Saturday, May 30, 2009

SCOTTISH CLIMATE DELAYERS

ATTEMPTS to toughen carbon emissions targets were rejected by MSPs yesterday. Liberal Democrat MSP Alison McInnes called for Scotland's climate change laws to include a target of 3 per cent annual emissions reductions. This was rejected by members of Holyrood's Transport, Infrastructure and Climate Change Committee.

As the climate bill stands, the draft laws will only bring in annual 3 per cent reduction targets from 2020.

Campaign group Stop Climate Chaos Scotland said the lack of early action in the current draft legislation "put at risk" hopes that it would be "world leading".

MSPs also voted against an amendment by Green MSP Robin Harper to increase the 2050 target for emissions reductions from 80 to 90 per cent.

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Woman deliberately left in burning car by Muslim boyfriend

In the usual way, the newspaper makes no comment on the origins of Waqas Arshad but you don't have to know much to recognize it as a Pakistani or Indian Muslim name. There are many such people in Britain as a result of the negligible immigration controls in recent years. Waqas Arshad seems to have been quite a piece of work, starting out with drunk driving and driving while uninsured. I am sure Miss Brady's family wish that British immigration had been more selective in the past. I literally cannot imagine an Englishman behaving the way this piece of slime did

Waqas Arshad, 24, crashed into a tree but told emergency services there was nobody inside, despite knowing 17-year-old Emily Brady was trapped in the burning wreckage. Yesterday, Miss Brady's mother Patricia said: 'It was despicable behaviour to make no attempt to try and pull her out of the car.' It was only as firefighters tackled the blaze that they realised the teenager was in the car, still strapped into the passenger seat.

Arshad, of Luton, pleaded guilty yesterday to causing death by careless driving while over the alcohol limit, and causing death by driving while uninsured.

Speaking outside Luton Crown Court today Mrs Brady, 48, said the family were shocked at hearing Arshad had left his girlfriend in the car and made no effort to help her. She said: "Emily lost her precious life on November 2, changing forever the lives of those of us that love her. This was a community tragedy." She said Emily was a full-time student at college, training to be an accountant, and worked on Saturdays at Sainsburys.

'There is a very good reason why drinking and driving is illegal - the consequence is there are many victims,' she added. 'Emily lost her life so horrifically, there are many years of pain ahead. I will never recover from this enormous loss, her terrible absence will be with us until we die.

'However, I am shocked and distressed to learn at this hearing that Waqas Arshad denied she was in the car, made no attempt to rescue her, and in fact lied to the emergency services that she was in the car, trying to conceal her body.'

Natalie Carter, prosecuting at Luton Crown Court, told the court Arshad lost control and crashed into a tree in Eversholt, Bedfordshire, at 3am on November 2 last year. But instead of calling for help, he got out of the car and did nothing. Mrs Carter said: 'After the collision it's plain that Emily Brady was in the passenger seat; the defendant in the driver's seat. 'She did not die as a result of the injuries received in the collision, which included two broken vertebrae, but she died as a result of carbonisation.'

The court - packed with relatives of Miss Brady, who lived in Dunstable - heard how firefighters answering a call from a witness asked Arshad if there was anyone in the car. He told them 'no'. The couple had been together for about six months and had been out drinking together that night. It had been raining and the road surface was wet. Mrs Carter said Arshad had failed to negotiate a right-hand turn on the country lane and crashed into a sycamore tree. The vehicle eventually came to a halt in a field and caught fire. She told the court that both had been wearing seat belts.

Yesterday, Judge John Bevan QC told Arshad a prison sentence was inevitable. He adjourned the case and remanded the defendant in custody until sentencing on June 19. The court also heard that Arshad had been arrested for drink driving while on bail following the incident.

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Surgical stockings ‘don’t prevent blood clots in stroke patients', but have nasty side-effects

Another instance of theory-based medicine doing more harm than good

Surgical stockings commonly given to stroke patients to prevent blood clots do not work, a new study suggests. Doctors have found that the compression stockings have no effect in preventing deep-vein thrombosis (DVT) — a life-threatening form of blood clot that can travel up into the heart or lungs — in people who have suffered a stroke. Research carried out by a team from the University of Edinburgh suggests that cutting the use of stockings in stroke units could save the NHS about £7 million and 320,000 hours of nursing time each year. More than 150,000 Britons a year suffer a stroke.

The stockings have been proven to reduce clots in surgery patients, so experts had long thought that the cheap solution might also help stroke patients. About two thirds of stroke patients are unable to walk on admission to hospital and approximately 15 per cent develop blood clots because of this lack of movement.

The Edinburgh team studied more than 2,500 stroke patients in Britain, Italy and Australia. All were treated with routine care, including aspirin and assisted exercise, and half were offered surgical stockings as well. After 30 days, there was no significant difference between the groups in the occurrence of DVT and the patients using stockings suffered more skin breaks, ulcers and blisters than those without. Compression stockings are still recommended for patients who have undergone surgery and for people travelling on long-haul flights.

The results were simultaneously published in The Lancet and presented at the European Stroke Conference in Stockholm on Wednesday. Martin Dennis, Professor of Stroke Medicine at the University of Edinburgh, said: “Until now, the guidelines on the use of these stockings have been based on evidence collected in surgical patients and not in stroke patients. “We have shown conclusively that compression stockings do not work for stroke patients. The national guidelines need to be revised and we need further research to establish effective treatments for these patients. Abandoning this ineffective and sometimes uncomfortable treatment will free up valuable resources in our health services.”

Charles Swainson, Medical Director of NHS Lothian, said: “This research underlines the huge importance of close collaboration between the NHS and universities. “Professor Dennis and his colleagues in Lothian and beyond could prove highly important in making sure that nursing time and NHS money are used more effectively for the benefit of patients in Scotland and throughout the world.”

Ralph Sacco, president-elect of the American Heart Association, who was not linked to the study, said: “We have used these stockings because we assume they work. But sometimes you’re surprised when you find out the truth with a randomised trial.”

The CLOTS (Clots in Legs or Stockings after Stroke) trials are funded by the Medical Research Council, Chest, Heart and Stroke Scotland, the Scottish Government Chief Scientist Office and the UK Stroke Research Network. They are also supported by NHS Lothian.

David Clark, chief executive of Chest, Heart & Stroke Scotland, which co-funded the study, said: “This important research shows conclusively that compression stockings do not prevent DVT for stroke patients and can often have unpleasant side effects. More research like this, which will make a practical and positive impact on the lives of stroke patients, is needed.”

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New cost-cutting NHS guidelines on back pain 'will lead to more surgery'

Thousands of patients could undergo unnecessary spinal operations because of new NHS guidelines on treatments for lower back pain, warn experts. Dozens of hospital consultants say the ‘cost- cutting’ restrictions mean more patients will end up having major surgery. They claim less risky procedures using spinal injections have been wrongly dismissed as ineffective, even though they help hundreds of thousands of patients with chronic back pain each year.

Guidelines issued earlier this week by the National Institute for Health and Clinical Excellence (NICE) set out permitted treatments for patients whose back pain has lasted for at least six weeks but less than a year. They endorsed widespread use of ‘alternative’ therapy, letting patients opt for a three-month course of acupuncture, manual therapy such as physiotherapy, or exercise.

Described as a ‘sea-change’ for back pain sufferers, the guidelines also told doctors not to recommend therapies with ‘little evidence’ to support them, controversially including injections of small amounts of steroids into the back, MRI scans, X-rays and ultrasound. Now, many patients who fail to respond to initial treatment could miss out this intermediate stage and proceed straight to risky spinal fusion operations.

NICE estimates the NHS will make annual savings of £33million on back injections and £11million on MRI scans. However, it will spend £24million extra on acupuncture and £16million extra on manual therapy, making the cost-cutting aspect negligible.

