Carbohydrates, fats and type 2 diabetes – are there patterns to be found?

By James Garbutt

When it comes to managing type 2 diabetes, there are lots of extreme diets out there with passionate advocates. Avoid carbs! Reduce fat! Restrict calories! However, researching the effects of diet on health in terms of single nutrient changes can be misleading. We don’t just eat single nutrients such as carbohydrates or fats on their own, we eat all kinds of combinations of nutrients from all kinds of different foods. How we combine all these foods together forms our ‘diet pattern’, and studying the health effects of diet in this more holistic way could offer insight into less extreme dietary management of type 2 diabetes.

What is type 2 diabetes?

For the majority of us, our blood glucose levels are kept in check by our pancreas. When we eat, carbohydrates in our food break down into glucose which then travels straight into our bloodstream. Our pancreas, sensing this increase in blood glucose, releases the hormone, insulin. Insulin, acting like a key, unlocks the cells of our body and shuttles the glucose inside, providing us with the energy we need to go about our day-to-day lives. Thankfully, our blood glucose levels return to normal.

In type 2 diabetes however, the cells of our body stop responding to insulin and our pancreas also stops producing as much. The insulin keys no longer fit the locks. Our body’s inner security systems fail to keep watch over us and our blood glucose levels begin to rise, bringing along for the ride a number of potentially serious complications.

Does diet matter for type 2 diabetes or is it all about weight loss?

Many types of diet have been shown to help blood glucose control in type 2 diabetes. Despite already being the focus of a lot of research, there is still no single diet that appears to win every time. Sometimes low-carbohydrate diets come out on top, at other times, low-fat diets. Very low-calorie diets are currently standard. Many people suggest weight loss is all that matters for improving blood glucose control, so whatever diet you can stick to will do the job. Lowering the amount of any macronutrient in your diet can instigate weight loss because your calorie intake is typically lowered as well. Maybe different diets can improve blood glucose control simply because they happened to help people lose more weight? However, eating carbohydrates (specifically, starches and sugars) does directly increase blood glucose after you eat them and constantly managing a large rise and fall of glucose may be an issue in its own right, regardless of weight loss. I wanted to try to make sense of what is going on here. Is dietary management of type 2 diabetes all down to weight loss or does the dietary pattern you eat matter too?

Using real-world data from people living with type 2 diabetes to find patterns in diet

Using a statistical technique called reduced-rank regression, I analysed real-life data on food intakes to find the best combination of foods (a diet pattern) that could separate people’s diets by the amounts of carbohydrate and fat that they contained. This allowed me to understand how people living with type 2 diabetes consumed foods which make their diets higher or lower in carbs or fats.  Each person receives a score for how much their own diet follows this unique pattern. The most prominent foods in the diet pattern we found were (sized and in order of importance):We named it the ‘carb/fat balance’ diet pattern. Those who had higher diet pattern scores ate more fruit, milk, baked potatoes and beans alongside less processed meat, butter, white bread and chips, which translated into higher carbohydrates and less fat overall. None of the people we studied consumed extreme intakes of fat or carbs, rather intakes remained in the ‘normal’ range typical of diets commonly consumed in the UK. Hence the key word, ‘balance’. Higher scores also coincided with general improvements in diet quality; something which has been independently associated with cardiometabolic improvements in previous research.

Over time the diets we analysed became more balanced, moving closer to meeting UK healthy eating guidelines. We found that people with diets that became a more balanced intake of carbs and fats had better glucose control. Weight loss associated with better glucose control too, but even after we accounted for weight loss a small effect of diet pattern remained. While the improvement to blood glucose control from weight loss vs. diet pattern change was bigger, our results indicate that overall diet still has a role to play.

The conclusion? Weight loss is still king, but glucose control in type 2 diabetes could be improved further by maximising overall food quality and moving towards meeting UK dietary guidelines i.e. a moderate intake of both carbohydrates and fats. Demonising specific nutrients is certainly a simpler message but it fails to account for the complex interplay between different nutrients, foods and eating behaviours on health.

The old adage, ‘everything in moderation’, rears its head yet again.

 


James Garbutt, BSc MRes RD, PhD student in the Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies. This blog relates to his recently published co-authored paper in BMC Medicine: Is glycaemic control associated with dietary patterns independent of weight change in people newly diagnosed with type 2 diabetes? Prospective analysis of the Early‑ACTivity‑In‑Diabetes trial.


 

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“I was pleased to be able to use my learning, and the opportunities the Social Work Masters gave me, to influence future social work practice in my own career and beyond.”

In this blog, we catch up with Flora Miles, a Bristol graduate and newly qualifed Social Worker. She was recently invited to present her dissertation at an event organised by the University of Bath to mark World Social Work Day 2022, celebrating recent developments in practice, activism and research.

Here she talks about the findings of her research along with her experiences of the masters programme:

Flora Miles

After completing my undergraduate degree in Social Anthropology, I wanted to further focus my skills and knowledge towards helping people live fulfilled and empowered lives. I was inspired by social workers who I had encountered through my voluntary experience with charities. The Masters in Social Work at the University of Bristol offered me a great opportunity, building on my previous studies and some experience which I had gained through volunteering. The course was highly rated and I was excited at the opportunity to study in Bristol, which is a city I did not know well before the course and have now become very fond of!

I found the programme varied and engaging. Teaching on a range of topics by faculty members was supplemented by interesting guest lectures. My learning was supported by the knowledgeable and generous members of the service user and carer forum who, through appearances at lectures and in small group workshops, helped us keep service users and carers at the centre of our learning. One of my favourite things about the course was my fellow social work students, who were interesting and friendly people with a breadth of experiences from which I learned a lot and gained treasured friendships.

“Work placements…expect the unexpected and respond with creativity!”

