Tuesday, April 24, 2007

Pesky genes again: This time for exercise

The Government may be wasting its time encouraging children to spend more time on sport and exercise in an effort to reduce obesity. Research at Peninsula Medical School in Plymouth, reported in today’s times2, suggests that a child’s propensity to be active is genetically determined. Children are said to find their own activity level, regardless of how many opportunities are offered. If the naturally inactive are forced to be more active at school, they do less at home, while the naturally active need no encouragement.

Professor Terence Wilkin, who has carried out trials with young people, says that his research shows that Government programmes to increase levels of activity do not reduce obesity. There are 1.8 million overweight children and 700,000 obese young people in Britain. Rates of obesity more generally have trebled since the 1980s, and the condition is estimated to cost the nation 7 billion in health expenditure. But while active children may be healthier, it remains unproven that inactive ones can be persuaded to do more, Professor Wilkin says. “So far, the evidence is bleak,” he adds.

The claim follows US research last week suggesting that a fat gene can decide whether some people have a propensity to put on weight. Some research has suggested that activity does help. In one study, children who tried a nine-week programme with their parents, which involved a combination of exercise, healthy eating, motivation and positive thinking strategies, were still benefiting from the scheme 12 months later.

The researchers found improvements in the overweight children’s body mass index, waist circumference, fitness, lifestyle and self-esteem following the programme and these were “largely sustained” after a year. “Thirty per cent of UK children are now considered to be obese or overweight — it is an immense public health issue in both immediate and long-term health,” said Professor Alan Lucas, director of the Medical Research Council childhood nutrition research centre at University College London Institute of Child Health.

His “Mend” approach — “mind, exercise, nutrition, do it!” — was adopted by 107 families during the trial but it is now being rolled out across the country. More specifically, a study in Bristol found a link between increased activity alone and obesity, suggesting that an extra quarter of an hour vigorous exercise a day was enough to make a difference. But the problem with these studies is that they do not show if fat children are fat because they are inactive, or inactive because they are fat. If Professor Wilkin is right, efforts to expand school sports may make children fitter, but no thinner.


Systematic corruption of British High-school examinations

Examination bodies are making thousands of pounds selling tips to schools on how to beat the A-level and GCSE systems. Senior examiners offer advice on a freelance basis and at least two boards provide courses to help teachers to improve pupils' grades.

A government adviser condemned the practice as disgraceful, saying that it preyed on schools' fears about their position in the league tables. Head teachers gave warning that there would be a "major moral issue" if boards were giving unfair advantage to some pupils over others.

Many pupils spend the Easter holidays doing intensive tuition courses. Parents often hire former teachers to help them to prepare for exams.

Teachers, too, are under growing pressure to succeed. Senior examiners allegedly give seminars for up to 200 pounds a time, offering tips on what pupils should write in coursework. Now examining bodies are also cashing in. This year, the OCR board is offering teachers hundreds of courses at up to 120 each. It offers a full-day course in GCSE English literature titled "Get ahead - improving candidate performance". The board says that the course offers "guidance and practical support" for teachers preparing pupils for this summer's exams, to "exemplify standards for the externally assessed components" and "suggest teaching and learning approaches for each component" of the GCSE.

The Assessment and Qualifications Alliance also offers courses, most of them free. A spokeswoman said that they were about raising standards and intended to "support teachers in developing qualifications". Senior markers also earn thousands privately by advising staff on how to "control" what pupils write for coursework and script foreign language oral exams so that pupils know in advance what will turn up.

Warwick Mansell describes two seminars in his book Education by Numbers, published next month. In one, French teachers were told to be "realistically generous" when marking coursework and that teaching less able pupils grammar was not worth the effort because it was allocated few marks. History teachers were advised against aiming for top-quality work because pupils could gain an A* GCSE without it. Instead, they should concentrate on areas where little historical knowledge was required - such as using historical sources. Examining bodies already brief schools on syllabus changes, give feedback on exams and make the previous year's papers available.

