ties so if I had voted against that precept I would have been voting for the axing of 18 bus services affecting largely residents in South Cambridgeshire and I wasn't prepared to do that but again we've talked at length about council tax exemptions and so on you know we're having I know we are in a cost living crisis but in a cost living crisis provision of public transport becomes ever ever more important particularly to those on low incomes and those people who might well have to stop using their cars because they can no longer afford the fuel or the maintenance costs of those cars point of information chair just that I'm sure there are elderly gentlemen as well as ladies that use the bus service we don't want any more accusations no the letters I received were exclusively from women the letters I received were what I was saying I'm sure thank you we understand what we're talking about thank you I'd just like to like to report that last week I attended the Rural Bus Summit for Cambridgeshire in Brisbane and at that summit we were presented by the combined authority lead officer on bus services Tim Bellamy and we had a days worth of consultation and discussion about how we could best cope with a changing scenario and particularly with this loss of confidence that the actions of stagecoach took by deregistring their services re-registering some of them to get more money it really seems as though they look like they're gaming the system in many respects putting up the bus fares in January when the cap the government's cap of £2 a journey came in so that they would be more more money and it's not exclusive then they're answerable to their shareholders so this ongoing issue that we have with managing our bus services can really only lie with the combined authority we're hopefully going to move to as quickly as possible to a franchising scheme because that holds up the best prospect of giving our rural communities the best service that is likely to be possible but that's not a quick process. Thank you Thank you very much Councillor Bill Handley Yes thank you I'm really pleased that the combined authority took the decision they did because one of the services that is going to underpin is the city five service which serves my villages over in Willingham and which calls a huge furory when stagecoach elected to discontinue it so thank you combined authority Thank you very much Councillor Tim Hawkins Thank you Chair, just very quickly my ward faced having both his bus services removed city 4 was re-routed away from my villages and number 18 faced the axe and people were already asking the question what's going to happen in March so seeing this I can report back to them to say something is going on and the buses will still be available Thank you very much Members, Councillor Ewington I'm sorry to cast dispersions on this back slapping but yes the buses stopped in Swayce the buses used to go one hour that way and one the next hour they came back that way so if you wanted to go to over surgery you could go to over surgery and you could catch the next bus back now they go in a circle so it takes over two hours if you want to go to doctor's surgery and every single bus I have seen in the last fortnight is empty because they are not run in a way which is compatible with what the residents need and I believe the message should go back to Cambridge and Peterborough combined authority that they need to put somebody in charge of them who knows what they're doing when they're putting bus services on sorry I'm in a problem The operator is still currently stagecoach so I don't think we've done anything so thank you Councillor Ellington that's an extremely strong argument for bus franchising and that's what the combined authority is looking at because you're absolutely right some of the services we have and not the services we need we have the GCP working towards doubling the bus network thank goodness because it's an adequate and it doesn't go where it needs to go and fortunately the combined authority are also now talking about introducing franchising in a quite short period of years which is ambitious but that means that we will then have a strong voice in determining what those routes are what those buses are how frequently they run and where they go thank you very much I'm going to call Holt there as indeed there are no further hands up so this item is noted thank you so we move on to item 15 the Greater Cambridge Partnership which is pages 377 to 380 in our agendas and this is feedback from the joint assembly meeting on the 23rd of November our representatives on the executive board of what is Councillor Bridget Smith does anybody wish to raise anything thank you Councillor Fygott and Councillor Cohn thank you Chairman so on page 378 in paragraph 3.2 there's a mention of the issues of design quality and LTN 120 and my question is does this cover the question of safety what safety measures is the GCP going to put in place following the recent fatality on the cycle way between Gert and Okington and should the GCP continue to design routes for cyclists or horse riders immediately adjacent to busy roads thank you thank you Councillor Fygott so our representative is Councillor Bridget Smith thank you very much indeed so this was obviously the meeting of the assembly not the board and we do have Councillor Baer Park here who is there I wonder whether Councillor Baer Park would like to respond rather than me because I think he's probably had that very discussion Councillor Baer Park would you like to respond? yes I'm very happy to respond to that and at the most recent GCP meeting where we were discussing the Melbourne Barton Horningsea and sorry Sorstyn, Greenway, thank you I also raised this and I have been asking the GCP to look at ensuring that there is separation between the NNU routes and the roads wherever possible thank you and Councillor Cone thank you chair my was just a quick request to give an update on the full born to Cambridge cycle greenway just it seems to have gone a little bit quiet again it doesn't have to be today but if I could have a written update on that from the members that would be great, thank you noted, thank you, right I'm sure that will come back to you so members this item is noted then we move on to item 16 which is the Oxford Cambridge regional partnership pages 381 to 388 in our agenda packs