I undertook my first practice placement with Exeter Homelessness Partnership at CoLab in Exeter, where I live. I loved this experience in the voluntary sector, during which I met some brilliant people and learned so much about creativity and resilience. Unfortunately, the covid pandemic began during the early stages of this placement, leading to a change of plans in which my placement was suspended. Luckily, I gained employment as a project worker with CoLab’s Resilient Women project and as a mental health support worker with Rethink Mental Illness. The university supported me to take learning and reflection opportunities from this employment, which allowed me to progress to the second year of the Masters. This was a very challenging time requiring much flexibility and adaptation from myself and the university, but I am proud to say that we got through it and that I gained valuable experiences. A key takeaway for me was to expect the unexpected and respond with creativity!

My second placement was with Devon County Council, in an adult safeguarding team and a community health and social care team. I was pleased to have this experience in a statutory setting, following my experience in the voluntary sector in first year. This placement was invaluable for my learning regarding the principles and processes at the heart of social work in a local authority, where many social workers are employed. I was helped by committed and supportive social workers as my practice educator and supervisor, who were role models to me. This placement was very useful, especially as I have gone on to work for Devon County Council and therefore continue to directly apply context-specific learning gained while on placement.

“My dissertation has stuck with me powerfully, and opened up opportunities…”

One of my favourite parts of the Social Work Masters was writing a dissertation. It was a real challenge but I grew and learned a lot through it. My dissertation was entitled  Mental Capacity in cases of Self-Neglect: A Thematic Analysis of Safeguarding Adults Reviews in England. I became fascinated by topics of mental capacity in adults throughout my studies at Bristol. With the help of my supervisor, I identified that looking at mental capacity in cases of self-neglect would be especially interesting. Having read some Safeguarding Adults Reviews throughout my studies, I wanted to become more familiar with these documents and see what they could teach us.

Three key findings emerged from my dissertation:

  1. People at risk of self-neglect were let down when professionals failed to assess mental capacity
  2. Safeguarding processes failed to protect people who were found to have capacity to make self-care decisions
  3. Assessments needed more nuance and scope to account for the complexity of mental capacity

These findings enabled me to make recommendations for social care practitioners, team managers, policy makers, those involved in the commissioning and creation of Safeguarding Adults Reviews, and researchers.

My learning from researching for and writing my dissertation has stuck with my powerfully, and opened up opportunities. One such opportunity was being invited to speak on my findings at an event to celebrate World Social Work Day 2022 organised by the University of Bath. It was a pleasure to speak alongside other practitioners, researchers, and educators. I am proud of the presentation I gave, having received positive feedback including social work educators asking to share my findings with their students and practitioners telling me that they would use the findings to inform future work with people at risk of self-neglect. I was very pleased to be able to use my learning, and all the opportunities the Social Work Masters gave me, to influence future social work practice in my own career and beyond.

The masters in Social Work at the University of Bristol was challenging, however I am grateful to be the social worker I am today because of it. I would recommend the course to anybody looking to learn a lot, meet passionate people, and take steps into a social work career.

Find out more about our MSc Social Work programme and what makes our joint professional and academic practice award unique.

 

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Understanding ‘rough sex’

This week, Dr Natasha Mulvihill, Senior Lecturer in Criminology and researcher at the Centre for Gender and Violence Research in the School for Policy Studies, is launching an anonymised online survey to investigate experiences of ‘rough sex’.  She introduces here the context and aims of the research.

Photo by Kristin Vogt from Pexels

‘Rough sex’ refers broadly to aggressive physical or degrading acts during sex.  In recent public and popular discourse in the UK, the term has been used commonly in two contexts.  The first is to refer to consenting sexual practices following the Fifty Shades trilogy, published by E.L. James over 2011-2012. The second refers to instances of death, usually involving a female victim and male perpetrator, and commonly following asphyxiation, beating or injuries through penetration.  In the second case, ‘rough sex’ is an inaccurate euphemism, as such acts represent sexual violence, manslaughter and homicide.

Beyond these two examples, lived experiences of ‘rough sex’ may be better understood on a spectrum, with the line sometimes misjudged between consensual rough sex and sexual violence and abuse.

In a research project commencing this week, I am seeking to understand individual experiences of unwanted ‘rough sex’ – however defined by participants – which occurred within the context of consensual sex, but which the participant felt at the time or later was non-consensual, harmful or upsetting. The research invites participants across different identities of gender, age and sexuality and recognises different contexts of sexual relations, including one-off encounters and short-, medium- and long-term relationships. It recognises too, and welcomes comment on, the limitations of the term ‘rough sex’.

The impact of Fifty Shades is disputed.  It is celebrated by some for catalysing popular acceptance of, and engagement in, consensual BDSM (bondage, dominance, sadism, submission, masochism); and by others castigated for promoting unsafe practice, commodifying and mass-marketing kink, and sexualising an essentially abusive relationship (see, for further discussion, Bonomi et al, 2013).

Downing (2012) argues that the non-sexual behaviour of one of the book’s protagonists, Christian, is far more “sinister” (2012, p.99) than the exposition of what happens intimately between the couple.  She is concerned here to separate sexual practices from normative assessments of character: a fair concern given how, historically, society has stigmatised sexual activity which falls outside of a heteronormative and reproductive template.  Yet from a coercive control perspective, it could be argued that the protagonist’s sexual behaviour is entirely consistent with his wider techniques of emotional, psychological and physical control. So, the insight here is that it is not what happens within a relationship or encounter, so much as what it means to each of those involved – albeit recognising from inside when behaviour is harmful, rather than as an external observer, is not always easy.