Yesterday heads gave warning that expensive advice sessions risked giving some pupils an unfair advantage. Malcolm Trobe, president of the Association of School and College Leaders, said: "There is a dividing line between giving appropriate information to teachers to prepare children adequately for exams and giving or selling tips which would directly influence their grades. If it gives some students an advantage, there would be a major moral issue there."

Since 1997 the Government has focused increasingly on league tables and targets in education. If results are not up to scratch schools can be closed, heads can lose their jobs and, from September, teachers face losing out on pay awards.

Alan Smithers, a government adviser and director of education and employment research at the University of Buckingham, said that this approach was key in creating the "disgraceful" new market. He said: "Finding ways of helping students to do their best has always been part of teaching, but the big difference here is that the people on the inside are giving hints on coursework and areas where students are more likely to get A* grades. "Education has become distorted by the over-emphasis on scores. But schools are playing the game to maximise the scores and, as businesses, the exam boards are jumping on the bandwagon. "What follows is that the scores are further removed from the children's ability and what they can achieve." Professor Smithers said that the boards should stop offering such sessions and that examiners should not be allowed to enter into a private enterprise.

A spokesman for the Joint Council for Qualifications, the umbrella body for the examination boards, said that it took "complaints or evidence" which raise questions about the probity of the assessment process seriously. He said that the code of practice set out the roles and responsibilities of examiners and that the regulators would pursue cases where conduct related to malpractice.



Or so a noted commentator on British upper class manners says:

But it all goes to show that class isn’t dead. It reminds me of the true story about the aristocrat being treated for depression by the psychoanalyst. The sessions were going nowhere and in exasperation the psychoanalyst said: “Tell me exactly what you’re thinking about right now.” And the aristocrat replied: “I was just thinking what a vulgar little man you are.” And the sessions collapsed because the psychoanalyst felt he’d lost all ascendancy.

Dame Barbara Cartland famously replied, when the television journalist Sandra Harris asked her in the 1960s whether class barriers had broken down: “Well, of course they have, otherwise I wouldn’t be sitting here talking to someone like you.”

Most of the outward signs have gone. When we arrived here 25 years ago I was told it was irredeemably common to have red flowers in a Cotswold garden. Now nobody cares about anything as long as you pay your local bills and don’t hurtle down the village in your shining Chelsea tractor, scraping the paint off parked cars.

But one thing likely to give you away as non-U these days is political correctness because it’s so euphemistic. The aristocrat tends not to be politically correct. In fact he’s generally a randy old sod whose family has spent 700 years fornicating and shooting things. If a girl’s got a pretty face, he won’t care what class she’s from.

But if you start referring to your “partner”, or “lone parents”, or people being “vertically challenged”, you will be instantly marked out as non-U. The papers said Prince William had telephoned Kate during all the furore and been very “supportive” — another dreadfully non-U word. Soon they’ll be rabbiting on about them “achieving closure”, another horror.

There’s a lot of confusion about class. Most of the Labour party thinks Tony Blair is terribly grand, but he isn’t. He’s charming, of course, but very, very middle class, not even upper middle class. And I’ve found out while researching Wicked!, which is set in schools, that among young people the word “posh” often isn’t used to denote class, but to accuse someone of being irritatingly clever. Perhaps people who are “posh” are destined to do well in exams and make it to the top.

Class has given us great comic characters, from Mrs Bennet and Hyacinth Bouquet to Tim Nice-But-Dim and Vicky Pollard, the archetypal working-class girl, mouthy, inarticulate and terribly funny.

It’s much more fun to have a class system than not, as long as everyone can go on gently laughing about it. The thing that’s horrid is when people feel hurt by it. But you should remember that the royal family isn’t nearly as old as half the aristocracy — so a lot of people look down on them, too!


The British hospital experience

Notes from a patient -- Prof. Brignell. He got prompt treatment only because he had private insurance but even then the NHS did not make it easy

Kafkaesque! That is the word. If you don't know what it means, make an appointment as an outpatient with the British National Health Service. An hour or two in the waiting room is enough to induce that feeling of hopelessness endured by Joseph K. In my case they had taken the trouble to write, bringing the appointment forward by half an hour, but I was still there in suspended animation an hour later than the original appointed time. About fifty assorted human beings sat glum and dispirited, some occasionally whispering to each other with a librarian reverence. In the background, people in various shades of uniform bustled through unseeing, intent on their business. Behind the reception desk women rattled computer keyboards with intense determination.