and I invite Councillor Bridget Smith to speak to that so I think I've probably said everything that I need to say in answer to the question from the member of public on this so I won't say any more but if there's any questions I'm happy to do my best to answer them so members do you have any questions so Councillor Heather Williams there's not much questions but focusing on the recommendations I think the Ops cam arc I remember Councillor Nick Wright one of the first meetings I attended asking the leader what the vision was that the council was sending in relation to the arc and how I think we asked nearly every meeting on the track and we still felt no further forward now I do appreciate there are benefits to that and I can see why it's something that the Government are supportive of promoting however I am concerned about the lack of scrutiny that's been available for us to hold the administration to account on this previously and I am concerned that our previous concerns have always sort of been battered away and not really taken as seriously as we would like so with that in mind we are minded to not support what Cabinet wishes to do and therefore the appointment of anybody I think we have seen what has come out in the way that this has been represented at this council and there are other councils where this may be beneficial I'm not against the whole principle but I think right now can I be certain that what is happening will be as a result of what happens here in this council our views represented there that's not our experience and I will not support something that I don't know what's going to happen and I think that's how very much I feel at the moment due to the lack of information and responses we've had previously thank you chair we are only being asked to note this report this is in fact a recommendation for which is on page 381 paragraph 2 so we'll take it as a vote sorry I need your proposal for this recommendation thank you councillor Smith and a seconder councillor Brian Milms thank you so does anybody wish to have any further discussion on this yes sure so councillor Milms absolutely agree with you over the frustration on the lack of transparency over the last five years and your views have been reiterated at numerous meetings by myself and leaders of all other political persuasions time and time again and the block was government government did not approve meetings being in public genders and minutes being published or the creation of a website so it was a massive frustration to us all so you know this is a cross party partnership across a large number of councils and it is a government served of government sponsored sponsored scheme so you know all of the leaders of all political persuasions when we were discussing the possibility of a pan regional partnership and these came out of the levelling up white paper we all of us said one of our red lines was that it had to be in public because we were all of us getting battered by the oppositions in our councils about it and it was really really difficult and you know if we could have shared stuff with you we would have shared stuff with you there was nothing terribly contentious and actually we all of us get on well and we all see what the opportunities are here so there is now a website there's now there's various governments documents and constitution there's now a shadow board genders and meetings and minutes and everything will be on this website so you can go on it now so that was a red line for all of us and we would I think without failing we would all have just said no if government didn't agree that so you know this is embryonic but we all of us know that there is only a certain amount that we can achieve in isolation as a relatively small district council but there's an awful lot we can achieve in partnership and that's why we have a combined authority because you know the previous administration when they signed up the combined authority acknowledged that we are much more powerful and much stronger voice working in partnership and this is like a bigger combined authority but actually without the constraints of the combined authority so yes but you know if things if things go wrong then then we'll stop doing it but if we're not in the room we're not involved in the conversation and we don't have the opportunity to influence things and we don't get the opportunity to benefit benefit from it so this is the early days of this and as I say I think it's important to be around the table with everybody else and I'd just like to reiterate cross party the chair is councillor Barry Wood of Chirwell council and Chirwell is the accountable body as well but anyway so I think it's a good thing for us to be doing but we'll keep it under review and hopefully there'll be a lot more information for you to scrutinise moving forward thank you councillor Don Lentel not if it goes wrong when it goes wrong because the problem about these regional partnerships is that they're trying to plug a hole in a failure of the 1990s to deliver meaningful devolution to England and the problem that we've got is that these partnerships start out with the best of intentions he said with a large pinch of soul but they're not accountable and so we've now got a situation where the leader of this council is going to the combined authority with Peterborough and saying yeah yeah go on tax us more, tax us more we love it, we love our bosses can we guarantee that there will be no tax implications that Oxcamark will never be able a transregional partnership lefi on people's council tax bills councillor Don Lentel thank you, I just thank you for moderating your language councillor Smith so in responding to councillor Don Lentel I'm going to be very mindful of the joint motion about debate not hate and curts in public life that we're going to be discussing at the end of this meeting so it's quite clear that this partnership has no powers can't precept you can't make planning decisions it's a consultative body to work in partnership to identify projects and there's a nice list of projects there on page 382 which by working together we can hopefully attract government funding and funding from elsewhere so it's quite clear that it's not going to be a precepting body to take away any of our powers so it's not about devolution thank you very much I can't see any other councillor