The second context relates to where the defendant in a criminal trial claims that a victim’s death occurred through sexual ‘misadventure’ or ‘accidental injury’. The campaigning group We Can’t Consent to This and the Centre for Women’s Justice have been at the forefront of documenting the stories of victims, and seeking a change in the law to ensure that perpetrators of sexual violence cannot retrospectively represent their harmful actions as consensual ‘erotic play’.  Campaigning and research led to specific amendments to the Domestic Abuse Act 2021 (England and Wales), namely:

  • Section 70 of the Act makes non-fatal strangulation an offence in its own right
  • Section 71 of the Act states that “it is not a defence that the victim consented to the infliction of the serious harm for the purpose of obtaining sexual gratification”

It remains to be seen how effectively these offences will be enforced in practice or whether sexual violence packaged as ‘rough sex’ (or the threat of repeating previous episodes of rough sex) is sufficiently recognised by police and prosecutors as part of the repertoire of perpetrators of coercive control (Weiss and Palmer, 2022).

It is likely that experiences of unwanted rough sex broadly are reasonably common and under-disclosed.  Indeed, in 2019, a BBC survey revealed high prevalence, particularly in the female under 40 age group, and low police reporting.  In common with other sexually harmful experiences, disclosure may be inhibited by embarrassment, shame and confusion about what happened, especially when it occurs within what began as a consensual encounter.

While there is some evidence to suggest that exposure to sexually explicit material online is associated with either a desire to, or an engagement in, ‘rough sex’, the directionality and nature of the relationship continues to be disputed (see, for example, Vogels and O’Sullivan, 2019), as does the assumption that individuals will, through ongoing exposure, come to conflate consensual rough sex and sexual violence. The consumption by young people of sexually explicit material which mainstreams rough sex practices is thought to be a more compelling concern, since their sexual scripts are still in development (see, for further discussion, Wright, Herbenick and Tokunaga, 2021), including their understanding of active and ongoing consent.

Using an anonymous online survey, this research study therefore aims to understand:

  • The experiences and contexts of unwanted ‘rough sex’, where study respondents feel, either at the time or subsequently, were harmful to them, physically, sexually or psychologically
  • The impact of that experience(s)
  • Whether, why (not) and how respondents sought support, advice or justice for what they had experienced and what happened next?
  • The respondents’ broader feelings about ‘rough sex’, its nature and prevalence
  • What respondents would like to see in terms of, for example, political, media, criminal justice, cultural or educative interventions, to both prevent future harmful experiences of unwanted ‘rough sex’ and to secure accountability or recognition for what happened to them

It is hoped that this work will inform work with police and criminal justice professionals and practitioners working in support services, including with young people and the production of free online briefings to raise awareness and improve practice.

Participation in the survey is entirely voluntary and can be completed by anyone aged over 18, although participants may refer to experiences under 18.  It is open from Monday 7 February 2022 to Friday 29 April 2022.

https://sps.onlinesurveys.ac.uk/experiences-of-rough-sex


For further information, please contact the lead researcher: natasha.mulvihill@bristol.ac.uk Updates on this project will over 2022-2023 be signposted from here.


Sources of support:

https://rapecrisis.org.uk/

https://www.womensaid.org.uk/

https://www.survivorsuk.org/

https://www.switchboard.org.uk/


 

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Lockdown saw couples share housework and childcare more evenly – but these changes didn’t last

Halfpoint/Shutterstock

Susan Harkness, University of Bristol

It may feel like a common occurrence today, but if you cast your mind back to the first COVID lockdown, having whole families working and studying from home was a very unfamiliar situation. And it was one that had unfamiliar consequences.

For opposite-sex couples, lockdown disrupted the traditional gender division of household chores. In research that my colleagues and I conducted, we found that having both partners at home saw men increase how much of the domestic burden they took on, so that women’s typically greater share decreased.

We discovered this by analysing data from Understanding Society, a big longitudinal household panel study – the largest of its kind. The study follows a sample of UK households, periodically asking them questions to see how their lives are changing. Between April 2020 and September 2021, its participants were asked to complete web surveys every few months specifically about the impact of the pandemic on their lives.

We looked at responses from people of working age who were in opposite-gender relationships that continued throughout this period of COVID surveying. This provided a final sample of just over 2,000 couples for us to analyse. Here’s what we discovered.

Lockdown shocks

The couples were asked about the gender division of housework during the first lockdown, and we then compared this with information collected from pre-lockdown surveys carried out during 2019. The couples were also asked whether those changes persisted when the first lockdown eased. On top of this, we also compared the changes experienced by those with no children at home and those with children of various ages.

What we saw was that overall, women’s share of housework fell from 65% pre-COVID to 60% during the first lockdown. So initially there was a moderate amount of gender rebalancing in the sharing of domestic work. However, by September 2020 the old gender divisions were being re-established. By this point, women were on average doing 62% of housework.

These changes coincided with changes in working behaviour. Overall, the findings showed that both men’s and women’s paid working hours reduced substantially in the spring of 2020 but had recovered by September.

A woman vacuuming a rug
Despite some rebalancing, on average a sizeable majority of the domestic burden still fell on women.
Olena Yakobchuk/Shutterstock

And during the spring lockdown, around a third of both male and female respondents were employed but working from home. However, this had fallen to just under a quarter by September. Similarly, around one in five women and one in seven men were furloughed in the spring, but this had dropped to fewer than one in 20 by September.

This seems to suggest that having both members of a couple at home, with less time committed to work, leads to the domestic burden being more evenly shared.

Having both family members spending more time at home also appears to have led to there being more housework to be done. Both men and women increased their weekly hours of domestic work during lockdown – from 12.5 to 15.5 for women and from 6.5 to 10 for men. Come September 2020, these figures had fallen again, though they remained above their pre-lockdown levels.

Childcare burdens

However, the rebalancing of work wasn’t consistent across the couples we looked at. The extent of the change depended on the number and age of the couple’s children.

When the respondents were split into three groups – those who had no children living at home, those who had children under the age of five and those who had older children – marked differences emerged.

For couples without children at home, women’s share of domestic labour fell during the spring and continued to fall after the summer. Though these women still did more domestic work than their partners, their input did not return to pre-COVID levels as 2020 progressed.

For those with children aged between six and 15, the drop in women’s share of housework had partially reversed by September, but it hadn’t fully bounced back. In the autumn they were still doing less than before the pandemic.

But for those with children under five, the drop in women’s share of housework had reversed completely by September. This was despite the initial drop in the spring having been greater for this group compared to the other two.

Family dynamics

So what do we make of this? In terms of family dynamics, the lockdown may have had more lasting effects for some families than for others. Fears that advances in gender equality could be reversed during the pandemic were more real for those with very young children, who were much less able to keep themselves busy with other tasks and whose children were not old enough to make use of online education.

One important reason for the division of labour changing during lockdown was men’s and women’s working hours. Women with young children tended to reduce their paid working hours more as the pandemic progressed in order to take on the increased burden of care that stemmed from schools and nurseries being closed.

A grandfather and grandson walking outside
Having family support nearby will have influenced how much childcare and housework couples did.
Monkey Business Images/Shutterstock

Our study shows that changes to family life during the pandemic were nuanced, with different family set-ups resulting in different changes to the balance of housework and the rebalancing of work changing over time. Indeed, there may be further nuances that we’re yet to fully identify.

In the future, it would be good to look at whether extended family networks were able to alleviate the increased care burden for some families. We could also look at how the pandemic affected the mental health of women with and without children, and it would be useful to see whether different countries’ lockdowns affected families differently as well.The Conversation

Susan Harkness, Professor of Public Policy and Director of the Centre for Poverty and Social Justice, University of Bristol

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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‘Substituted parenting’ – a term with no apparent consensus, clarity, consistency of meaning, or transparency as to its application by the family courts.

Project team: Nadine Tilbury (Policy officer for the Working Together with Parents Network (WTPN ) and Beth Tarleton (WTPN Co-ordinator and project PI)


“Substituted parenting” What does this mean in the family court?

We aim to be in a position to answer this question by the end of our 18-month project (April 2023) and are extremely grateful to the Nuffield Foundation for providing the funding and support that will enable us to do so.

Published family court judgments show that the expression ‘substituted parenting’ is often used during care proceedings in cases involving parents with learning disabilities and tends to result in the children being permanently removed from their families.

The term appears to be being used by local authorities when the support they have identified as necessary for the parents is extensive. They say the high level of support required equates to substituted parenting which is detrimental as it confuses children as to who is the parent. Since most parents with learning disabilities are likely to need long-term support, this approach risks becoming a discriminatory blanket policy.

Where has this term come from? What is the research evidence base for the concept and its conclusion that ‘substituted parenting’ or parenting by others is necessarily detrimental to a child’s welfare? What level of support is regarded as substituted parenting? Is it / should it be a matter of how much support is provided or, instead, should the question be how that support is provided?

Experienced family court lawyers are unclear how the use of this term has developed, ”… appears to be becoming an ‘orthodoxy’” or the ‘default position’ (Senior barristers – email).

“… the family would need … support throughout the children’s waking hours. That would be substituted parenting, not support.”  A Local Authority v G (Parent with Learning Disability) (Rev 1) [2017].

Whether the situation I have described could or indeed should be described as “substituted parenting” is a matter for others to decide… In the absence of a clear description of the dynamic that defines what substituted parenting is …” HHJ Greensmith in PQR (Supported Parenting For Learning Disabled Parents) (Rev 1) [2018].

It is this absence of a clear definition – and the dire consequences that follow a finding of substituted parenting i.e. removal of the child – that prompted our bid for funding to clarify what social workers, lawyers and judges mean by the term ‘substituted parenting’ and how it is applied in care proceedings involving parents with learning disabilities.

Our project aims to establish clarity, consistency and transparency in the understanding and application of the term by the family courts and to highlight good practice, where it exists.

Background to the project

All parents are entitled to support from the state to carry out their parenting responsibilities. So say the UN Convention on the Rights of a Child and the United Nations Convention on the Rights of Persons with Disabilities. The Care Act 2014 specifically includes parenting responsibilities as one of the eligibility factors for support and the central ethos of the Children Act 1989 is that children are best raised by their families, where possible, with local authority functions designed to provide support to the children and families.

The first edition of the Good Practice Guidance on working with parents with a learning disability (2007), published by the Department of Health and the Department for Skills and Education, emphasised the right to support, drawing heavily on the work by Beth Tarleton and colleagues in 2006, Finding the Right Support.

The 2016 and 2021 updates of the Good Practice Guidance by the Working Together with Parents Network did likewise.

And yet, despite this clear, rights-based foundation, cases were continually being reported where parents with learning disabilities were having their children permanently removed as they were unable to parent them safely without the right (or, in many cases, any) support.

In 2016, we started sending emails to the office of the President of the Family Division, highlighting published family court judgments showing local authorities’ routine failure to apply the principles of the Good Practice Guidance, when working with these families.

In April 2018, the then President, Sir James Munby issued guidance:

‘My primary purpose in issuing this Guidance is to bring to the attention of practitioners and judges, and to commend for careful consideration and application by everyone, the very important “Good practice guidance on working with parents with a learning disability” issued by the Working Together with Parents Network and the Norah Fry Centre in September 2016.’ Family Proceedings: Parents with a Learning Disability | Courts and Tribunals Judiciary

Almost overnight, the right to support began to be acknowledged by local authorities and their proposals scrutinised by the family courts.

‘ …Following the court’s request for additional evidence from the local authority including evidence of how the guidelines in respect of parents with a learning disability had been followed and direct evidence from the independent reviewing officer (in the form of a statement confirming her position in the light of the new evidence), the local authority reviewed its position’.

‘…The court is confident that this package of support …meets the obligations of the local authority to follow the Good practice guidance on working with parents with a learning disability (2007) revised September 2016 (The Guidelines) (Recognising the Role of the Independent Reviewing Officer (IRO)) [2018] EWFC B71 (08 November 2018)

Unintended consequence

It was all going so well… And then, we started receiving reports of cases in which local authorities confirmed that the necessary support had been identified and could be provided, but went on to assert that, such support would amount to substituted parenting, which was detrimental to the child’s welfare and so the child needed to be permanently removed.

We began to look into this concept of ‘substituted parenting’. We tried to find out where it came from, what level of support was considered to tip the balance from acceptable to unacceptable, whether costs and timescales were factors. We checked the literature, and we asked the academics and practitioners. We couldn’t find the information. ‘Good question’, they said.

We scrutinised published judgments, looking for mention of any analysis of the risk that the proposed support would amount to substituted parenting, and any options considered to address/reduce/eliminate that risk. We couldn’t find that either.

Timing

This project started 1st November 2021 and runs until April 2023. The timing couldn’t be better for us as the President of the Family Division, Sir Andrew McFarlane, has just released his report on the need for greater transparency in the Family Court: Confidence and Confidentiality: Transparency in the Family Courts and has confirmed that transparency will be a key priority for him over the next three years:

‘… it is legitimate for the public to know of these judgments [family court cases], to provide a basis for trust in the soundness of the court’s approach and its decisions, or to establish a ground for concern in that regard.’

’It is the case that the Family Court is currently not sufficiently transparent even to those, in particular the judges and the social work professionals, who are working within it. Educational opportunities are thereby being missed.’

Since the family courts are not open to the public, we depend on published judgments for finding out how care proceedings involving parents with learning disabilities are in fact being dealt with. Any move towards greater transparency, in terms of the number of judgments published and the level of information contained within them, can only lead to better and more consistent practices and thereby improved confidence in the fairness of the family justice system.

Next steps

We very much look forward to speaking with the social workers, lawyers and judges involved in working with parents with learning disabilities in the care proceedings context. We look forward to being able to highlight good practices found in the course of the study and to establishing consensus, clarity, and consistency as to the meaning of the term ‘substituted parenting’, and transparency as to its application by the family courts.

We particularly look forward to working with our Advisory Group of parents with learning disabilities. They will help to ensure that the findings of our study can be made widely available to parents with learning disabilities and in such a way that parents will be able to understand what is meant by the risk of support being considered to be ‘substituted parenting’, the significance of such a risk and, most importantly, how to avert that risk, where possible.

Because, in the much-quoted words of Baroness Hale in a landmark adoption case, “nothing else will do”.


This project has been funded by the Nuffield Foundation, but the views expressed are those of the authors and not necessarily the Foundation. Visit www.nuffieldfoundation.org.


 

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Top tips from the editors of Policy & Politics for getting published

Policy & Politics is a leading international journal in the field of public and social policy. It spans the boundaries between theory and practice and links macro-scale debates with micro-scale issues. It seeks to analyse new trends and advance knowledge by publishing research at the forefront of academic debates.

Co-Editors: Oscar Berglund, University of Bristol, UK, Claire Dunlop, University of Exeter, UK, Chris Weible, University of Colorado, US

From the Policy and Politics Blog.

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Ending gender-based violence: what role does research play?

Ensuring that that our research considers and promotes equality, diversity and inclusion is central to the work we do at the School for Policy Studies. Working in partnership with communities and stake holders to identify research questions that matter and ensuring that studies are co-produced wherever possible helps achieve these aims. This series of blogs looks at some of the ways what we research and how we go about it incorporates EDI principles.


In this blog, Kate Bowen-Viner (Social Policy PhD student) explores how research from the Centre for Gender and Violence is addressing inequalities and tackling gender-based violence.

Introduction

Gender-based violence describes any harmful act towards individuals or groups on the basis of their gender.

It includes domestic violence which UK law defines as ‘any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality.’

Domestic violence is a gendered crime that is unequally experienced by women and perpetrated by men. It is extremely common in the UK. For the year ending March 2019, the ONS estimated 1.6 million women aged 16 to 74 years experienced domestic abuse.

Gender-based violence is a well-documented problem and there are many organisations and activists working to stop it. How can research help to address it? Academic staff in the Centre for Gender and Violence Research conduct high quality research, in collaboration with practitioners and activists, to inform action on addressing the inequality that is gender-based violence.

In this blog, I start by explaining why the Centre’s intersectional, inclusive and collaborative approach to research is vital for addressing gender-based violence. I then explain how findings from research projects contribute to ending violence and supporting survivors/victims.

Doing research: why is an intersectional and collaborative approach important?

Intersectionality explains how different social justice issues (e.g. gender, ethnicity, sexuality, age) cross over with one another.

Taking an intersectional approach is important for understanding how different forms of gendered abuse emerge and addressing the needs of marginalised groups who face violence. For example see: Rape, inequality and the criminal justice response in England: the importance of age and gender. This paper takes an intersectional approach and concludes that, ‘(r)esults suggest age and gender are significant factors in how sexual violence, and the criminal justice system (CJS), is experienced. Victims-survivors from BME or LGBTQ+ groups are underrepresented within the CJS, implying these groups are not seeking a criminal justice response in the same way as ‘white’ heterosexual victims-survivors.’

Collaboration with practitioners is also important. As Marianne Hester explains:

“The partnership between practitioners, researchers and activists is absolutely key. We don’t create change if we sit in our little bubbles. We need to work together.”

Using findings: understanding how violence works

The way domestic abuse manifests is constantly changing so it is important to know how violence works and changes in order to act against it, including emerging forms of coercive control. The Understanding and Responding to Coercive Control project addresses a series of important issues in tackling domestic violence and abuse that have not previously been dealt with to any extent, relating specifically to emerging forms of Coercive Control.