Around 50 specialists belonging to the Interventional Pain Medicine Group of the British Pain Society are writing to NICE, claiming it has dismissed good evidence about spinal injections, which do not cure pack pain but give a period of relief from chronic pain. Dr Ron Cooper, past chairman of the group and a consultant pain specialist in Northern Ireland, said: ‘I have never known so many pain medicine specialists to be so furious. More patients will end up having more expensive surgery, which is unnecessary, risky and has worse results.

‘NICE made it difficult for us to submit evidence to a committee on which there was not one experienced pain physician. [Very suggestive of a non-medical agenda] ‘The guidelines will make us the laughing stock of Europe, Australia and the U.S. where pain specialists will continue to have full access to a wide range of treatments.’ Dr Raj Munglani, a consultant in pain medicine at West Suffolk Hospital, Bury St Edmunds, said: ‘There could be as many as 400,000 patients (a year) who will be eligible for spinal fusion – when it should be a last resort. ‘There is a lot of concern that this is actually a way of banishing waiting lists for some procedures, because they will no longer be available.’ Dr Serge Nikolic, a chronic pain specialist at Bart’s hospital in London, said any savings made from the guidelines would be a false economy if they led to more spinal surgery.

A NICE spokesman said: ‘The guideline sets out... those approaches which either don’t work as well as alternatives, or for which there is little evidence of benefit. ‘The guideline recommends that new research is needed to decide if injections into the back are, or are not, effective.’

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The egregious bloodymindedness of bureaucratic Britain

Bureaucrats have contempt for those they have power over. It was only the intervention of a Member of Parliament that squeezed some semblance of decency out of them. In Britain, yellow lines beside the kerb indicate that parking is not permitted there



Ruth Ducker always legally parks her Volkswagen Golf around the corner from her house, so it came as a shock when she discovered it had disappeared from its spot - and in its place was double yellow lines. Her confusion deepened when Lambeth council claimed to have no knowledge of where her car was.

It took three weeks for the council to admit its contractors were behind the disappearance, and then add insult to injury by telling the 44-year-old graphic designer she owed more than £800 in fines. In fact the car had been carefully lifted out of the way for the double yellows to be painted in Gordon Grove in Camberwell, then replaced on the new restrictions by the contractors responsible. The same day a different set of parking enforcers spotted the 'illegally parked' car, and had it towed away - after photographing it on the newly painted double yellows.

Mrs Ducker had left the runabout without its battery, meaning she knew that it had not been stolen. She said: 'My little VW disappeared a week before Christmas. I had parked for years on an unrestricted stretch about 40 yards from my home. When I returned on 19 December to replace the battery my car had disappeared and yellow lines had suddenly appeared. There’s no way I could have driven onto those lines. 'Initial inquiries with the council found no trace of the car. It was three weeks before I received my first official notification.'

It took a further two months and the involvement of her local MP Kate Hoey to make the council back down and waive the fines, which by now totalled £2,240. 'What they did was disgraceful,' said Mrs Ducker. “I’m very grateful to my MP. When I saw the photos of my car on the yellow lines I was furious. 'I knew that to pay up would be an admission of guilt, so I decided to fight them. But I didn’t get the car back until the middle of February and they offered a paltry £100 to compensate for lost road tax, insurance and inconvenience. Needless to say I still haven’t received a penny.'

In a letter to Ms Hoey the council said contractors had told them the 'vehicle may have been lifted in order to facilitate the painting of lines' and admitted residents had not been advised of the planned work. The letter also confirmed that penalty notices were not due to be issued until the day after Mrs Ducker’s car was removed. Lambeth council blamed a 'breakdown in communication' between its contractors and has now offered Mrs Ducker £150 compensation.