Martin Cohn I've got a comment here in terms of the comments of councillor Lentel Chairman about the situation in France where the situation is that you have lots of small local authorities which are stuck in AXBIC because the senate which is half made up of local authority mayors would be needed to improve any changes in the local authority structure and where as a result you have many intercommunal interlocal authority structures like you've got here so this is a pragmatic response to a difficulty in the structure that the Liberal Democrats have always been favour of devolution to England I absolutely agree with councillor Lentel on that but the situation at present I can't see that the situation is much more logical in Wales and Scotland where local authority has been restructed to a devolution settlement it's absolutely needed in London I agree but we are where we are and we have to work with what we have and this is the pragmatic solution we have got available and we have to it's important that we are participating in it so that's where we are the fact that the situation isn't satisfactory is a matter for government we can't change it so I'm going to go to the recommendation on page 381 paragraph 2 it's recommended that council support South Cambridgeshire District Council cabinet's intention to confirm its membership of the Oxford to Cambridge partnership as it becomes formally recognised and funded by government as a pan regional partnership and the appointment of the leader as the council's representative on the pan regional partnership if you are in favour of that can I ask that you vote with the green button if you object vote with the red button and if you wish to abstain vote with the yellow button if you have voted there will be two blank buttons and one showing the colour that you have voted if you're not in that situation please let us know 35 ok so that is six in favour nine objections and no abstainers so that is carried right because we have such a long agenda I am proposing to continue now unless there is a wild request to stop and to go to the questions which are on item 17 actually I will also take a vote that we continue because we have been going for four hours members so can I ask that we are have approval to continue agreed thank you so much right ok chairman chairman very very quickly I know all the questions are very important and I don't speak that but you might be about to pre-empt something I'm going to say I might just ask if we could have the notice of motion first because I think that's very important let's have the notice of motion then if people have got to go the notice of motion has been done which is very important I believe I can only say my opinion it's in your discretion have you got a second to council howl a cloud of them ok so with that can I just all in favour of that would you like to raise your hands so let's do that we'll bring wait for council Heather Williams because she was seconding that motion so we'll just pause on that until she returns we'll take five minutes I'm going to wait for her to come back she's done it yes exactly so I'm not going to wait Heather won't go back she's just could you take the boat down please could you take the boat down no no I'm just please don't we haven't stopped the meeting the meeting is still ongoing so members we have it's been proposed and seconded that we bring forward the motion which is currently at number 18 but out of courtesy since you are the seconder council Heather Williams I'm 18 can I just are we all in agreement that we bring it forward ok thank you so you are reminded that a maximum period of 30 minutes is allowed for each motion to be moved seconded and debated including dealing with any amendments at the expiry of the 30 minute period debate will cease immediately and the mover of the original motion or if the original motion has been amended the mover of that amendment now forming this substantive motion will have the right of reply before the motion or amendment is put to the vote so we have councillor Bridget Smith would you there's a motion standing in the name of councillor Bridget Smith and councillor Heather Williams councillor Bridget Smith would you like to move the motion thank you the key issue here is the normalisation of abuse for those of us in local government and that abuse can be in person it can be written it can be online it happens in many ways and it's a situation that's getting worse and worse and the abuse can be member on member public on member public on officer member on officer MP on member so many ways but those of us and I'm speaking on behalf of officers as well as members are on the receiving end of abuse on a daily basis and I have no doubt that this toxicity is getting worse and worse and very regrettably and that's what the work we were doing at the local government association the threshold for intervention is getting higher and higher and the number of times people say to me oh you've got to have a thick skin to do this job why do you have to have a thick skin that's not right so I'm going to give you three examples so some of I met quite recently somebody who used to be a district councillor I'm not going to mention them by name because some of you know them and when I talk to this person for the first time they said to me the reason I stopped doing this was this person left about six seven years ago was because the what went on in this council chamber they found so unpleasant that it made them really unhappy and really depressed and really ill and this was a super councillor who contributed so much to the life of this council and actually sowed quite a lot of the seeds to some of the good stuff that we're doing now and I was really sad actually that I didn't know about it at the time because I think I fell into the pit assuming that everybody had a thick skin and actually there was somebody here who didn't have a thick skin who was really really suffering so we lost somebody who would have been an asset to us and who I wish was here today I've got a friend who is a councillor who is a young woman of colour and she's not a lived-in and she receives death threats on a daily basis and she has received photographs which have been manipulated to show her family members being mutilated so just about as bad as it can be I'm very good friends with the leader of Stevenage