Coercive control is defined as an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim, for example the use of chemical restraints (abuse via medication). The project will also look into the use of faith and faith practice as part of coercive control; assess domestic violence incidents recorded by the police for evidence of coercive controlling behaviour; improve measurement of coercive control; explore survivors’ mental health for implications on employment and ability to seek safe accommodation; develop briefings on the relationship between coercive control, financial /economic abuse and housing crises faced by DVA victims-survivors; and briefing on the abuse of pets in the context of coercive control.

Another project will be looking at the questions we ask to collect data about domestic abuse from the Crime Survey for England and Wales.

Conclusion

Research has a role to play in ending gender-based violence, but it does not operate in a silo. The Centre for Gender and violence’s work shows why an intersectional and collaborative approach to research is so important for making change happen.

Read more about some of the issues raised here

Articles and links based on research from the Centre for Gender and Violence Research:

Nine in 10 domestic abusers also target pets, survey finds – The Independent, 24 November 2021

‘My ex-partner would take his anger out on my dog – I’d rather he hurt me’ – The Telegraph, 23 November 2021

Student spikings: universities told to step up prevention efforts – Times Higher Education, 4 November, 2021

‘You couldn’t leave your husband. It just wasn’t done’, The Independent, 02 October 2021

Improving the justice and healthcare response for victims & survivors of gender based violence 

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Developing smart cities: where are citizens’ voices? Learning from Mexico City and Bristol

Ensuring that that our research considers and promotes equality, diversity and inclusion is central to the work we do at the School for Policy Studies. Working in partnership with communities and stake holders to identify research questions that matter and ensuring that studies are co-produced wherever possible helps achieve these aims. This series of blogs looks at some of the ways what we research and how we go about it incorporates EDI principles.


In this blog, Kate Bowen-Viner (Social Policy PhD student) explores how research in the Centre for Urban and Public Policy Research is making smart city innovation more inclusive.

Smart city innovation raises questions about citizens’ inclusion and participation in city governance.  The term ‘smart city’ is usually used to describe an urban area that uses digital technology to collect data (e.g. from citizens and the environment) to monitor and manage spaces. Such management may lead to environmental and social benefits in urban areas. For instance, smart city technology can be seen as a way to improve environmental sustainability and citizen’s welfare by optimising cities’ limited resources or monitoring and deterring crime. Whilst these potential benefits appear promising, smart city technology necessitates consideration of equality and inclusion issues related to urban governance, including:

  1. What role could and should citizens play in developing smart cities?
  2. What are the opportunities, risks and vulnerabilities for citizens created by increasing reliance on digital technology?
  3. What does an inclusive approach to smart city development look like?

In this blog, I set out the problem with developing smart cities without citizens’ input and explain how research from the Centre for Urban and Public Policy Research is helping to make smart city innovation more inclusive and equitable.

What’s the problem?

Across the globe, cities are investing in smart infrastructure. The Covid 19 pandemic appears to have accelerated the growth and use of smart city innovations in some places. As the OECD highlighted in July 2020, “the pivotal role of digitalisation in emergency responses to the pandemic has pushed many cities to systematise the use of smart city tools more permanently, while staying alert and monitoring the risk of contagion.”  Whilst the rapid growth of digitalisation in some urban areas may provide solutions to some issues, not including citizens in decisions about smart city infrastructure could create long-term problems, including:

  1. Urban areas and citizens being ‘locked in’ to using certain types of smart city innovation

Decisions to buy digital infrastructure are likely to have long-lasting consequences. If one type of technology (e.g. from a particular company) is installed in an urban area, this may have impacts on what other forms of smart city technology can be used in the city. It may be expensive or difficult to install another type of technology in the future. Thus, not including citizens in decisions about smart city innovations could mean that citizens are forced to use and fund a type of technology that they do not want, for a long time.

  1. Smart city innovation not responding to citizens priorities and interests

If decisions are made about smart urbanism without citizens’ input, innovations may not respond to citizens’ priorities and interests. This could result in some citizens not engaging with smart city innovations and smart city innovations failing to address citizens’ needs.

  1. Individuals or groups being disadvantaged or excluded by smart urbanism

There is a risk that some citizens could be disadvantaged or excluded by smart city innovations. For example, if citizens need a certain level of digital literacy to engage with smart city technology, or if they need certain tools like smart phones, this could exclude some individuals or groups from elements of urban life.

Professor Alex Marsh from the Centre for Urban and Public Policy Research is working with Dr Arturo Flores from Anáhuac University, Mexico to lead research that aims to address these issues. In collaboration with Knowle West Media Centre, Professor Marsh and Dr Flores are leading the Empowering Citizen-Orientated Smart City Innovation in Mexico (ECOSCIM) project which aims to develop a new framework to guide smart city innovation to be more inclusive, responsive and reflexive.

The ECOSCIM Project

The ECOSCIM project aims to develop a framework to guide smart city innovation in a way that pays attention to citizens’ needs and priorities. The project involves examining smart city innovations in Mexico City to see how they measure up to the new framework, as well as investigating the social and political contexts in which Smart City innovation takes place.

To achieve its aims, the ECOSCIM project involves working with citizens, community groups and policy makers in Mexico City to understand different perspectives and to build a new method to help the smart city innovation project. ECOSCIM has a particular focus on Mexico City as the city is large and its smart city innovation has not been researched in great depth. Conducting the research in Mexico City, rather than cities like Singapore or London which have more digital infrastructure, therefore means that the project can shed light on new perspectives about how smart city development can work in different contexts. Whilst the project will help citizens in Mexico City and other parts of Mexico, research findings will also support citizens all over the world who are interested in being involved in smart city innovations.