Suddenly my name was called and I found myself whisked from the large waiting room to a small waiting room. There was no silence here. A very large Irish woman was regaling the reluctant company with an account of her recent experiences as an inmate, including details of biological functions we would rather not know about. After another half hour, a woman approached me and said "The registrar has looked at your notes and has decided to let you see the consultant." Perhaps welcome news, except that it was the consultant who had asked me to come back and see him ten weeks after the first examination. People came and went. I waited.

It was quite different once I penetrated the inner sanctum. The consultant was urbane and gentlemanly, radiating that cultivated assurance that we used to expect of our medical advisors. He recommended that I have a course of intravenous antibiotics, but we would have to wait for a hospital appointment, as it should commence under observation in case there were any reactions. I mentioned that I had managed to retain sufficient medical insurance to cover hospital admission, so he left it with me to make the appointment. When I phoned BUPA there were no problems and a bed was found for me for the following weekend.

The difference! When you approach the NHS hospital, the first thing you see is a large yellow notice with ominous black capitals announcing THIS IS A WHEEL-CLAMPING ZONE. Just the thing for people in distress and pain, who have to grope around to see if they have the coins to feed the meter! It induces the same sort of anxiety as a notice I remember from almost forty years before YOU ARE NOW ENTERING THE GERMAN DEMOCRATIC REPUBLIC. The notice at the entrance of the private hospital said "Welcome" and directed you to the car park. Inside, the atmosphere was calm and kindly. What was striking was the obsessive hygiene and asepsis, from another age. Inside and outside each patient's door were dispensers for alcoholic hand rubs, which visitors were encouraged to use. Despite the occasional puncturing it was actually a pleasurable experience.

My local GP practice had volunteered to carry on the injections, so the consultant had arranged that I would pick up the antibiotics at the town pharmacy and take them in. I received a phone call to say that the pharmacy had discovered that it was not licensed to handle those particular antibiotics and would I drive back to the hospital pharmacy (a three hour round trip) to pick them up? Five days of injections went smoothly, but hanging over me was that threat of the unknown - THE WEEKEND. Don't worry, I was told, just phone one of these numbers and arrange an appointment with the out-of -hours service and we will give you the kit of parts to take with you.

Hello, is that the out-of-hours service?


I would like to make an appointment for some intravenous injections.

How did you get this number?

I was given two numbers and the first one did not work.

This is an administration number, you are not supposed to have it.

What would happen if I had used the other number?

It would come to the same place, but that is not the point.

I would like to make an appointment for some intravenous injections.

Well you can't. The system does not work like that. You will have to phone on the day.

I went back to the local surgery and the receptionist kindly arranged the appointments for the Saturday and Sunday. Fortunately, the appointments were in nearby Shaftesbury, at a local cottage hospital of the sort that the Government is trying to close. It was charming and, above all, clean, even having a hand-rub dispenser on the waiting room wall.

The professional staff were kindly and efficient, indeed magnificent. This is not just a ritual nod of politeness. These people, fully aware that they are working in a mad system, still manage to maintain and integrity and dedication that is a wonder to behold. As the intravenous injections are a slow business, there was an opportunity for conversation, during which I elicited some interesting remarks:

Reorganisation is the norm in the NHS.

The rules change so often that nobody actually knows what they are.

The trouble with the big hospitals is that the cleaners are no longer part of the team, as they were in matron's day, and anyway they can barely communicate in English.

It takes an intellectual to be really stupid: "A third of women graduates will never have children, research has concluded. The number of highly educated women who are starting families has plummeted in the past decade, according to findings that provide the most detailed insight yet into education and fertility. While some women are making a conscious decision not to have children, others are simply leaving it too late after taking years to build their careers, buy a home and find the right partner. Graduates who do become mothers are having fewer children, and later. If the low birth rate trend continues, then the eventual rate of childlessness among graduates now aged in their twenties is likely to be even higher than a third".

No comments: