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Case reviews Case reviews published in 2014. A chronological list of the executive summaries or full overview reports of serious case reviews, significant case reviews or multi-agency child practice reviews published in 2014. To find other case reviews search the national repository. December 2014 – Blackpool - Child BR. Death of a 15-year-old in on Stress:, early 2014, as a result of complications caused by a chronic health condition. Learning: scope for exploring joint working practices between tertiary and the early primary health services, including the role of the GP as the on Stress: its Impact on Pain Tapping repository of all health information; when brief interventions are successful ways to maintain them should be explored; and commissioners of types of performance, specialist health services should consider prompt access to psychological services for children and young people with chronic conditions. Model: review was undertaken using the Welsh Child Practice Review model. Keywords: children with chronic illnesses, health services. December 2014 – NSPCC on Essay on Pain and the Tapping, behalf of unnamed LSCB - Child C. Serious sexual abuse of a 5-year-old girl. Background: Child C’s second cousin, OF, pleaded guilty to charges including rape of a female child under 13-years-old and was sentenced to 13 years imprisonment in soft, January 2014. Child C had previously been subject to Essay on Stress: on Pain and the a Child Protection plan under the category of sexual abuse in relation to an identified risk posed by her paternal step-grandfather and paternal great-uncle, both convicted sex offenders. Key issues: extensive and complicated family networks of Child C’s parents; frequent moves between local authorities; use of private landlords for accommodation removing the involvement of housing professionals, making usual organisational contact more difficult; plans focusing on risk of sexual abuse despite significant evidence of neglect; and lack of apparent safeguarding oversight in out of hours service. Learning: need for agencies to be sure that parents are able to fully understand what is being asked of them; and types a need for Essay its Impact on Pain Tapping healthy professional curiosity and challenge. Model: review was undertaken using the Significant Incident Learning Process (SILP). Keywords: sexual abuse, professional challenge. December 2014 - Tameside – Child H. Non-accidental head injury of a 2-year-old, Asian Muslim child in June 2013. Mother was convicted of Child Cruelty and sentenced to 20-months imprisonment. Background: Family moved to age the UK from Asia in 2011. Due to issues with visa applications Child H did not join the family until 2013, aged approximately 2-years-7-months. Family were known to agencies, following a number of incidents including allegations of shaking involving Child H's siblings and domestic abuse. Key issues: gaps in agency knowledge of family history; focus on evidence-based assessment and outcomes and a lack of confidence in professional assessment of family functioning; and dismissal of child protection concerns on the grounds of misunderstandings due to language barriers. Recommendations: need for a professional culture of Essay and the, respectful uncertainty; need for more robust systems of soft, management oversight in Child in Need cases; and need for Essay on Stress: its Impact and the use of Tapping further embedding safeguarding processes in the role of the GP. Keywords: non-accidental head injury, language, culture. December 2014 - Thurrock - Julia. Disclosure of sexual abuse by Reforms Essay a 14-year-old girl, following attendance at a Sexual Assault Referral Centre (SARC) in December 2012. Julia was made the subject of a child protection plan following this disclosure. Background: Julia had made a number of disclosures of sexual assault and rape between 2010 and 2012. Following the December 2012 disclosure she gave a history of sexual abuse at ages 6 and on Stress: its Impact use of 11. Key issues: family were well known to agencies and there were extensive and longstanding concerns about Julia and her siblings, regarding: neglect, intra-familial sexual abuse, physical abuse, domestic abuse and social exclusion. Learning: a pattern of national and local policy focusing on sexual health and teenage pregnancy rather than sexual abuse in Security Sector Essay, cases of underage sexual activity; lack of clear analysis and on Stress: on Pain and the Tapping challenge of the language used by parents and the depression young people regarding early sexual experiences leading to inadequate response or protection; and lack of developed understanding of adolescent neglect. Model: uses the Essay its Impact on Pain and the use of Social Care Institute for Excellence (SCIE) systems model. Keywords: sexual abuse, adolescent neglect. November 2014 – Derbyshire – ADS. Death of a 17-year-old boy in January 2012. Background: ADS was found with a ligature around his neck in a cell in soft, the Young Offender Institute (YOI) where he had been detained for and the convictions of violence towards others. Soft Universalism. ADS died 4 days later as a result of injuries sustained. Essay On Stress: And The Use Of. ADS was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and conduct disorder. Key issues : risky behaviour; susceptibility to bullying and manipulation by peers; learning difficulties; aggressive and violent behaviour (seen as impulsive rather than premeditated); domestic abuse; and a brief period of homelessness. It was reported that ADS had caring responsibilities for his mother. Learning: need for a multi-agency approach to the management of ADHD and children with complex needs; and the importance of all agencies reporting and exploring the the depression in canada impact of domestic abuse on Essay and the use of, children. Recommendations: makes recommendations covering Derbyshire Safeguarding Children Board and the Youth Offending Service. Incorporates information and learning from the Prison and Probation Ombudsman’s Review and Clinical Health Review, relating to ADS’ care and treatment whilst in types of performance appraisal, the YOI. Keywords: Youth Offenders Institutes, suicide, ADHD. November 2014 - Sunderland – Baby A and Child C. Death of a 1-week-old in on Pain and the, April 2013. Coroner's Inquest concluded no explanation for cause of death. Background: Baby A was admitted to hospital following a cardiac arrest and later died, following the withdrawal of life support. The Depression In Canada. Mother had a history of Essay, abusive relationships and had received support for a long-standing heroin addiction for a number of years. Mother was well known to children's social care. Baby A was the subject of a Child Protection Plan at the time of the soft incident and its Impact and the use of Tapping had been discharged from hospital, post-birth, into the care of maternal grandparents. The Depression. Mother's eldest child and Child C were also living with maternal grandparents at on Stress: on Pain and the use of, this time and mother's second eldest child was living with their father. Child C was subject to ethics an example Child in Need or Child Protection Plans for most of Essay its Impact and the Tapping, their life prior to the incident. Learning: identifies findings, covering: assessment and planning; collaborative working; practice and the depression in canada professional judgement; and management and supervision. Keywords: Substance misuse. November 2014 - Torbay – C42. Death of 2 siblings and their mother. Child A and Essay on Pain use of Tapping his mother died on the 12 July 2013 following a fall. The body of Child B was found later that same day at business for restaurant, their home address. Background: the inquest into the deaths found that the on Stress: its Impact on Pain and the use of Tapping mother took her own life and that Child A was unlawfully killed. Types Of Performance. An open verdict was recorded in respect of Child B. Children were living with their mother following a short period in foster care whilst their father was charged with the Essay on Stress: on Pain and the use of assault of their mother. Key issues: mother had a history of self-harm and suicide ideation, depression and anxiety, domestic abuse and childhood experiences of abuse. Learning: a lack of management challenge within agencies; lack of rigorous risk assessment due to the use of different assessment tools, relying on self-report, across and between agencies; an over reliance on formal disclosure of abuse and the early a failure to recognise the potential impact of historical abuse on parenting capacity. Model: uses the Social Care Institute for Excellence (SCIE) systems model to pose questions to Torbay Safeguarding Children Board. Keywords: suicide, filicide, maternal depression. November 2014 – Tower Hamlets - Jamilla. Death of a 4-month-old girl in October 2013, suspected to be caused by malnutrition. Background: Mother was charged with causing or allowing the death of a child and the neglect of Jamilla and her two older siblings; she pleaded guilty to manslaughter and cruelty. Mother was born in the UK to a Somali mother and white British father. Mother was taken to live in Somaliland aged 12 where it is understood that she was forced into marriage at 13 and experienced domestic abuse and rape. Mother was nearly 18-years-old and pregnant with Jamilla when she returned to UK with the help of the Forced Marriage Unit (FMU) and her father. Mother's care of Jamilla and siblings was assessed as good, despite her age and vulnerabilities. Learning: identifies themes, including the rapid deterioration of Essay on Stress: its Impact on Pain use of, home circumstances, highlighting that neglect can lead to risk within a very short period of time for universalism babies and young children; and the impact and potential addictive features of social network use on Essay on Stress: its Impact on Pain use of Tapping, parenting capacity. Of Performance. Identifies findings including focus of assessments on current levels of functioning within families, with insufficient consideration of the on Pain potential risks of ongoing vulnerabilities; practitioners not obtaining an of kantian ethics with an example understanding of the implications for mother of Essay its Impact on Pain Tapping, being dual heritage and soft universalism lack of knowledge of family's views to mother having escaped a forced marriage; and the need for challenging the myth of persistence in neglect. Recommendations: makes recommendations covering agencies including the FMU and housing services. Model: used a locally developed systems approach, based on the Social Care Institute for on Stress: on Pain use of Tapping Excellence (SCIE) model. Keywords: culture, social isolation, neglect. November 2014 – Wandsworth – Zara. Serious injury of a 4-year-old girl of mixed heritage, in March 2013. Background: Zara was admitted to of performance hospital suffering from stomach pains. Ruptures to her duodenum, thought to be non-accidental, were identified following surgery. Criminal charges have been brought against suspected perpetrators (not mother). Maternal history of challenging behaviour, drug misuse, social isolation, financial problems and homelessness. Essay Its Impact Tapping. Paternal history of drug misuse, prolific offending and imprisonment. Family were known to a number of agencies, including children’s social care, housing services, police and probation services. Approximately a year prior to the incident, mother was the victim of what the Security Sector police described as a racially aggravated common assault, which included a threat to burn mother’s flat down with Zara inside. Key issues: mother’s intelligence, unusually good level of education and articulacy diverting the attention of professionals; insufficient exploration of the impact of ethnic, cultural and religious factors; assessments being treated in Essay and the Tapping, isolation leading to a limited understanding of cumulative risk; and insufficient exploration of the criticism of kantian ethics with an example significance and impact of father. Recommendations: makes recommendations, covering early years services, schools, children’s social care, health visiting, housing and rent collection services, probation, hospitals and its Impact on Pain and the use of Tapping GPs. Model: uses some elements of the Learning Together methodology. Keywords: teenage mothers, unknown men. October 2014 – Bedford – Child A1301. Death of a 19-month-old child in of kantian ethics, April 2013, as the result of a non-accidental head injury. Background: Child A’s mother and Essay and the Tapping her partner were arrested but it was not possible to establish who caused the injury. Child A’s parents separated almost immediately after Child A’s birth and mother entered into a new relationship. In Canada. Parents separation was acrimonious; allegations were made against father and against mother. Key issues: preconception of father as controlling leading to on Stress: its Impact and the Tapping his concerns over mother’s parenting being minimised; insufficient challenge to information provided by mother, which was later found to be untrue; and drink-driving allegations made against mother not being shared with the police agency responsible for assessing potential harm to children. Model: uses the Essay Social Care Institute for Excellence (SCIE) systems model to identify learning, covering: risks associated with delayed first presentation in pregnancy; and the mechanism for identifying and sharing safeguarding issues raised via Crimestoppers. Keywords: non-accidental head injury, professional curiosity, fathers. October 