To carry out the project, the research team is collaborating with Knowle West Media Centre and using the Bristol Approach to understand more about Mexico City citizens’ priorities and to involve them in developing smart city innovation. Developed by Knowle West Media Centre, Ideas for Change and Bristol City Council, the Bristol Approach is a way of working that aims to ‘understand the issues people care about’ and how digital technology might help to address problems that citizens experience in everyday life. It involves local groups working together to identify issues that are affecting their cities and gathering information that will help to tackle those issues. The ECOSCIM project is exploring how the Bristol Approach can be used in Mexico City, as well as how Mexico City is involving citizens in smart city development. These inquiries will feed into the creation of a smart city toolkit aimed at communities.

Toolkit for taking action

The key output from the ECOSCIM project will be a toolkit that will help to make smart urbanism more inclusive and equitable. The toolkit will support citizens to get involved in smart city innovation and help them to address issues or problems that people are facing in their cities. Whilst the toolkit will be based on the research project in Mexico City, the research team intends for it to be helpful to communities across the globe.

Citizens’ voices are important

Research from the Centre for Urban and Public Policy Research is helping to highlight the importance of citizen voice and the necessity for an inclusive approach to smart city innovation. In a world where digital and technological infrastructure is quickly becoming more ubiquitous in urban settings, it is vital to remember: citizens can and should be included in decisions about their cities.


 

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Social differentiation in later life: the interaction between housing wealth and retirement in the UK and Japan

‘Social differentiation in later life: The 2nd UK-Japan international collaborative workshop exploring the interaction between (housing) wealth and retirement’

By Misa Izuhara, Professor of Social Policy

Who supports you in your transition to retirement? Is it the state, your employer or are you left to yourself to manage? Do you have sufficient financial resources including your own home to choose when to retire? Do you need to have paid work or will you look for different social participation such as volunteering after retirement? The process of retirement is becoming more complex and differentiated in terms of timing and financial resources. Active ageing policies in many advanced economies encourage older workers to remain in the labour market. However, the reasons and opportunities to do so depend on both market and institutions (e.g. retirement age, social security, attitudes of employers) as well as individual capital (e.g. health, skills, financial resources).

After a long break from the first workshop in Tokyo due to the COVID-19 pandemic, we re-convened via an online platform to explore those questions at the second collaborative international workshop on 17th September 2021. This workshop is part of the UK-Japan collaborative project ‘Social Differentiation in Later Life: Exploring the interaction between housing wealth and retirement in Japan and the UK’ which brings together scholars and stakeholders with the different disciplinary backgrounds of social policy, economics and management to examine the relationship between housing wealth and the extending working life of ageing baby-boomers in the contrasting welfare systems of the UK and Japan.

Five papers were presented covering inter-related themes:

  • Matt Flynn (University of Hull) talked about older workers’ mid-career job change in the UK and Japan and how institutional structures like internal and external labour markets; regulations; unions and jobseeker support facilitate and/or inhibit older jobseekers in their pursuit of meaningful second careers. Using Amartya Sen’s Capability Approach and illustrating his arguments using interview data of older jobseekers in the two countries, he discussed how older jobseekers were able to mobilise resources to make a successful job change. He concluded by noting that people who leave the Armed Forces after the age of 50 in order to pursue a civilian career might be a useful case study for comparing the experiences of people making mid-career job changes across different countries.
  • Jo Stokes (Community Services Manager, Age UK Bristol) highlighted the importance of a holistic approach to retirement in her presentation “What have we learnt from Post-Retirement Opportunities (PRO) programme”. PRO was a project, delivered by LinkAge Network in 2018-19, supporting people who had recently retired, were approaching retirement, or facing redundancy in later life to manage the transition from work to retirement. The programme delivered free workshops, events and work placements to help older workers explore opportunities and discover what they wanted from the next phase of their life. This presentation argued the importance of social participation and connections for older people beyond paid work in their post-retirement age and the role of the voluntary sector supporting the process.
  • Widening wealth inequalities within and between generations was the theme of the following two presentations. Drawing on the data from the Japan Household Panel Survey, Shinichiro Iwata (Kanagawa University) and Junya Hamaaki (Hosei University) examined the impact of unpredicted shocks to house prices on labour supply decisions among older homeowners. They found that Japanese older homeowners tended to remain in the labour market even when they experienced house price inflation. Instead of leaving the labour market, older workers tended to reduce their working hours. However, such practice differs by income level and employment status since reduced hours are only observed among older men in regular employment with a high income and women in non-regular employment. The presentation raised further questions regarding the use of housing wealth in later life including the availability and actual use of equity release schemes.
  • While the Japan paper discussed the impact of the economic crisis on house prices, James Smith (The Resolution Foundation) revealed the uneven impact of the COVID-19 crisis on wealth accumulation between households and between generations. The COVID-19 crisis is the first UK recession in 70 years in which wealth has increased but these gains are concentrated among households at the top of the income distribution. This partly reflects the effect on active changes in households’ savings and debt, varied by age but also by the labour market experiences and personal circumstances of individuals. For example, younger people without children were most likely to report that their savings increased during the pandemic (‘forced savings’ given the lockdown restrictions on social consumption). But changes in the value of household wealth were more affected by changing asset prices than by active changes in savings and debt. UK house prices are up around 10 per cent and equities are more than 20 per cent higher. These asset price increases drove an even larger intergenerational wedge in wealth shock. During the pandemic, adults aged 55 and older accrued 63 per cent (£559 billion) of the total increase in British household wealth (£900 billion). By contrast, those aged 20-40 accounted for just 13 per cent (£117 billion) of the total wealth rise. These large, and generationally uneven, increases in wealth mean that the picture of stalled wealth progress for younger cohorts is unlikely to come unstuck anytime soon. By way of inheritances, they are also likely to exacerbate absolute wealth gaps within younger generations, which we expect to open up in future.
  • Brian Beach from University College London (formerly International Longevity Centre, UK) presented three pieces of comparative work between Japan and the UK in relation to ageing. The first example covered work published in Ageing & Society, which included seven advanced economies and examined policies related to pensions and retirement and their relationship to labour market participation in later life. Scored across four dimensions each for early retirement and later retirement, Japan and the UK were quite similar in their scores, despite having very different rates of employment among older people. This may suggest that cultural factors related to work play a significant role, above that of policy.