A council spokesman said: 'This was an unacceptable case and when the council became aware of it we acted to cancel all the charges. We are very sorry for the distress this has caused Mrs Ducker. 'We have raised the case with our contractors in order to avoid something like this happening again in the future. While one case like this is one case too many, this is very much an isolated incident, and all our figures show that in general parking is becoming fairer in Lambeth.'

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Teaching to get the best out of a child: is streaming or mixed ability the best way?

How best to teach children is a question which few people agree on - even though parents, teachers and children would benefit from a definitive answer. One issue which does keep cropping up is whether to set children by ability or to teach them all together. This is a topic on which there is strong disagreement.

On Women's Hour last week, Professor Jo Boaler talked about how she is in favour of mixed ability teaching for her subject, maths. She then followed this up, summing up her thoughts in a letter to the Times where she stated: "The highest maths-achieving countries in the world — countries as diverse as Finland and Japan — teach all students to high levels and communicate to all students that they can do well in maths. In England we do the opposite and assign young children to low groups, which we know they never get out of. We then lament the fact that millions of school children leave school unable to use basic mathematics. Teachers may tell you that it is better to divide children into different levels in order to teach them well, but the reality is that it is easier for teachers to divide and label children in such ways."

I spoke to Professor Boaler this morning to confirm whether she believed in mixed ability teaching for all subjects. She said she did, and is passionate on this subject, particularly when it comes to primary aged pupils. Younger children, she says, should never be grouped by ability. It just turns the ones put into lower ability groups, off learning.

It's ironic that the day I heard Professor Boaler speak on Women's Hour was the same one when I met up with Shadow Schools Minister Nick Gibb. He strongly disagrees with mixed ability teaching, suggesting that even in primary schools "there is some benefit in having separate classes for early literacy and potentially for maths." When it comes to secondary school, he thinks that every subject should be streamed. He also believes that this will help all children. "We believe that every academic subject - including history and geography - should be set by ability in comprehensive schools in each year group," he said.

Mr Gibb refers to research, particularly by Kulik, to back up his point. He also says that the key is to tailor the curriculum to the ability level and that when this happens, there are huge increases in educational attainment amongst the more able pupils and no falls in achievement lower down. He even argues that you see a small RISE in self esteem amongst the least able children and a small fall in self esteem amongst the most able children.

"I also believe that the better and more experienced teachers should be asked to teach the least able sets, which should also have smaller class sizes," he says. "In this way, not only are these children given the space and time to learn they will also have very able teachers. Much research on setting highlights the fact that the lower sets often have the weakest teachers. This is an indictment of the schools involved in the research rather than an objective critique of setting."

It's a fascinating argument. Many private schools use setting and streaming, and so did a lot of state schools in the 70s. It then went out of fashion, but has been used more often in recent years. Many parents of brighter pupils are strongly in favour, as they want to see their children "stretched". How best to do this is a moot point.

I think that people's views on setting depend hugely on which set they were in at school. Those in the bottom sets often argue that it made them feel stupid, and inclined to give up on a subject. Research has suggested that those in the lower sets do lose out in terms of self-esteem, while those in the higher sets benefit. Meanwhile those in the top sets often say they felt inspired to carry on achieving, and were pushed by being surrounded by very able peers.

Both these responses are interesting because they suggest that setting might be good for more able children, and not for the less able. However, Nick Gibb argues that all children benefit from being separated according to ability, as long as they are taught well, and as long as the sets are "fluid." Meanwhile Professor Boaler argues that mixed ability teaching benefits all, including the brightest, as long as it is done properly.

"It's not okay to expect all children to do the same work in these mixed ability groups," she adds. "They need to work at different levels, which is hard for the teacher, but means that achievement levels go up massively."

There has, of course, been a great deal of research into this issue. "Complex instruction" which mixes children of all abilities so that they can help each other, has recently been reported to be a success. Professor Boaler is the woman pioneering this in the UK, and found her experiences of it in the US to be a fair and impressive way of teaching. But the subject is still controversial, and as with so many issues, there seems to be research to prove each side....

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