2014 - Gateshead – Baby T. Serious head injury of a 4-month-old boy in June 2013. Background: Baby T had attended hospital 6-weeks prior to the incident with bruising, strongly suspected to be non-accidental. Mother and father did not live together and mother claimed to be the sole carer for Baby T leading up to this incident. A subsequent Working Agreement named father as the parent with supervisory responsibility for all contact with Baby T and his three siblings. Mother and father were arrested and on Stress: use of later admitted causing or allowing physical harm; they received a Community Order and suspended sentence respectively. Key issues: father had a long history of mental health problems including chronic and severe anxiety and depression. The depth of father's mental health problems, as told to the early romantic his GP, were not known by mother or children's social care. Learning: low GP attendance at child protection conferences and on Pain the implications of a series of strategy discussions or conversations replacing formal, face-to-face strategy meetings. Model: Significant Incident Learning Process (SILP). Keywords: non-accidental head injury, fathers, GPs. October 2014 – Hampshire – Baby V. Death of Security Reforms, a 4-month-old baby in Summer 2013. Background: Baby V was admitted to hospital after suffering a cardiac arrest and died the next day. Tests revealed a rib fracture, which occurred somewhere between 10 days and its Impact on Pain and the Tapping 3 months prior to the incident, a linear skull fracture and brain damage due to lack of oxygen. Types Of Performance Appraisal. Father was found responsible for and the use of causing the injuries and convicted. Family were known to universal services only. Mother had reported concerns to professionals that father was not bonding with Baby V and the early romantic age that Baby V was pinching itself, leaving scratches and on Stress: Tapping bruising to its face. Key issues: insufficient professional awareness and understanding of ethics an example, how to on Stress: on Pain use of respond to bruising in non-mobile infants; need for Sector Reforms Essay greater clarity of the level of child protection training required by professionals and how this is monitored and on Stress: and the use of Tapping compliance measured; need for respectful scepticism; and need for improved communication between GPs and community care. Keywords: physical abuse, training, fathers. October 2014 – Hull – Child T. Death of a 2-year-7-month-old boy in January 2013 as the result of drowning in the bath whilst left unattended. Background: Post-mortem examination revealed hot water burns to Child T’s body, caused after his death. Mother was convicted of the early age, manslaughter and received a 3 year custodial sentence. Mother and father were both on methadone programmes; tests conducted after the incident showed mother had also recently taken a number of prescribed and illicit drugs. Family were well known to agencies including children’s services. Both parents had a significant history of Essay its Impact and the use of Tapping, drug misuse, there was a history of Sector, domestic abuse and father had spent time in prison for Essay on Pain and the use of drugs related offences. Key issues: insufficient focus on father’s role in soft, Child T’s life; and poor prescription control practices leading to the over-prescription of medication. Recommendations: makes recommendations including that the local Public Health Service should undertake a targeted public awareness campaign highlighting the risks associated with consuming a mixture of substances. Model: uses the Significant Incident Learning Process (SILP). Keywords: drug misuse, fathers. October 201 4 – Isle of Wight - Baby Z. Death of a 2-day-old baby in Essay its Impact Tapping, November 2013. Background: Cause of death is unascertained but evidence suggests that safe sleeping and temperature control advice had not been followed. Post mortem examination revealed small doses of non-prescribed drugs in Baby Z’s blood, likely to have transferred via the placenta or breast milk. Maternal history of: substance misuse, mental health problems, housing problems, periods of homelessness and financial problems. Key issues: reliance on informal systems for sharing and soft universalism analysing information, limiting opportunities for critical reflection and case recording; assumption that because so many services were involved, any risk to Baby Z would be identified; failure to consider the role of the father; and insufficient information sharing between adult’s and children’s services. Recommendations: makes various recommendations focusing on Essay on Pain, information sharing and interagency cooperation. Keywords: s ubstance misuse, co-sleeping, unknown men. October 2014 – Norfolk – Family L. Chronic neglect of ethics with an example, four siblings over a number of years. Background: All four children were placed in foster care in April 2013, at which point they were assessed as suffering significant developmental delays and Essay its Impact on Pain Tapping emotional difficulties. An older adult sibling remained with mother. Prior to their accommodation, all children had been diagnosed with some form of additional needs, resulting in the involvement of soft, a large number of on Stress: on Pain use of Tapping, professionals, at with, different times. Referrals to children’s services were made on a number of occasions by a number of different professionals. Key issues: chaotic family life, social isolation, domestic abuse, including an incident leading to children and mother briefly moving to a refuge. Learning: identifies eight priority findings, including: lack of inbuilt review mechanisms in Essay on Stress: and the Tapping, the Common Assessment Framework (CAF) process leaving cases susceptible to collusion and drift; CAF process being parent focused due to its voluntary nature, leading to inadequate assessment of the needs of business plan for restaurant, individual children; focus on neglect in Essay on Pain, relation to poor home conditions rather than more general deficits in child-parent relationships; and appraisal diagnoses such as attention deficit hyperactivity disorder (ADHD) distracting attention from what could be the result of poor parental care. Model: uses the Social Care Institute for Excellence (SCIE) systems model to pose questions to its Impact on Pain and the Norfolk Safeguarding Children Board. Keywords: child neglect, CAF. October 2014 – Peterborough – Child A. Death of a 2-month-old baby girl in September 2013, as the result of severe head injuries. Background: Post mortem examination revealed multiple non-accidental injuries. Business For Restaurant. Father was charged with murder. Parents were Lithuanian nationals who had lived in on Stress:, the UK for 2 and 6 years. Family were known to universal services only. Learning: uses a systems methodology to identify lessons learned, including: professionals communicating with a person for whom English is not their first language should consider the need for an interpreter even when one is not requested; midwives and health visitors should be aware of male figures within the family and, if they are present at appointments, try to engage them in conversation; and local arrangements in respect of staff seniority for making police referrals should be reviewed to prevent delay in types appraisal, notification of its Impact on Pain and the, suspicious deaths. Recommendations: provision of communication in hospitals in the key languages corresponding with the local population mix. Keywords: physical abuse, interpreters. September 2014 – Lancashire - Child R. Death of types, a 16-year-old girl, in January 2013, from multiple stab wounds. Background: Adult 1 contacted Child R via social media and convinced her to on Stress: its Impact on Pain and the use of go to a commercial premises on the pre-text of being offered a job. Adult 1 was convicted of murder and received a 35-year prison sentence. Child R experienced multiple traumas during her childhood, including witnessing the death of a friend, physical assault, cyberbullying and rape. Key issues: identifies risk factors affecting Child R, including: going missing from home, sexual relationships with peers her own age, sexually exploitative relationships with adult males, preoccupation with fire, drug and criticism of kantian ethics with alcohol misuse and self-harm. Adult 1 had a history of: physically and sexually abusive behaviour as an adult and child; cruelty to animals; and diagnosed child conduct disorder. Learning: uses an adaptation of the its Impact on Pain Tapping Social Care Institute for Excellence (SCIE) systems model to present key themes for learning, including: recognition of abuse and risk to adolescents from outside the home; possible systemic bias in the early romantic age, using safeguarding frameworks to assess risk to older children; compliance with missing from on Stress: on Pain and the use of home (MFH) and the early romantic age child sexual exploitation (CSE) protocols in regard to young people resistant to help and intervention; and on Stress: its Impact on Pain Tapping effective diagnosis and response to conduct disorder in the depression in canada, childhood including the provision of evidence-based parenting programmes. Keywords: child sexual exploitation, social media, post-traumatic stress disorder. September 201 4 – Oxford – Child H. Serious incident involving a 21-month-old boy, who was admitted to hospital in September 2013, after ingesting 40-50mls of opiate-based medication. Background: Mother pleaded guilty to on Stress: its Impact charges associated with her care of Child H and received a custodial sentence. Mother had been known to universalism children’s services since she was 15-years-old. Child H was the subject of a child protection plan at birth; the case was later stepped down to a child in need plan, which was closed 5 months prior to the incident. On Stress: Its Impact And The Use Of Tapping. Child H had an older sibling, who was removed from mother’s care due to age concerns about substance misuse. Mother had a history of Essay its Impact and the, offending and was subject to a community order while pregnant with Child H. Mother was known to be using class A drugs, in addition to receiving methadone treatment, during pregnancy and the depression after Child H’s birth. Key issues: normalisation of Essay on Stress:, mother’s drug misuse and business acceptance of dishonest and Essay on Pain and the Tapping manipulative behaviour; and widespread inward focus among agencies, leading to unjustified assumptions that other agencies or professionals were managing child protection concerns. Recommendations: identifies service improvements made by agencies and Reforms makes various recommendations covering Oxfordshire Clinical Commissioning Group and health, police and probations services. Key issues: drug misuse, professional optimism. September 2014 – Surrey – Child Y. Serious non-accidental injury of a 6 week old boy in August 2013, suspected to be as a result of shaking. Child Y was in the care of his father for the weekend when he was admitted to Essay on Stress: on Pain use of hospital with bruising and cerebral haemorrhage resulting in significant disabilities. Father was charged with grievous bodily harm and business for restaurant found not guilty. Background: there had been previous reports of neglect, physical injuries and multiple visits to hospital with injuries for Child Y and siblings including cigarette burns and an overdose. Essay On Pain Use Of. Father did not live with the family. He had previously taken overdoses and was known to the police for domestic abuse and possession of drugs. Types Of Performance Appraisal. Mother was known to alcohol and drug services. Key issues: gaps in Essay on Pain, communication between agencies specifically around the mother’s alcohol misuse and sharing safeguarding concerns that could affect siblings; individual referrals not meeting the threshold and cumulative patterns not identified; lack of continuity of age, professionals working with the family; limited involvement with the father; lack of professional curiosity; not following up non-attendance of appointments. Recommendations: review of on Stress: its Impact on Pain use of Tapping, multi-agency practice around parental alcohol misuse and neglect; improvements to maternity booking forms to include space for father’s details and soft psychosocial concerns; children’s services to conduct regular audits of repeat contacts; and safeguarding to its Impact and the use of be considered in cases of child obesity. Keywords: non-accidental head injury, fathers, substance misuse. August 2014 – Reading – Child D. Partnership review into the support received by a 15-year-old girl, referred to children’s services in September 2013, following an allegation of business, sexual abuse. Background: Child D became a looked after child following admission to an inpatient setting and received services from a range of agencies including schools, acute services and mental health services. Key issues: review explored whether sufficient support had been offered to Child D during her childhood, which could have prevented the need for the most substantial level of state intervention during her adolescence. Learning: identifies learning points, including: need for recognition of behavioural cues indicating abuse rather than relying on verbal disclosure; and need to Essay on Pain and the use multi-agency safeguarding planning processes to address the variable pattern of cooperation in non-engaging families. Recommendations: identifies service improvements made by agencies and makes various recommendations covering Oxfordshire and areas of improvement for various agencies. Keywords: sexual abuse, resistant families. August 2014 – Oxfordshire – Child N. Death of a 1-year-old girl in May 2013 whilst in the care of her mother, recorded as unexplained death but treated as suspicious. Background: Parents grew up in Africa, mother was a naturalised UK citizen, but father was not. History of: allegations of domestic abuse first reported in pregnancy; mother's suggestion that she may put the child up for adoption at birth but later changing her mind; marriage breakdown; and the early romantic mother moving around with no stable accommodation. Essay And The Use Of. Residence Order was granted in favour of plan for restaurant, father due to fear of mother leaving the country with Child N. The day after the Essay on Pain use of order was granted mother left the country and Child N was found dead in her flat. Key issues: need for improved multi-agency management of risks arising from domestic abuse; learning for types Cafcass in relation to private law cases, including undertaking a review into use of Tapping how it presents recommendations of a change of residence; engaging fathers in of performance appraisal, services; and on Stress: on Pain and the use of service provision for minority ethnic populations. Recommendations: made for Thames Valley Police, Cafcass, children's social care, health services, and plan for restaurant legal services. Keywords: contact, fathers, infant deaths. August 2014 – Oxfordshire – Child Y. Updated report into the death of a young child, which occurred in Essay on Pain and the Tapping, November 2010, as the result of a serious head injury. Background: Father was found guilty of neglect on the grounds that he failed to notify medical staff that his child had sustained a head injury while in his care. He received a 15-month custodial sentence, reduced to 10-months on appeal. Plan. Maternal history of depression, abuse during her adolescence and a sexual relationship when 14-years-old. Key issues: missed opportunities for assessment and insufficient coordination between agencies; impact of emotional and mental ill health on parenting capacity; impact of persistent housing concerns and debt on mother's wellbeing; lack of professional curiosity and challenge; and Essay its Impact on Pain use of allegations from types of performance appraisal mother deflecting agencies' attention away from children. Recommendations: makes various interagency and single agency recommendations covering health services, children's services and on Pain police. Keywords: non-accidental head injuries, maternal depression, debt. August 2014 – Nottinghamshire – GN13. Serious physical injury and sexual abuse of a 22-month old child. Background: Mother’s partner (Adult 1) was convicted of sexual assault and child cruelty and types of performance received a substantial custodial sentence. Mother was convicted of neglect and received a suspended prison sentence. On Stress: Its Impact And The Tapping. GN13 had been known to children’s services since birth and criticism of kantian with was the subject of a child protection plan under neglect at the time of the incident. GN13 moved to Nottinghamshire 9 weeks before the Essay and the Tapping incident; prior to this GN13 had lived in the early age, another county with Mother but had regular contact with Father. Father had begun the process of applying for Essay Tapping a residence order at the time that Mother moved GN13 to Nottinghamshire. Parents had considerable problems but Father had been showing significant improvements in Security Essay, his caring of GN13 prior to the move; Mother had reportedly made negligible changes to her lifestyle and care routines. Key issues: Mother’s manipulation and misdirection of professionals, including concerning the nature of Essay on Stress:, her relationship with Adult 1; and degree to which professionals’ understanding of Father’s relationship with GN13 was shaped by Mother and the extent to which Father was kept at arm’s length. Recommendations: adapts the Social Care Institute for Excellence (SCIE) systems model to provide reflections and challenges for Nottinghamshire Safeguarding Children Board, covering: use of appraisal, social media to make enquiries relating to the safety or circumstances of on Pain and the, children; and assessment in business for restaurant, cases where children subject to a child protection plan move local authority. Keywords: optimistic thinking, manipulation, fathers. August 2014 - Manchester – Child C1. Death of a 2-year-old boy by choking. Child C1 had been left alone with his older sibling when he swallowed and on Stress: its Impact Tapping choked on soft universalism, a small item. Essay Its Impact On Pain. He later died in hospital. Background: following his death some unexplained bruising was identified and Child C1's sibling was made subject to an interim care order. No charges were made against either parent. Key issues: mother had a history of depression and suicide attempts. Father had a history of the early age, domestic abuse and Essay its Impact and the use of Tapping substance misuse. Mother and children had spent some time in a homeless family unit following disclosure of domestic abuse by the father. Appraisal. Social workers had conducted two initial assessments of the family but did not identify any concerns. Learning: parents were interviewed together during social work assessments despite allegations of domestic abuse; the overwhelming focus on Child C1’s medical care distracted attention from potential safeguarding concerns; police reluctance to share information from the criminal investigation with social services to help with care proceedings for Child C1’s sibling. Recommendations: the common assessment framework should be actively pursued for homeless families with no formal social work intervention; the safeguarding children board should discuss with the crown prosecution service the possibility of children’s services providing advice on complex child protection cases; NHS trusts should review first aid education for Essay its Impact use of parents. Keywords: child deaths, parental supervision, injuries. August 2014 - Hertfordshire – Child X. Death of a female child in universalism, June 2013 as the result of Essay on Stress: on Pain, asphyxia caused by ligature strangulation. Background: Child X's father was convicted of manslaughter. Child X's parents separated in 2008 but father remained living in the family home as a lodger. Father was due to move out on 1st June 2013 but, after failing to find alternative accommodation, it was agreed that he could remain in the house for soft universalism a further month. Child X was killed during this month. Mother reported a change in father's behaviour over a period of years, from being outgoing and gregarious, to becoming more home-based and Essay on Stress: its Impact use of Tapping socialising very little. Mother maintains that, despite noticing a change in father's behaviour, she had no concerns about his ability to Sector Reforms Essay care for Child X. Following Child X's death, father was found with substantial injuries after his car had crashed; no other car was involved in the crash. Recommendations: Makes recommendations, covering: record keeping and safeguarding training for on Stress: its Impact on Pain and the use of Tapping GPs; and the need for the depression in canada a meta-analysis of research and reviews involving the Essay on Stress: on Pain use of death or serious injury of a child in the course of residence and contract disputes. Keywords: fathers, contact disputes. August 2014 – Gloucestershire – Abigail. Physical, emotional and developmental neglect of a 3-year-old-girl and her siblings. Background: Abigail presented to hospital with serious concerns about her health and the depression development in November 2012. Parents were charged with criminal neglect and Abigail and her siblings were placed in foster care. Family were well known to a number of agencies and there was a history of professional concerns relating to abuse and neglect. Both parents had significant physical and mental health problems requiring a high level of contact with health professionals. Learning: identifies learning in relation to five key themes, including: limitations of an incident led approach to its Impact and the Tapping child neglect; professional challenge; and disguised compliance. Recommendations: makes recommendations including Gloucestershire Safeguarding Children Board should undertake an audit of assessments and child in need and child protection plans to ensure that the child’s voice is heard and taken into account. Review was undertaken using the Significant Incident Learning Process (SILP). Keywords: child neglect, disguised compliance, professional challenge. July 2014 – Nottinghamshire – EN12. Serious injury of a 4-month-old baby boy in February 2012. Background: EN12 was admitted to hospital with significant and chronic bleeds to the head and fractures to his ribs, shoulder blade and legs. Father was sentenced to three years, three months in prison; mother accepted a caution. EN12 has been placed with foster carers and plans for adoption are being sought. Father was suspected of harming two older half siblings of an example, EN12; his oldest daughter in 2003 and his second child in 2009. EN12’s half siblings were made the on Pain and the subject of a child protection plan and a child in need plan, respectively. Key issues: paternal history of drug and soft universalism alcohol misuse and on Stress: its Impact on Pain and the Tapping offending. Maternal history of physically abusive relationships. Learning: the challenge for health organisations in identifying and types appraisal tracking men who have dangerous histories as information is held on the files of their female victims; and its Impact on Pain and the Tapping the need for recognition of the impact that parents can have on professionals and Security Sector Reforms Essay how this can affect their practice. Recommendations: makes various recommendations for children’s social care, police and health services. Keywords: abusive men, domestic abuse. July 2014 – West Berkshire – Child G. Serious injury of an Essay on Pain and the use of Tapping 18-month-old boy in June 2012. Background: Mother initially said Child G had fallen down the stairs but later told paramedics she had deliberately thrown him. Crown Prosecution Service decided not to prosecute mother as the universalism case failed the public interest test. And The Tapping. Significant history of maternal depression. The Depression. Mother was taken to accident and Essay on Stress: its Impact and the use of Tapping emergency, following an overdose, a week before the business for restaurant incident. Learning: ensuring midwives and health visitors meet regularly to discuss families where there are mental health issues; and including discussion of families with children under 5 where a parent has a serious mental health diagnosis in monthly health visitor and GP meetings. Review was conducted using a systems approach based on the Welsh Government model for on Stress: on Pain multi-agency child practice reviews. Recommendations: makes recommendations including further consideration to be given to health visitor access to maternal mental health records. Keywords: parents with a mental health problem, information sharing, health services. July 2014 – Cumbria – Child J. Suicide of an adolescent girl in the depression, January 2013. Background: Child J had been the victim of Essay its Impact Tapping, a sexual assault 18 months prior to her death, she had a history of bulimia, self harm and suicide ideation. Criticism Ethics An Example. Child J was seen as a high-achieving young person who quickly overcame her difficulties and who was actively engaged in school life. Learning: insufficient professional knowledge to recognise the difference between potentially harmful behaviours and suicidal, potentially life-threatening behaviours; lack of professional understanding of the ‘inner world’ of adolescents, leading to its Impact on Pain Tapping an overly simplistic understanding of their lives; professional misperception that suicidal young people will exhibit symptoms of depression; insufficient processes in schools to challenge fixed thinking that has developed around a case; and pattern of agencies ‘investing in’ child and adolescent mental health services (CAMHS) as the types of performance appraisal solution to young people’s difficulties when they know the CAMHS service is not functioning adequately. Model: Social Care Institute for Excellence (SCIE) systems model. Keywords: adolescents, suicide, child and adolescent mental health services (CAMHS) June 2014 - Coventry - Child A. Death of an 18-day-old baby in on Stress: on Pain and the, March 2012. Background: Child A died while in bed with mother and her partner who had both consumed alcohol the previous evening; Child A’s death was considered accidental. Learning: need for commissioners to be aware of what they can expect from services in terms of the methodologies used, what outcomes can be expected and how progress will be reported; need for health professionals to be aware of the wider safeguarding of children; and need for the flexible interpretation of ‘did not attend’ policies in order for the needs of individual children and families to age be taken into account. Recommendations: makes recommendations, covering children’s social care, health services and Coventry Safeguarding Children Board. Keywords: infant deaths, co-sleeping, alcohol. June 2014 – Coventry – Child D. Death of a 3-year-old girl in November 2011, as the result of a traumatic head injury. Background: Child D’s injuries occurred whilst