The second example covered a fact-finding study in Japan in May 2017, which highlighted different initiatives to address wellbeing and healthy ageing. Genki-zukuri (health creation) stations are one community-based approach in Yokohama that helps older people set up, develop, and run health-based activities and exercises. Days BLG!, in Machida City, was also featured for its innovative approach to providing day care to people with mild and moderate dementia. With links to local businesses and organisations, the service ensures that participants are engaged according to their capacity, with the group reflecting on their activities at the end of each day.

The third example highlighted the work from the UK-Japan SWAN project (Social relationships and Wellbeing in Ageing Nations). The importance of social connections for wellbeing and other outcomes in later life cannot be underestimated, but challenges appear when conducting comparative analyses in the social realm due to the complexity of measuring social connections. The critical message from this work is that people from different groups, backgrounds, or cultures may view the exact same question differently; ignoring this potential difference risks drawing invalid conclusions from comparative work exploring best practice in policy.

The presentations brought together different issues associated with ageing and work such as work-related transitions, post-retirement opportunities, and widening wealth inequalities, which generated lively discussion among the panellists and participants. Retirement processes and decisions are often not experienced or made independently from one another. The workshop indeed highlighted the dynamic interactions between (housing) wealth and retirement trajectories and decisions. Moreover, we drew interesting comparisons by exploring the topics between Japan and the UK since institutions (social security, retirement age), the housing and labour markets as well as cultural factors related to work and home ownership combine to produce differentiated practices of late career transitions and retirements.

This international project is funded by the UK Economic & Social Research Council (ESRC) UK-Japan Connections Grant. The Principal Investigator is Professor Misa Izuhara, School for Policy Studies, University of Bristol, UK. The project members include Professor Shinichiro Iwata (Co-I) (Kanagawa University, Japan), Professor Matthew Flynn (Hull University), Professor Junya Hamaaki (Hosei University, Japan) and Professor Atsuhiro Yamada (Keio University, Japan).

 

Contact:

Misa Izuhara, School for Policy Studies, University of Bristol (E: M.Izuhara@bristol.ac.uk, T: @MisaIzuhara)

 

 

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Blog from the winner of Policy & Politics 2021 undergraduate prize

Blog by Lara Gordge, winner of the Policy & Politics 2021 undergraduate prize to the student achieving the highest overall mark on the ‘Understanding Public Policy’ unit at the School for Policy Studies

Originally published on the Policy and Politics Blog.

My name is Lara and I’m currently about to enter my final year of the BSc Social Policy with Criminology undergraduate degree at the School for Policy Studies, University of Bristol (home of the Policy & Politics journal). Winning the student prize for the ‘Understanding Public Policy’ unit came as quite a surprise, but I’m thrilled and honoured to have been chosen. All of my peers are brilliant thinkers and so very talented, so to win has given me a lot of confidence in my academic ability.

One of the main things I loved about the ‘Understanding Public Policy’ unit was the ability to write about such a broad variety of topics. One of the essays I enjoyed the most focused on two key questions around power within policymaking in the realm of behavioural economics – who is given the authority to make decisions on behalf of the greater good, and why are those decisions considered the right ones to make?

Since behavioural economics focuses on the presumed irrationality of human beings and how good decision making may be inhibited by different social or psychological factors, my essay relies on the principle that people’s choices are largely predictable and manufactured by their environment (coined by Thaler and Sunstein (2003, 2008) as choice architecture.) Therefore, I discuss the ways in which policymakers exploit the biases that are inherent in us all in order to subconsciously ‘nudge’ individuals towards certain choices. I focus on herding and status-quo bias as two main examples of choice architecture, largely due to the ease of which policymakers are able to manipulate inexorable defaults and the human tendency to conform.

Nudge: Improving Decisions About Health, Wealth and Happiness by Richard H. Thaler & Cass R. Sunstein (Penguin, 2009)

However, while writing this essay, discovering how easily our ability to make informed decisions can be undermined – even coerced – by those in power changed the overall tone and focus of my writing. I explored the shortcomings and criticisms of behavioural economics, focusing largely on the idea that nudges could be used to influence negative choices just as easily as positive ones depending on the intentions of the policymakers.

As behavioural economics relies on the notion that humans are imperfect and make flawed decisions, I make the assumption that surely those with the power to implement policy interventions are also primed to make bad decisions. Schmidt (2017) adds here that the ability to systematically nudge people allows those with the power to foist their will onto others, while possibly holding unobjective views regarding what constitutes a ‘bad’ decision.

Ultimately, my essay poses one major debate: who is the best judge of a ‘good’ decision – the individual, or the state? I conclude by stating that on the one hand, nudging can be an inexpensive method of encouraging healthy behaviour changes and creating small-scale, meaningful benefits at the individual level. But concerns over behavioural economics becoming too paternalistic remain – as exploiting human imperfection without the consent of the people will always be considered by some to be an immoral infringement on individual liberty.

I hope to be able to explore these important issues further in the future, but in the meantime, I will continue to read others research in the area, such as the recent special issue on nudge published in Policy and Politics. You can download the introductory article for free here.

If you enjoyed this blog post, you may also be interested to read:

Special Issue: Volume 49, Number 1, 2021
Beyond nudge: advancing the state-of-the-art of behavioural public policy and administration
Guest edited by Benjamin Ewert, Kathrin Loer and Eva Thomann

 

 

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