said that just because early results for favipiravir came first did not mean that researchers or the public should “put more hope on that solution than any other solution.”
“There are pretty good arguments to think that plasma can give good impact,” he continued. “It will be a shame if we don’t manage as a scientific community to test it.”
Dr. Xavier Anglaret, the lead investigator of the favipiravir trial in Guinea, said that he and his colleagues agreed that the other study was important. “The plasma trial should start as early as possible,” he said.
Both trials are all the more important because of the abrupt cancellation last Friday of a study testing a third therapy, the anti-viral drug brincidofovir, after the manufacturer concluded there was an insufficient number of Ebola patients in Liberia, where the trial was underway, to determine the effectiveness of the drug.
Dr. Anglaret said researchers had expected to have results from all three studies around the same time. Instead, one study advanced ahead of the others, with early results that are encouraging but not definitive. As of Tuesday, Dr. Anglaret said, the favipiravir trial had enrolled 101 patients in the continuing study.
The complications of managing the Ebola trials are a sign that more needs to be done to prioritize research in future outbreaks, said Dr. Bernard Lo, a bioethicist and president of the Greenwall Foundation in New York City.



For reducing cholesterol, corn oil better than olive oil, study suggests

For reducing cholesterol, corn oil better than olive oil, study suggests

Consuming vegetable oils has been associated with a reduction in total and low-density lipoprotein (LDL), or bad, cholesterol. But a study published in the January/February 2015 edition of the Journal of Clinical Lipidology suggests that between corn oil and extra virgin olive oil, the corn variety does a better job.
In a double-blind, randomized controlled crossover feeding study, researchers at Biofortis, a global clinical nutrition research team for dietary industry clients, found that corn oil lowered LDL cholesterol by nearly 11 percent, compared to extra virgin olive oil’s 3.5 percent reduction. Corn oil similarly lowered total cholesterol by over 8 percent compared to about 2 percent for extra virgin olive oil, according to a news release.
Fifty-four healthy men and women participated in the study and received four tablespoons of one of the oils in the same foods every day. Researchers measured the participants’ fasting blood samples before and after each treatment phase of the study.
Having high cholesterol is a risk factor for developing cardiovascular disease, which is the leading cause of death in the United States. According to the Centers for Disease Control and Prevention (CDC), about 600,000 Americans die of heart disease every year. That means the condition is responsible for 1 in 4 total annual deaths in the U.S.
Coronary heart disease costs the U.S. about $108.9 billion each year in health care services, medications and lost productivity, according to the CDC.
Study authors said corn oil was more effective at reducing cholesterol levels compared to extra virgin olive oil because it has a greater amount of plant sterols. Plant sterols are substances found in produce, nuts, seeds, legumes and vegetable oils.  A growing body of evidence suggests that they play a crucial role in maintaining a heart-healthy diet.
Compared to extra virgin olive oil’s 30 milligrams of plant sterols per serving, corn oil contains about 136 milligrams of plant sterols per serving, according to the news release.
"The study results suggest corn oil has significantly greater effects on blood cholesterol levels than extra virgin olive oil, due, in part, to the natural cholesterol-blocking ability of plant sterols," lead researcher Dr. Kevin C Maki, of Biofortis, said in a news release. "These findings add to those from prior research supporting corn oil's positive heart health benefits, and align with recommendations to replace saturated fats with unsaturated fats, such as those found in corn oil."
The study was funded in part by ACH Food Companies, Inc., which produces the corn oil product Mazola.
According to the Mayo Clinic, in the U.S., total cholesterol under 200 milligrams of cholesterol per deciliter of blood is considered desirable, while 240 milligrams per deciliter of blood is considered high. For LDL cholesterol, respectively, those values are below 70 milligrams per deciliter of blood and 160 to 189 milligrams per deciliter of blood.
Cancer organization partners with NFL on prostate treatment

Cancer organization partners with NFL on prostate treatment

Jan 30, 2015: General view of the Vince Lombardi Trophy
and helmets for the Seattle Seahawks and New England Patriots
during a press conference for Super Bowl XLIX
at Phoenix Convention Center.
 (REUTERS)

A U.S. cancer organization has partnered with the NFL alumni association ahead of Sunday's Super Bowl XLIX to raise awareness about screening, diagnosis and treatment for prostate cancer, a disease that kills tens of thousands of U.S. men a year.
The Cancer Treatment Centers of America (CTCA), a private, for-profit operator of cancer treatment hospitals and outpatient clinics, will treat NFL Alumni who are fighting prostate cancer, which afflicts almost one in seven U.S. men, at its five hospitals in Atlanta, Chicago, Philadelphia, Phoenix and Tulsa.
"CTCA is proud to partner with NFLA and we look forward to making a difference in the lives of those alums who are or will be diagnosed with prostate cancer," Gerard van Grinsven, chief executive and president of CTCA, said in a statement Thursday.
Prostate cancer is one of the most common cancers among men in the United States, second only to non-melanoma skin cancer. It also is the second leading cause of cancer death in U.S. men.
"This new partnership addresses one of the biggest health concerns among men today," said NFL Alumni head Joe Pisarcik.
The CTCA is already sponsoring sunblock dispensers for fans at pre-game events in downtown Phoenix ahead of the game between the Seattle Seahawks and New England Patriots.
The NFL Alumni Association is a group of former league players, coaches and other employees who help ex-players and their families with medical, financial and social programs.