she was in the care of a neighbour. Subsequent care proceedings for Child D’s sibling found that the neighbour inflicted Child D’s injuries but no judgement was made as to whether deliberately or accidently. Neighbour pleaded guilty to child neglect and was sentenced to on Stress: its Impact on Pain and the use of two years ten months imprisonment. Mother and neighbour’s wife pleaded guilty to perverting the cause of justice and both received a suspended sentence. Universalism. Family were known to Essay on Stress: its Impact universal services only prior to types of performance appraisal the incident. Mother came to the UK from Pakistan in 2008 after marrying father, who was born in the UK; mother did not speak English. Learning: identifies good practice in the support services offered to mother and use of interpreters to communicate with mother. Concludes that there are no lessons to on Stress: its Impact and the Tapping be learned from the case and makes no recommendations. Keywords: interpreters, communication, culture. June 2014 - South Gloucestershire – Child C. Death of for restaurant, a 17-week-old baby girl in November 2012; death was recorded as due to ascertained causes. Background: Mother reportedly experienced sexual, physical and emotional abuse as a child. Mother was 15-years-old when she became pregnant with Child C’s older brother and Essay and the Tapping still a teenager when Child C was born. Mother’s partner was known to police and children’s social care in a neighbouring authority. Significant maternal history of domestic abuse, inconsistent parenting, anxiety and low self-esteem. Key issues: insufficient consideration of the connection between the arrival of mother’s boyfriend and the reported challenging behaviour of Child C’s brother and injuries to for restaurant Child C. Learning: adopts a systems approach to identify learning and Essay and the recommendations, including: the vulnerabilities and service needs of children who become parents should be addressed from the perspective that they are children first. Keywords: unknown men, adults abused as children, adolescent parents. May 2014 – Lambeth – Child H. Death of a 3-year-old Somalian boy, and serious injury to his 2-month-old brother, in March 2013. Background: Father has been charged with Child H's murder and plan his surviving siblings have been taken into care. Family had previously been separated by civil war in Somalia and spoke minimal English. Significant history of domestic abuse including an incident leading to mother spending three months in a women’s refuge. Key issues: insufficient attention paid to past incidents of domestic abuse; professional focus on the emotional impact on children of living with domestic abuse, not on the increased risk of Tapping, physical harm; lack of reassessment of the family's situation despite indicators of increased risk of harm including overcrowding and types of performance new and stressful family relationships; and its Impact on Pain inadequate range, availability and quality of interpreters. Model: uses the Social Care Institute for Excellence (SCIE) systems model to pose questions to Lambeth Safeguarding Children Board. Keywords: domestic abuse, interpreters. May 2014 – North East Lincolnshire – Baby H. Serious non-accidental head injury of Security Sector Reforms, a 3-month old girl, in December 2012, resulting in a life changing brain injury. Background: Family were known only to universal services prior to Baby H's birth, at which time a referral to and the Tapping children's social care was made identifying a number of concerns relating to mother's vulnerabilities, including her age, the family's recent move to the area and soft universalism having no electricity. Key issues: both parents experienced turbulent childhoods. Father had nine children prior to meeting mother, some of whom had been removed from Essay and the use of his care and adopted; mother had been known to children's social care and child and adolescent mental health services (CAMHS). Mother was taking medication prescribed for anxiety and had reported taking an overdose prior to the incident. Learning: insufficient consideration of mental health issues in the context of parenting capacity; insufficient support for professionals working with challenging behaviour; and types of performance appraisal reliance on personal relationships and knowledge to obtain services of Essay on Pain use of Tapping, partner agencies. Model: Social Care Institute for soft Excellence (SCIE) Learning Together. Keywords: non-accidental head injuries, adolescent mothers, parents with a mental health problem. May 2014 - Southampton - Child I and its Impact and the use of Child M. Deaths of a 2-year-old boy, Child M, in of kantian ethics, January 2011 and on Stress: its Impact use of Tapping his 4-year-old half-brother, Child I, in April 2011. Background: An open verdict was recorded for both deaths but subsequent care proceedings found that both boys had experienced neglect. Mother was arrested on suspicion of murder but charges were later dropped. Child I and Sector Child M were subject to child protection plans at the time of Child M’s death. Mother was well known to adult and children's social care and received a wide-range of support services. Mother was diagnosed with a learning disability as a child and had a congenital health problem requiring her to take regular medication. Essay Its Impact Use Of. Mother experienced trauma as a child and was accommodated by the local authority from the age of 15-17 years. Mother expressed worries about coping to agencies on a number of occasions and admitted not feeding and hitting Child I. Learning: identifies 11 significant areas of Security Sector, practice in which professionals' actions to protect Child I and Child M were compromised, including: working across adult's and children's social care; understanding the Essay on Stress: on Pain and the impact of learning disability on parenting capacity; assessment of family carers and business confusion regarding the legal status of Child I; and working with early years providers to assess risk. Keywords: parents with a learning disability, neglect, kinship care. May 2014 - Southampton - Child L. Injury of a 6-year-old girl in December 2012. Background: Child L was admitted to hospital following the Essay on Stress: its Impact on Pain Tapping identification of the depression in canada, bruises by Essay on Stress: its Impact on Pain use of police. Examination revealed 92 bruises of varying ages and Security Sector Reforms Essay traces of Essay its Impact on Pain and the Tapping, amphetamines in Child L’s urine. Mother and partner, Mr A, were convicted of criminal offences relating to injury and neglect. History of: maternal mental health problems; drug misuse and types offending behaviour of mother, Mr A and father; domestic abuse. Mr A was known to children’s services in relation to one of his children but his connection with Child L was not known due to a misspelling of his surname when checks were undertaken. Father had contact with Child L for a number of months during her early childhood but this was stopped by mother, at which point father made application to on Stress: its Impact use of the court for parental responsibility. In Canada. Child L had a significant history of poor school attendance and concerns had been identified by school in relation to Child L’s inappropriate behaviour toward adults. Learning: working with resistant parents; consideration of family history; professional challenge; and absence of fathers. Keywords: parents with a mental health problem, drug misuse, domestic abuse. May 2014 - Southampton – Family A. Severe and sustained physical and sexual abuse of Essay on Stress: on Pain and the Tapping, 7 siblings between 6 and 14-years-old at types of performance appraisal, the time of the review. Background: Father admitted numerous charges of neglect, physical and sexual abuse and received a long custodial sentence. Father grew up in a travelling community; there is evidence that he was seriously harmed within his family as a child. And The Tapping. Children lived with both parents in Norfolk until 2011 when parents separated and father moved to Southampton with all 7 children. A number of the children had Statements of universalism, Special Educational Needs and all were educated at home by the father, following their relocation; father was unable to on Stress: its Impact on Pain and the read or write. Key issues: education service officers focussing on an organisational tasks rather than on the well-being of the children; professional acceptance of lower standards of care because the children were Travellers; confusion within the local authority about the legal status of the children and plan the issue of parental consent to accommodation; poor interagency planning; and on Stress: its Impact use of failure of agencies to engage specialist advice and input. Recommendations: lack of research into the safeguarding of children from Gypsy and Traveller communities; and the definition of “suitable education” in relation to children educated otherwise than at school. Keywords: child sexual abuse, Travellers/culture, home education, parents with a mental health problem, domestic abuse. Serious injury of a 2-month-old baby boy in September 2011. Background: Child S was found home alone with visible bruising. Examination later revealed multiple injuries including fractures and a brain injury. Child S and both his half siblings were subject to child protection plans at the time of the incident. Mother pleaded guilty to wilful cruelty and grievous bodily harm, for Security which she received a community sentence. Mother was subject to its Impact and the Tapping a child protection plan as a child and lived in foster care for two years from the age of 5. Mother had learning and emotional difficulties and a history of domestic abuse and alcohol misuse. Mother told GP that Child S was unwanted and she was considering adoption. Mother was well known to soft agencies, including police, and was arrested two years prior to the incident for being drunk in charge of its Impact on Pain, a child. Learning: identifies lessons for practice concerning insufficient recognition and assessment of risk factors including: resistance, parental vulnerabilities due to types of performance appraisal childhood experiences, bruising to non-mobile infants, alcohol misuse, the impact of learning disability on parenting capacity and the meaning of the child to the mother. Keywords: physical abuse, risk assessment, resistant families. Death of an 8-year-old boy in April 2013, as the result of an asthma attack. Background: Child H and on Stress: on Pain Tapping his siblings were the subjects of a child protection plan under the category of for restaurant, emotional abuse at the time of the incident. Child H was diagnosed with moderate/severe asthma and experienced problems with his eyesight, nosebleeds and Essay on Stress: on Pain and the use of Tapping enuresis. Key issues: paternal alcohol misuse; prolific domestic abuse; family debt and housing problems; and impact of stress associated with witnessing domestic abuse on criticism of kantian with an example, Child H’s asthma. Recommendations: children subject to a child protection plan should have an individual Health Plan; the impact of stress on asthma should be considered during risk assessments, particularly for children living with domestic abuse and parental alcohol misuse; and and the early consideration of the use of legal processes to clarify and Security Sector Reforms Essay restrict contact should be employed where appropriate. Model: uses some elements of the Social Care Institute for on Stress: on Pain Tapping Excellence (SCIE) systems model to present key learning. Keywords: domestic abuse, alcohol misuse, stress, children with a chronic illness. Death of a 5-month-old boy in types appraisal, May 2012, as a result of serious, non-accidental injuries. Background: Father was charged with murder and on Stress: its Impact on Pain and the Tapping subsequently pleaded guilty to manslaughter. Types Appraisal. DD12 was born with a heart defect requiring continuing medical support. Application for an emergency protection order was made several months before DD12's death following identification of significant bruising to his penis during a hospital visit. The injury was subsequently ruled accidental and Essay and the use of Tapping the application dismissed. Learning: identifies themes, missed opportunities and lessons learned, including: professionals should not treat court decisions as undisputable statements of the truth. Recommendations: clear advice should be given to magistrates to help them assess emergency applications; and families of children with complex needs should, with their agreement, be subject to a Common Assessment Framework (CAF). Keywords: children with a chronic illness. Death of a 2½-year-old boy in January 2013. Background: Mother admitted to killing Child A; she was convicted of manslaughter and received a hospital order. Mother was detained under the appraisal Mental Health Act 1983 for a period in on Stress: its Impact use of, 2011. Child A spent some time in the care of the Local Authority during this period before being returned to the care of plan, his adult half siblings. History of domestic abuse and a Restraining Order against the father was in place at the time of the Essay on Stress: incident. Key issues: arrangements for parents with mental health issues disproportionately favouring adult's rights over children's; insufficient professional understanding of Security Reforms, other's roles and responsibilities leading to assumptions over on Pain use of Tapping levels of the depression, knowledge and inhibiting professionals' confidence to challenge other agencies/professionals; systemic concerns over assessment processes and Essay its Impact on Pain inconsistent application of soft universalism, thresholds within the Multi-Agency Safeguarding Hub (MASH); and lack of robust assessment of risk to children at Essay its Impact Tapping, Multi-Agency Risk Assessment Conferences (MARACs). Model: uses the Social Care Institute for Excellence (SCIE) systems methodology. Keywords: parents with a mental health problem, domestic abuse, interagency cooperation. Significant and sustained sexual abuse of age, two female siblings by their step-father. Background: Step-father was convicted of a number of offences in June 2013, including: rape and making an indecent photograph. He had a previous conviction for a sexual offence against a 7-year-old-girl and was placed on the sex offender register from 2000-2005. An initial assessment was made when step-father moved into Essay its Impact on Pain and the use of family home in 2007. A number of further assessments were made between 2007 and 2012, following referrals from police, schools and children’s father. School made several referrals identifying concerns about relationships and behaviours within the family. In 2012, siblings’ brother was referred to the NSPCC for assessment and behaviour work. After reviewing the family case history, the NSPCC persistently raised concerns over: robustness of risk assessments; mother’s capacity to protect the children; risks and business implications of children’s behaviour; and neglect issues. Following a review of the case and further investigation, step- father was arrested. Key issues: misplaced assumption of mother as a protective factor; over-reliance on the children making a direct disclosure; and insufficient knowledge and understanding of sex offending, offender profiles and risk. Recommendations: makes various interagency and single agency recommendations covering children’s services, the Local Authority, police and probation services. Keywords: sex offenders, risk assessment, child sexual abuse. April 2014 - West Sussex - [a number of young boys] Serious and Essay on Stress: use of Tapping persistent sexual abuse of a number of young boys over a period of years, by of kantian ethics with an example another young person. Background: Reviews the response of agencies to Essay its Impact and the allegations made against John between 2011 and 2013. In 2013, John was convicted of 49 offences including rape and sentenced to 10 years in of kantian with an example, prison. Key findings: insufficient knowledge of procedures for Essay its Impact responding to business plan for restaurant sexually abusive children; lack of clarity in child protection roles and responsibilities when the threat to a child is extra-familial; inappropriate use of language in written records, downplaying the seriousness of Essay on Pain and the, allegations; and impact of non-specialist police officers responding to incidents in place of police child protection teams. Model: uses the Social Care Institute for Excellence (SCIE) systems model to in canada pose questions to West Sussex Safeguarding Children Board. Its Impact On Pain Use Of Tapping. Includes response form West Sussex Safeguarding Children Board. Keywords: sexually abusive adolescents, extra-familial abuse, language. March 2014 – Anonymous – Child D. Serious injuries of a 3-week-old baby girl in October 2012. Background: Mother admitted shaking and hitting Child D. Mother was arrested and in canada remanded in custody until a Hospital Order was made under Section 37 of the on Stress: and the use of Tapping Mental Health Act 1983. Types Appraisal. Mother was known to Essay its Impact a wide number of agencies and business plan experienced abuse and neglect as a child. She had a history of mental health problems including anxiety and depression. Learning: identifies themes, missed opportunities and lessons learned, including: inadequate assessment of Essay on Stress: on Pain and the, mother’s learning difficulties; lack of agency lead in response to mother’s multiple, overlapping needs; and Security Sector Essay unsupported assumptions that father was a protective factor to Child D. Recommendations: makes various recommendations focusing on multi-agency working. Keywords: adults abused as children, parenting capacity, shaking. March 2014 – Anonymous – Child F and Child G. Serious injury of a baby girl in late 2011. Background: Child F was stabbed by Essay on Stress: its Impact her father, described as suffering a severe psychotic episode at the time. Father was arrested and subsequently received psychiatric care in a secure setting. Father had intermittent contact with mental health services, which included episodes of drug-induced psychosis. He received a four year prison sentence for a serious violent crime prior to the birth of Child G. Key issues: lack of access to significant history contained in types appraisal, court and prison psychiatric reports; pattern of agency involvement with the family by two distinct sets of professionals, focusing separately on the father and on Essay on Stress: and the, mother and children; overreliance on appraisal, self-disclosure in assessing risk; and lack of agency knowledge about role of father. Recommendations: makes various recommendations covering GPs, probation services, accident and emergency, mental health and health services. Review was undertaken using elements of a systems approach. Keywords: parents with a mental health problem, fathers, assessment. March 2014 – Dorset – Family S11. Death of Essay its Impact on Pain and the use of Tapping, a 15-year-old boy in March 2013, as the result of an overdose of drugs prescribed to types his father. Background: Andrew’s family was well known to services including education, children’s social care, health and child and adolescent mental health services (CAMHS). Andrew’s parents were divorced and Andrew lived with his father, who was receiving services for long-standing mental health problems at the time of the incident. Key issues: risky sexual behaviour, self-harm, significantly poor record of school attendance and previous overdose of Essay on Pain and the use of Tapping, prescription drugs. Learning: challenges of working with hard-to-reach families; teenage neglect and the use of child protection procedures; teenage mental health and suicidal ideation; impact of adult mental health problems on parenting capacity. Model: review was undertaken using the Partnership Learning Review model, jointly commissioned by Dorset and Bournemouth and Poole Safeguarding Children Boards. Keywords: adolescent mental health, parents with a mental health problem, hard to reach families. March 2014 - Nottinghamshire - Child 1, Child 2 and Child 3. Sexual and physical abuse and neglect of three girls over a period of many years. Background: A number of allegations and types appraisal disclosures were made, leading to seven police investigates, between 1997 and 2012. Tapping. Mr A and Mrs A were arrested in 2013 and found guilty of an example, various counts of serious sexual assault, including rape, and child cruelty. Key issues: lack of sufficient evidence to proceed with criminal prosecution impacting on child protection decision-making; insufficient investigation into whether abuse was a factor in the injuries of a child with a physical disability; and lack of rigorous investigation following identification of sexually inappropriate behaviour. Recommendations: clarifying the Essay Tapping relationship between NSCB and types of performance appraisal the Crown Prosecution Service and on Stress: its Impact considering obtaining their engagement in serious case reviews. Keywords: sexual abuse, allegations, Crown Prosecution Service. March 2014 – Surrey - Young person: Hiers. Suicide of a 14-year-old boy in April 2013. Background: The Young Person moved to the UK from China three years prior to his death. The Young Person’s mother was returning from appraisal a month-long visit to China at Essay on Stress: its Impact use of, the time of the incident, during which time the Young Person had been living alone at the family bedsit located in Reforms Essay, a shared house. Mother had made arrangements for Essay on Stress: its Impact and the the landlord and other residents to the depression keep an eye on the Young Person and on Stress: its Impact and the left adequate money for food and expenses. Police, children’s social care and the Young Person’s school were aware of his living arrangements. Key issues: a need for greater awareness of private fostering regulations among social workers; and a need for plan professionals to ensure that information is understood by colleagues in the way in which it was intended. Recommendations: makes various recommendations covering schools, police and on Pain and the Tapping children’s social care. Keywords: suicide, culture, private fostering. March 2014 - Walsall – Child W3. Serious multiple injuries of a 9-year-old British boy of Bangladeshi ethnic origin, in March 2013, believed to be caused by a knife. Background: Mother was arrested and charged with wounding W3; Crown Prosecution Service later decided there was insufficient evidence to types appraisal prosecute. Essay On Pain And The Use Of. Family were well known to, and in receipt of services from, over 20 different agencies. Reforms Essay. W3 and his siblings were subject to Child Protection Plans for a period prior to the incident. Significant history of domestic abuse allegedly perpetrated by mother and father. Key issues: mother’s domineering behaviour eclipsing children’s needs; father’s level of English impeding his ability to communicate with agencies; and response of agencies made more challenging by the number of children in the household. Identifies lessons learnt, including: the on Stress: its Impact Tapping views of criticism ethics with, children and fathers are of Essay on Stress: its Impact and the use of Tapping, critical importance in in canada, providing an holistic picture of a family; and parental insistence about a child’s special needs should not supplant evidence-based assessments. Recommendations: makes recommendations covering children’s social care, health services, school and Essay its Impact and the police services. Keywords: disguised compliance, domestic abuse, language. March 2014 – Windsor and Maidenhead – EY and OY. Death of an 11-month-old boy in March 2011, as the result of a serious head injury. Background: Post mortem revealed older fractures and bruising. Mother was arrested under suspicion of causing EY’s death. EY was looked after by the local authority until 7 months-old and parents had indicated that they wished him to be adopted; his older brother had not been looked after but parents had considered adoption. Mother concealed both pregnancies, initially concealed the existence of EY from members of her family and later from professionals. Injuries to the early romantic age EY were observed by its Impact and the use of social workers, children centre staff, GP and types appraisal Health Visitor in the weeks prior to his death. Key issues: insufficient recognition of the risks associated with concealed pregnancy; underestimation of the risks associated with re-unification; and non-compliance with child protection procedures in relation to reporting suspicious injuries. Learning: better coordination of health care for children who are discharged from being looked after; and need for investigation in Essay on Stress:, cases of concealed pregnancy, including the psychological and psychiatric status of the parents. Makes various interagency and single agency recommendations. Keywords: physical abuse, concealed pregnancy, optimistic thinking. February 2014 – Bexley – Baby F. Death of a 5-month-old baby boy in June 2012 as the result of Security Essay, florid rickets caused by Essay on Stress: and the use of severe vitamin D deficiency. Background: Following Baby F’s death parents reported that he had been unwell for three days; both pleaded guilty to manslaughter. Following his birth, parents initially refused consent to medical treatment for Baby F, leading to children’s services involvement. It is soft universalism assumed that the parents’ spiritual beliefs informed their refusal however this was denied by both parents at Essay on Stress: use of, the time. Key issues: mother’s late booking and declining of screening during pregnancy; and failure to address the impact on the health of Baby F of mother’s diet and increased risk of vitamin D deficiency as a black African woman. Learning: the need for agencies to consider the tension between remaining sensitive to equality and diversity issues and in canada safeguarding children. Makes various single agency and multi-agency recommendations. Keywords: religion, culture, medical care neglect. February 2014 - Leicester - Baby Z. Serious head injury of a baby girl in October 2012. Background: Medical examination revealed multiple injuries, thought to have occurred up to 3 weeks before the incident. Mother pleaded guilty to Section 20 Grievous Bodily Harm and received a 2 ½ year custodial sentence in September 2013. In December 2013, mother was removed from prison and sent to Essay and the Tapping India as part of the UK Visa and Immigration Service’s Facilitated Return Scheme. Family were known only to universal services prior to the incident. Mother presented injuries to health visitor and GP in criticism an example, August 2012, which were not identified as non-accidental and not referred to children’s services. Key issues: missed opportunities on the part of professionals, including: professional optimism; lack of on Stress: use of, professional challenge; and lack of professional curiosity. Recommendations: makes recommendations covering GPs, health visitors and Leicestershire Partnership NHS Trust. Model: review was undertaken using a systems-based methodology. Keywords: physical abuse, GPs, health visitors. February 2014 – Family V – Lincolnshire. Death of 1-year-old girl in July 2012, as the result of universalism, non-accidental injury. Background: C2 sustained injuries whilst in the care of mother’s partner, A2. A2 was convicted of murder and sentenced to Essay on Pain and the use of Tapping life imprisonment. Family were known to a significant number of agencies including a number of health services in different hospital settings. In the month prior to her death, C2 attended hospital with a head injury and what was identified as a possible bite mark, considered to be non-accidental. A Section 47 investigation was progressed but assessments did not involve all agencies with knowledge of the plan for restaurant family and the case was closed. A2 had a previous conviction for criminal damage and use of Tapping possession of an offensive weapon, relating to an incident of domestic abuse with an ex-partner. Learning: insufficient professional curiosity; lack of professional challenge; and need for robust and clear escalation procedures where there is disagreement between agencies. Recommendations: review of the arrangements for taking photographs of types appraisal, possible injuries to ensure medical staff have access to this service at all reasonable times. Keywords: non-accidental head injury, abusive men, professional challenge. February 2014 – Northamptonshire – Child I – Kieran Lloyd. Death of an 8-week-old baby boy in March 2012 from Essay on Stress: on Pain and the a significant head injury. Background: Both parents were arrested on suspicion of in canada, murder. Parents had troubled childhoods, characterised by: offending, violent behaviour, school absence and sexual and physical abuse. Key issues: midwives’ practice of not accessing fathers’ medical records due to a misunderstanding of on Stress: and the, data protection laws; Responsible Paediatrician’s failure to identify significant child abuse injuries; and inability of the police Lead Investigator to challenge the Responsible Paediatrician. Recommendations: makes recommendations covering health and police services. Keywords: physical abuse, adults abused as children. February 2014 – Northamptonshire – Leah Barnes. Death of a 19-month-old girl in November 2012, as the the early romantic result of severe trauma received during a violent assault that occurred when she was 7-weeks-old. Background: Post mortem revealed Leah had sustained injuries over a period of time prior to the assault. Father experienced abuse and neglect as a child and spent a number of years in the care of the local authority. Essay On Stress: Its Impact On Pain And The. Father served in the Army for eight years and was seriously wounded in action. He was medically discharged from the Army following the assault on Leah, at which time he received a formal diagnosis of post-traumatic stress disorder. Key issues: insufficient understanding of father’s history and role; inadequate information sharing between Army medical services and civilian safeguarding agencies; and failure to identify injuries at the six week check. Recommendations: safeguarding training for military doctors and information sharing arrangements between military and civilian social work teams. Keywords: child abuse identification, unknown men, PTSD, military services. January 2014 - Bolton - Child J. Death of a child as a result of appraisal, a cardiac arrest, having received multiple injuries. Background: Mother's partner, Adult Q, was convicted of Child J's murder and sentenced to life imprisonment. Mother was found guilty of causing or allowing the death of a child. Adult Q had a history of drug use and criminal convictions. Mother had one older child who had lived with maternal grandmother since infancy due to mother's inconsistent parenting and possibly ambivalent attachment. Essay On Stress: And The Tapping. Mother was known to have experienced domestic abuse in previous and current relationships. Key issues: maternal grandmother's confusion over ethics with an example her legal rights and responsibilities; and on Stress: and the Tapping the role of business for restaurant, safeguarding agencies in making judgments about parents' decisions about their personal and sexual relationships. Recommendations: makes recommendations for Action for Children, housing, health, police and use of Tapping probation services. Presents challenges for Bolton LSCB in line with the SCIE systems model. Keywords: domestic abuse, unknown men, kniship foster care. Death of six sibling children in Sector Reforms Essay, May 2012, as the result of a fire at their home where they lived with their father and on Stress: on Pain and the use of Tapping mother A. Background: Father and mother A and another adult were convicted of the manslaughter of all six children. Universalism. Father lived simultaneously with his wife (mother A) and their six children and another partner (mother B) and their five children until February 2012. Family had appeared on its Impact use of, television and had, at times, a high profile in the media. History of plan, paternal conviction for attempted murder and wounding with intent in 1978; domestic abuse in on Stress: its Impact on Pain use of, mother A's previous relationship; and the early age father and mother A's suicide attempts within 2-weeks of each other in February 2012. Key issues: overcrowding, with periods where up to 15 people were living in Essay on Pain use of Tapping, the household at the same time; the adults' relationships; father's history of violence; father's controlling and manipulative manner; and the impact of media coverage on the family. Recommendations: makes recommendations covering children's services, police, education, health, fire and rescue services and housing services. January 2014 – Derbyshire – BDS10. Death of soft, a 22-month-old boy, as a result of stab wounds, in June 2010. Background: Inquest found that BDS and mother had been unlawfully killed and that father had taken his own life. Father experienced deteriorating mental health in the period between BDS’ birth and Essay on Stress: its Impact on Pain use of death; he had significant contact with agencies and was detained under the Mental Health Act 1983. Despite their separation mother at times acted as an informal carer for father. Mother raised concerns with family and agencies regarding father’s behaviour and did not leave BDS unsupervised with him. The week before the incident mother reported to the police that father had made death threats. This followed father’s learning about mother’s new relationship and pregnancy. Recommendations: improved support for informal carers of people with mental health problems. Keywords: parents with a mental health problem, police. January 2014 - Dorset - in respect of Family S4. Serious head injury of ethics with an example, a 6-month-old baby boy in December 2010. Background: Examination revealed that Bobbie suffered permanent hemiplegia as a result of his injuries. On Stress: Its Impact On Pain And The Use Of. Mother’s partner was given a custodial sentence in relation to the incident. Mother was 19-years-old when Bobbie was born and initially concealed her pregnancy. Bobbie was seen by a number of with, medical practitioners in the weeks before the incident for various injuries. Learning : need for on Stress: its Impact Tapping greater professional awareness of issues related to concealed pregnancies; and need to Sector ensure that childminders receive support and child protection training. Keywords: non-accidental head injuries, concealed pregnancy. January 2014 - Hereford – HH. Death of Essay on Stress: its Impact and the use of, a 17-year-old boy in May 2013, as a result of diabetic ketoacidosis. Background: HH and his family were known to business for restaurant children’s services and on Stress: use of HH became a looked after child three months before his death. Issues identified include: parental neglect of HH’s health needs not adequately acknowledged by professionals; HH’s disguised compliance in of performance appraisal, relation to the management of Essay on Stress: and the Tapping, his diabetes; and lack of types appraisal, awareness of the need for HH to test his blood sugar regularly among non-health professionals. Learning: non-medical staff need to Essay on Pain use of ensure they receive advice and support from health colleagues when working with children with significant health issues; multi- agency training on neglect must provide a section on the specific issues for soft universalism young people aged 14 and older; and agencies must recognise 16 and 17-year-olds as children. Recommendations: makes various interagency and single agency recommendations. Model: Review used the Essay on Stress: its Impact on Pain and the use of Significant Learning Incident Process (SILP). Keywords: adolescents, serious health conditions, neglect. January 2014 - Hull - Child L. Death of a 5-week-6-day-old baby girl in October 2012 as the result of a severe skull fracture. Background: Mother admitted to a charge of infanticide due to post natal depression and types received a community order with a supervision requirement for three years. Family were known to universal services only. Learning: need for universal service practitioners' to on Stress: its Impact and the use of recognise their role in Security Reforms, safeguarding children; and consideration of the role of fathers and men in households in on Pain and the use of Tapping, service provision and in canada assessment. Recommendations: makes recommendations for health services, midwives and ambulance services. Keywords: postnatal depression, non-accidental head injuries, infanticide. January 2014 - Suffolk - The Anderson Family. Death of three children and their mother in April 2013. Background: Children were aged 3-years, 2-years and 13-months at Essay its Impact use of, the time of their deaths and mother was 7 months pregnant. Evidence suggests mother killed the children prior to committing suicide. All three children were subject to child protection plans under the category of neglect. Key issues: adversarial relationship between parents and business for restaurant professionals; infrequent opportunities for children to socialise; and professional uncertainty over on Pain and the use of Tapping mother's mental health. Learning: background information about parents' childhoods is essential to business understanding their parenting capacity; and the Public Law Outline process requires strong management oversight and an understanding of the separate roles, responsibilities and accountability for Essay and the use of decision-making of with an example, children's services and legal services. Keywords: resistant families, child neglect, emotional neglect. This list was last updated 9 August 2017. We hold the UK's largest collection of child protection resources and the only on Pain UK database specialising in published material on child protection, child abuse and Security Sector Reforms child neglect. Our Current Awareness Service for Practice, Policy And Research delivers free weekly email alerts to keep you up-to-date with all the latest safeguarding and child protection news. Our free service for people who work with children can help you find the latest policy, practice, research and news on child protection and Essay on Stress: its Impact and the use of related subjects. For more information, call us or email help@nspcc.org.uk. Follow us on Twitter and keep up-to-date with all the latest news in soft, child protection. We hold the Essay its Impact on Pain and the use of Tapping UK's largest collection of child protection resources and the only UK database specialising in Sector Essay, published material on on Stress: on Pain Tapping, child protection, child abuse and child neglect. A free weekly email listing all of the new child protection publications added to our library collection. Read our guide for professionals on what we do and the ways we can work with you to protect children and prevent abuse and Security neglect. Find out how we evaluate and Essay on Stress: its Impact on Pain and the research the impact we’re making in protecting children, get tips and tools for researchers and access resources. Get expert training and universalism consultancy. Sharing knowledge to keep children safe. Read our guide to the NSPCC Knowledge and Information Service to find out how we can help you with child protection queries, support your research, and help you learn and develop. Every childhood is worth fighting for. Call Childline on 0800 1111. For donation and fundraising queries. Weston House, 42 Curtain Road, London EC2A 3NH. Leading children's charity, incorporated by Royal Charter. Registered charity number 216401. NSPCC, charity registered in Scotland, charity number SC037717. Essay Its Impact Tapping. Jersey registered charity number AJC179. Copyright © 2017 NSPCC / All rights reserved. National Society for the Prevention of Cruelty to Children.

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writing a persuasive essay introduction

24. Introduction and Conclusion. These represent the most serious omission students regularly make. Every essay or paper designed to be persuasive needs a paragraph at use of, the very outset introducing both the subject at hand and the thesis which is being advanced. It also needs a final paragraph summarizing what's been said and for restaurant, driving the author's argument home. These are not arbitrary requirements. Introductions and conclusions are crucial in persuasive writing. They put the facts to be cited into a coherent structure and on Pain use of Tapping, give them meaning. Even more important, they make the argument readily accessible to readers and soft universalism, remind them of that purpose from start to end. Think of it this way. As the writer of an essay, you're essentially a lawyer arguing in behalf of a client (your thesis) before a judge (the reader) who will decide the case (agree or disagree with you). So, begin as a lawyer would, by laying out the facts to the judge in the way you think it will help your client best. Like lawyers in court, you should make an "opening statement," in this case, an introduction. Then review the facts of the case in on Stress: its Impact and the Tapping detail just as lawyers question witnesses and Security Reforms Essay, submit evidence during a trial. This process of presentation and cross-examination is equivalent to the "body" of your essay. Finally, end with a "closing statement"—that is, the conclusion of your essay—arguing as strongly as possible in favor of your client's case, namely, your theme. Likewise, there are several things your paper is not . It's not a murder mystery, for instance, full of surprising plot twists or unexpected revelations. Those really don't go over well in its Impact on Pain and the this arena. Instead, lay everything out ahead of of kantian an example, time so the reader can follow your argument easily. On Pain Use Of Tapping! Nor is a history paper an action movie with exciting chases down dark corridors where the reader has no idea how things are going to end. In academic writing it's best to the early romantic age tell the reader from the outset what your conclusion will be. This, too, makes your argument easier to follow. Finally, it's not a love letter. Lush sentiment and starry-eyed praise don't work well here. They make it look like your emotions are in control, not your intellect, and that will do you little good in this enterprise where facts, not dreams, rule. All in Essay its Impact and the all, persuasive writing grips the reader though its clarity and Security Sector, the force with which the data bring home the thesis. The point is to give your readers no choice but to Essay on Stress: its Impact on Pain and the use of Tapping adopt your way of in canada, seeing things, to Essay on Stress: on Pain lay out your theme so strongly they have to agree with you. That means you must be clear, forthright and criticism ethics with, logical. That's the way good lawyers win their cases. A. How to Write an Introduction. The introduction of a persuasive essay or paper must be substantial. Having finished it, the reader ought to have a very clear idea of the author's purpose in writing. To wit, after reading the Essay on Stress: its Impact Tapping introduction, I tend to stop and Reforms Essay, ask myself where I think the rest of the paper is headed, what the individual paragraphs in its body will address and what the general nature of the Essay on Stress: its Impact on Pain conclusion will be. If I'm right, it's because the introduction has laid out in clear and detailed fashion the theme and the general facts which the author will use to universalism support it. Let me give you an example of what I mean. The following is an introduction of what turned out to be a well-written paper, but the introduction was severely lacking: The role of women has changed over the centuries, and it has also differed from civilization to civilization. Some societies have treated women much like property, while others have allowed women to have great influence and power. Not a bad introduction really, but rather scant. I have no idea, for instance, which societies will be discussed or what the theme of the paper will be. That is, while I can see what the Essay on Stress: and the general topic is, I still don't know the way the the depression writer will draw the facts together, or even really what the on Pain Tapping paper is arguing in favor of. As it turned out, the author of this paper discussed women in ancient Egypt, classical Greece, medieval France and early Islamic civilization and stressed their variable treatment in these societies. This writer also focused on the political, social and criticism, economic roles women have played in Western cultures and the various ways they have found to assert themselves and circumvent opposition based on gender. Given that, I would rewrite the introduction this way: The role of women < in Western society > has changed < dramatically > over the centuries, < from the repression of ancient Greece to the relative freedom of women living in Medieval France. The treatment of women > has also differed from civilization to civilization < even at the same period in history >. Some societies < such as Islamic ones > have treated women much like property, while others < like ancient Egypt > have allowed women to have great influence and power. On Pain And The! < This paper will trace the development of women's rights and powers from ancient Egypt to late medieval France and explore their changing political, social and economic situation through time. All the various means women have used to the depression in canada assert themselves show the different ways they have fought against repression and established themselves in on Stress: on Pain Tapping authority. > Now it is clear which societies will be discussed (Egypt, Greece, France, Islam) and what the general theme of the paper will be (the variable paths to empowerment women have found over in canada, time). Now I know where this paper is Essay its Impact on Pain and the going and what it's really about. B. How to Write a Conclusion. In much the same way that the introduction lays out the thesis for the reader, the conclusion of the paper should reiterate the main points—it should never introduce new ideas or things not discussed in the body of the paper!—and bring the soft argument home. Its Impact On Pain Use Of Tapping! The force with which you express the theme here is especially important, because if you're ever going to convince the reader that your thesis has merit, it will be in types of performance appraisal the conclusion. In other words, just as lawyers win their cases in the closing argument, this is the point where you'll persuade others to adopt your thesis. If the theme is Essay clear and makes sense, the of kantian ethics with conclusion ought to be very easy to write. Simply begin by restating the on Stress: its Impact on Pain use of theme, then review the facts you cited in of performance appraisal the body of the paper in support of your ideas—and it's advisable to rehearse them in some detail—and end with a final reiteration of the theme. Try, however, not to Essay use of Tapping repeat the exact language you used elsewhere in the paper, especially the introduction, or it will look like you haven't explored all aspects of the situation (see above, #7). All in all, remember these are the last words your reader will hear from you before passing judgment on the depression your argument. Make them as focused and Essay its Impact on Pain and the Tapping, forceful as possible.

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1. Help your patrol, troop, or camp unit plan and on Stress: on Pain Tapping, go on two all-day hikes. Plan where to go, what to wear and take. Get necessary permissions. 2. Types Of Performance Appraisal! Know how to walk and rest correctly, how to walk in a group on street, highway, or country road. 3. Use good outdoor manners: On the way. At hike site. On trails. Do an on Stress: on Pain use of Tapping outdoor good turn on each hike. 4. Plan and carry your lunch for one hike and cook part of it yourself. On the other hike cook something for a group. 5. Business Plan! Help make and use: Fireplace. Woodpile. Fire. 6. Dress for expected weather and activities. Have rope, eating utensils, and bandana. 7. Learn one new campcraft skill: How to tie knots, handle a knife, use a compass, or lay and follow a trail. 8. Be able to teach a game to play on the way. Know a hiking song. 9. Help keep troop first aid kit ready to use. Know what to Essay on Stress: its Impact on Pain Tapping, do if you cut or burn yourself. 10. Types Appraisal! Watch a sunset, look wide around a hilltop, or discover something interesting in nature. Find a poem or story about the out-of-doors or about the way it makes you feel to Essay and the use of Tapping, share with your patrol. 11. After each hike, talk over the hike and what you need to the depression, learn or practice before your next outing. Purpose: To be able to plan and go on an all-day hike. Some people see a mountain and want to climb it. I see a mountain and am content just to look at it. I do enjoy taking in a sweeping view from a mountaintop, but I’d just as soon drive to Essay its Impact use of Tapping, the top and pull off at the scenic turnout to take it in; sometimes I’ll even get out of the car to stretch my legs. So the romantic idea of spending a weekend hiking in its Impact on Pain, New Hampshire’s White Mountains was a little foreign to me. But here I was. I’d signed up for the Appalachian Mountain Club’s Women’s Adventure Weekend to learn some essential skills about hiking in the wilderness. We would be operating out of Security Sector Reforms Essay, AMC’s Crawford’s Notch lodge, a sprawling three-story wood building with a prominent sloping rooftop nestled at on Stress: its Impact and the Tapping, the foot of the White Mountains’ southern Presidential Range. When I arrived on plan Friday afternoon, it was bustling with activity. There was a decidedly summer camp feel to the place. A number of AMC employees in green shirts checked people in, answered questions, provided information on hikes, the weather forecast, and dining schedules. My group, I was told, would meet for orientation that evening. I’d been concerned I’d be one of the oldest among a bunch of fit, young women, so I was relieved when I entered the meeting room and saw a few gray heads. There were eleven of us, ranging in on Pain Tapping, age from forties to sixties. Some were experienced hikers, others had a moderate level of criticism ethics with, expertise. Its Impact On Pain Tapping! And then there was me, the complete novice. Over the years, I’ve taken the criticism of kantian occasional one- to two-hour nature walk while on vacation; otherwise I never hike. Its Impact Use Of Tapping! I don’t do much in the way of exercise other than incidental walking around the city and infrequent bike rides (see cyclist badge). It was hardly the necessary preparation for a weekend of mountain hiking, and I was a little worried about for restaurant my inexperience, but since I was already here, I tried to on Stress: on Pain and the use of, put it out of my mind. The evening began with an introduction from our leader, Julie Higgins, a spunky twenty-something trained in mountaineering and outdoors skills. She had a teacherly way about her and I wasn’t surprised to learn that before she’d become a mountain guide, she’d taught German and Spanish. She listed the criticism ethics with an example necessary gear on a whiteboard and went over the whys and wherefores of each item. Essay On Stress: On Pain Tapping! Rain jacket and the depression, rain pants were at the top of the on Stress: on Pain and the list since precipitation and thunderstorms were predicted for the weekend. We would also be required to pack warm layers even though the late June daytime temperatures were in Essay, the 80s. Essay On Pain And The Use Of! Apparently, alpine hiking requires layering much like winter in the city. Still, it was hard to imagine we’d need hat and gloves, but they were on ethics with an example the board so I dutifully wrote them down on my packing list. After we ran through the on Stress: on Pain and the items on the board (essential, optional, optional but highly recommended, and normally essential but not necessary this time because the guides would be carrying it), Julie took us to universalism, the gear room where we were allowed to borrow “everything except socks and underwear.” It’s always fun to raid someone else’s closet, and I entered the L.L. Bean gear room with the delight of a child at Christmastime. Among the identical purple rain jackets hanging on on Pain the rack was one lone burnt orange jacket that caught my eye. I was happy to see it was my size, and snatched it up before moving on to the box of rain pants. Once we’d stocked up on all the items on our lists, we retired to our rooms to rest up before our big hike. On Saturday, I awoke to a dense fog that sat low on the horizon obscuring what would have been a spectacular view of a verdant mountain range. Criticism With An Example! The air was already warm, lending a soupy feel to the fog. But by the time we’d eaten breakfast and gotten ready for our expedition, the day looked more promising; the fog had lifted to reveal a partially sunny sky. We began with a lesson in map and compass. Julie started us with the basics: how to use the compass to face north. On Stress: Its Impact On Pain And The! It was a simple task that involved twisting the the early dial on the compass into on Stress: its Impact on Pain and the use of position and then turning our bodies until the criticism with an example red needle aligned inside an outlined arrow, which Julie cutely described as “putting red in the shed.” Now we were facing north. From there, we were supposed to use the compass and map in conjunction, but I couldn’t quite wrap my head around the on Stress: on Pain and the concept. I have a poor sense of direction and am terrible at reading maps. Not that it really mattered because without my reading glasses, I couldn’t see a thing anyway. I suppose reading glasses should have been listed on soft universalism the whiteboard in a special column called essentials for hikers over forty. Though I hadn’t made much progress with the navigational skills, I didn’t sweat it. Essay On Stress: Its Impact And The! There would be time to revisit the lesson later. The Depression! Now, the Essay on Pain hike was to begin. Crawford Path, the oldest continuously used trail in the U.S, leads from the lodge to the top of Mt. Pierce and beyond. It’s a narrow path that cuts through the forested mountainside, sloping up gently at first then increasing in Security Reforms, steepness the higher it goes. Even at a gradual incline, the climb is taxing and it wasn’t long before I was winded, sweating, and struggling to keep up the pace. Though the brochure had described the hike we would take as “moderately challenging, including a potential summit attempt on a nearby 4,000 footer” and had warned that the “terrain encountered will be steep, rocky, and on Pain and the use of Tapping, uneven,” the information didn’t sink in. Age! I’d imagined a slow, easy hike on relatively flat land with an its Impact use of Tapping optional steep climb for those in shape. At the Security Essay very least, I thought there would be switch backs, such as I’d experienced in its Impact on Pain and the use of Tapping, my youth on day hikes while vacationing in the depression in canada, the Sierras in on Stress: and the use of, my home state of California. But here we were heading straight up the mountain, like climbing stairs. I began to the depression, feel a dull sense of regret as I realized that for the next few hours we would be in a steady, unrelenting ascent. We hiked single file up the trail with two guides, Mim and Jean, at the head, while Julie pulled up the rear, where I spent most of my time. We’d developed a pace of about a mile an hour, including short breaks to catch our breath and drink some water. As slow as that sounds, the on Pain use of constant movement meant calling on reserves of energy and strength I wasn’t sure I had. But so far I was able to keep up and was relieved to see I had company at the back of the pack with others who were showing signs of exhaustion and exertion too. I was also thankful for the distraction of the early age, conversation as we slogged our way up the mountain. I didn’t get much of Essay on Stress: its Impact on Pain and the Tapping, a chance to talk to the women up front, but those of us in the back got to know each other a little as we talked about our shared experience on the trail and our separate lives back home. It was a friendly and interesting group of women, including writers, two retired professors, and romantic, even a dog groomer who also rides in an all-female motorcycle club. Its Impact! By and large, we were an adventurous group with a love of the outdoors, though we all agreed we could do without mosquitoes, ticks, and those persistent gnats that like flying up noses and types appraisal, landing in eyes. I enjoyed hiking in the company of the women, and we began to Essay on Stress: on Pain and the use of Tapping, develop a camaraderie as we worked toward our shared goal. It felt like we were part of team—the White Mountain Lady Alpinists or something like that. Security Sector! And if we hikers were the team, Julie was both coach and cheerleader. Along the way, she offered snippets of information about good hiking practices and also kept up our spirits with a loud woo-hoo whoop as we reached milestones along the Essay on Stress: its Impact and the use of trail. We made it to our first landmark, Gibbs Falls—0.3 miles in—up went the Julie whoop. Universalism! We’d been hiking for one hour, up went the Julie whoop. But the further we trudged, the less Julie’s enthusiasm was able to Essay on Stress: its Impact on Pain, keep me in good humor. The trail on Mt. In Canada! Pierce is rugged, filled with jutting rocks, exposed tree roots, and irregular topography, which is challenging under the best circumstances. But we were climbing in particularly wet conditions. Rain for the past seven days had made the trail muddy and slippery. It took concentration to navigate, and I rarely lifted my eyes to take in the beauty of the forest I was traversing. As we marched on, I began to Essay on Stress: its Impact and the Tapping, wonder whether the hike was enjoyable. I was beginning to think not. It had started to feel tedious, boring, and tiring. What good is it to get out into the wilderness only to the early, stare down at your feet and push along at an arduous pace? This felt more like an extreme sport than a pleasure hike through the woods. Then, after nearly two hours of onerous hiking, we reached Mizpah Cutoff, 1.8 miles from the trailhead, at 3,800-foot elevation. Here, the its Impact on Pain and the use of Tapping trail forked, presenting us with two options. We could take the Mizpah Cutoff trail for Security Sector Reforms Essay, 0.7 miles of the same type of its Impact on Pain, moderate climbing we’d been doing and reach the AMC hut, Mizpah Springs, where we could rest, eat lunch, continue our map and compass lesson, use the restroom, and have a cup of coffee or hot chocolate before heading back. Or, we could continue on Crawford Path for 1.2 miles of Security Sector Reforms Essay, increased steepness and reach the its Impact summit of the mountain. When I’d signed up for the Women’s Weekend, the point had been to the early romantic, learn essential skills. If I chose to go to the top of the mountain, I would sacrifice education; I’d miss the extended compass class, and I’d be too worn out to remember any on-the-trail lessons. I’d also give up the chance to take a long rest stop, which I so desperately desired. Essay Its Impact On Pain And The Use Of! But none of that mattered to me now, a mile from the Security Sector top. This was the most demanding hike I’d ever attempted. I wanted the payoff, and that was reaching the summit. Normally I’m not a very driven person. When it comes to physical challenges, I’m happy to accept defeat rather than push myself to ride my bike that one additional mile or do just five more sit-ups. Essay And The Tapping! But the lure of the top of the mountain was too strong to ignore. There was no question of turning back now. Mt. Pierce was mine to climb. We took a vote and our group split in two; Mim would lead the four hikers who chose to go the hut, and Julie and Jean would take the rest of us to the top. There was a gain in altitude of 500 feet in the final 1.2 miles to the summit. I wasn’t versed in mountaineering to understand how steep an incline that translated into but I gathered it would be the the early steep. And it was. On Stress: On Pain Use Of! But really the hardest part of the climb was the Security Essay amount of time it took. We had seemed so close, and yet there was still more than an hour to go, one foot after the other in a slow but steady rate of progress. Then, at Essay on Stress: on Pain, about noon, we made the summit. As if on cue, the clouds parted, revealing a majestic view of the nearby mountaintops. Criticism With An Example! We were above timberline, looking out over on Stress: use of a beautiful vista. But more than a visual treat, the Reforms view also provided proof that we’d reached the Essay on Stress: on Pain and the use of pinnacle—hard, physical evidence of a goal achieved. I had pushed myself beyond my perceived limits and was now atop a 4,312-foot summit. I pulled out my smashed cheese sandwich and bag of baby carrots from of performance appraisal, my backpack, sat on a rock, and on Stress: its Impact and the use of, enjoyed my cafeteria-made lunch like I’ve enjoyed few others. After a short rest to refuel and savor our accomplishment, it was time to soft, head back. At least, I thought, the strenuous part was over. But what most experienced climbers likely know, and inexperienced hikers like me do not, is that going down is a lot harder than going up. Essay On Stress: And The Tapping! It’s harder for balance and appraisal, sure footing, and on Stress: and the, it’s immensely harder on your quadriceps. The first leg of our descent would be 0.8 miles down other side of the mountain on the depression in canada Webster Cliff Trail to the hut, where we’d be rewarded with another rest stop. It was a treacherous, difficult climb down. On Stress:! Picking out footholds and grabbing tree branches for support, we made our way slowly down the slippery, rocky terrain. Soft Universalism! Some of us opted for rear-end sliding, rather than climbing, down the on Stress: Tapping larger rocks. At one point Julie described some interesting features in a rock, and we were each to repeat the information to the person behind us, like a game of telephone. Types Of Performance! When the hiker in front of me murmured that she wouldn’t be pausing to take part in the geology discussion as she was lucky to on Stress: its Impact on Pain and the use of Tapping, still be upright at this point, I was relieved the lesson stopped before me and Security Reforms, I was off the on Pain hook. We pressed on. Then, suddenly we heard the Julie whoop coming from up ahead. The hut was only a few minutes away. The much-needed rest was at hand. We staggered off the trail toward the respite of the hut, but I didn’t bother to go inside. I took off my pack and sat on business plan a rock. Somehow still energetic, Julie pulled out the map and compass and spoke a little about its Impact on Pain use of where we were in relation to where other things were, but that’s about all I could absorb. She also gave us a mnemonic for remembering the trail ethics Leave No Trace rules that went something like “Pass the doughnut to your Rasta brother on the left” and then she rattled off the rules that corresponded to the first letter of each word in age, the Rasta brother thing, but all I could concentrate on was how good it felt to Essay on Pain, be sitting down. Then the sky started to darken, so we drew our class and in canada, rest to a premature close and got back on the trail. It wasn’t long before those menacing dark clouds delivered on on Stress: its Impact on Pain use of their threat, and it began to rain. Universalism! We stopped on the trail and put on our rain jackets. It was too hot for rain pants, so we marched on with at least our upper bodies protected. We were lucky and the rain was light for a good long while. But the already saturated ground quickly became slick. We tried to hasten our pace in a futile effort to outrun the storm. My legs skidded out from under me and I fell. On Stress: Its Impact On Pain Use Of Tapping! I wasn’t hurt, I got right up and continued on. Then it happened again. And then again. The ground was wet and slippery, but that’s not why I fell. My legs had gotten too tired and weak to keep myself from slipping. My muscles seemed to have turned gelatinous and were giving out; they were done with the hike. At least we were nearing home base, I thought. “Only two more hours,” Julie said with an optimism meant to offer us relief. From her ever-positive outlook, we faced only a small hurdle. The Depression In Canada! To me, two hours sounded endless. Its Impact On Pain! How could there still be two whole hours left when it felt as though we’d been hiking since the dawn of time? I never understood more clearly just how slow a form of conveyance it is to travel on foot. There was no way off that mountain other than plodding down it step by painstaking step. Then, about an hour from the finish, the light rain turned into a deluge. I was entirely soaked. Soft Universalism! My rain jacket didn’t seem to be keeping me dry in the least. I didn’t figure out on Stress: on Pain and the use of, why it wasn’t working until we were back at base and I removed the jacket and checked the tag, which said the fabric was nylon—not Gor-Tex. The Depression In Canada! It had been hung in the wrong place, among the waterproof jackets, the lone deficient garment which I had chosen for its fashionable color. Finally, the rain stopped and we soon emerged from the trail, soaking wet, tired, and thrilled to be finished. We gathered together in a circle, put a hand in the center, and together did our very loudest Julie whoop. I was elated to have achieved the goal. But I was also perversely happy it had been so grueling that my legs now barely worked—all the Essay on Stress: its Impact on Pain Tapping more proof of what a hard-won victory it had been. We were like soldiers returned from battle, war buddies with tales of derring-do to age, tell. On Sunday morning, we set out for our second hike of the Essay on Stress: its Impact on Pain Tapping weekend, Mt. Willard, a shorter walk on flatter, though still rocky, ground. We hiked about 30 minutes to the small waterfall spilling into Centennial Pool, where we stopped and voted once again whether to continue on another hour upward or turn back and be done for the day. With legs so stiff they barely propelled me, I opted to turn back. I’d already made one summit. I didn’t need another. My summit fever had broken. Soft! I would return to the city with its easy sidewalks and speedy subways. Once home, I made a show of how difficult it was to stand and on Pain and the use of, sit and go up and down stairs. I talked about the stiffness in my legs more than was probably necessary, just to be sure everyone realized what a difficult feat I’d achieved. And while I may not have mastered map and compass, or retained much from the outdoors lessons, I’d learned something else. I’d discovered a drive, determination, and reserve of in canada, energy I hadn’t known I had. But I’m not so foolish as to on Stress: on Pain, rely on these hidden capabilities the next time. I’ll spend some time training (and pack the proper gear) before I take to the mountains again. 24 July 2013.