council she was attacked physically attacked on her doorstep about two years ago and then last week I was walking my dog in the village and somebody just suddenly decided to verbally attack me I won't repeat the words which were used and spat at me that's the first time in 15 years that's ever happened to me but so things are getting worse now I've been around for 15 years and I am tough and I do have a thick skin but if that had happened to me back when I was new actually I would probably have been really really upset by it and it would probably really have played on my mind and actually I might have thought I don't want to do this job anymore so the worry is that somebody shouting at you on the street and spitting on your feet it's a small step for that becoming physical violence and it's very very wrong that any of us should be in fear of physical violence against us because we're doing a job that is public service and we're all doing it because we want to make people's lives better none of us are doing this we have huge great political ambitions we're doing it because we care about our communities and we want to make life better for the people we care about and we all know we've already had a conversation today about the need for local government to be more diverse and more representative of the people in our communities but how do you sell to a potential candidate being a district councillor being a county councillor even being a parish councillor if this is possibly what happens if they're going to receive horrendous abuse on social media people spreading lies and misinformation about them and the problem with that is there are so many lies out there from so many sources and it can be member on member MP on member parish councillor on member member of the public on member and most horribly of all people attacking officers and so on so how do we sell this job which is a great job it's the best job in the world how do we sell it to people unless we get on top of this so there's five recommendations here which I hope you'll find it easy easy to support the most important thing we can do though is to lead by example so you know conduct ourselves in this chamber to set an example for everybody of the standards that we want to be treated by and we're very fortunate in our current chair and our previous chair that they are sticklers for the best conduct within public life so I'm sure others of you have similar stories but let's put a stop to these stories by supporting this motion and leading by example ourselves thank you very much thank you very much thank you chair so I'd like to say it was 15 years before I got my first but I think it was not as I've not been a counciller that long and chair I'm going to choose my words very carefully today because I have no doubt that in supporting this we will actually almost inspire some to do exactly what we're trying to stop inevitably that is a consequence it's not right but we do have to be careful and like the leader I reflect on some things that happened to numerous elected members of this council in the time that I've been here they've been threatened to be shot told they should be pinned up against the wall and exterminated threatened to be stabbed had their pets threatened to be stabbed been called scum been threatened with sexual assault and been told evil now I agree with the leader that we must conduct ourselves in this chamber in a way that is respectful although disagree and sometimes with humour but actually it goes beyond the walls of this council chamber I think every one of us has been told toughen up and that is because that is the reality of where we're at so it's not bad advice and I'd stress it's really not bad advice but it is regressible that it's necessary and for myself I think the real issue is how quickly people can be dehumanised and that's not inside this chamber that happens outside and I've put that while our differences of opinion and robust debate is natural and healthy and I do believe it's healthy in politics we all want the same thing it's just the method in which we get there that differs it's a responsibility of us as politicians but residents alike that they see strength in our differences do not belittle or dismiss others for having a different view and if we were to take the word politics out or put political beliefs out and replace it with many other things it would be protected but for some unknown reason because we hold particular political values it makes us fair game we must always remember that councillers are not names in front of us they're not pictures on a website they are human beings and with their families as well because the anxiety that some of these threats some are political, some are physical some are not meant to be intent some are does have an impact not just on ourselves but the families and the people around us we must never forget or attempt to dehumanise those who put themselves forward to serve their communities and I think there is a big onus on that for us outside this chamber if you put literature out there that suggests that because somebody has a particular view that they are somehow evil they are scum they are not worthy of your time then the consequences will be threats and unfortunately it's something that we have had to deal with we shouldn't and we will continue to deal with it I have no doubt for quite some time yet so while I'm happy to support this motion I am realistic about the outcomes of it and this will not be a quick fix we've seen sometimes and I've sort of referenced it earlier that we've put pen to paper and that's very easy for us all to agree on but the implications of that are harder to achieve thank you very much okay so I'll give it a speak on this council now ons I'd just like to add my support to this motion and I'm interested in the differentiation between what goes on in this chamber I've got to say, I think it's actually improved I remember very strident arguments between chair and opposition leader previously perfectly reasonable generally but not really an illustration of what we would be proposing to act as an example of no no no, not you a predecessor of yours and so what I'm saying chair is that this principle of civil disagreement is absolutely a requirement of us in this chamber but out in the wider world and I was pleased to be directed to read the Nolan Principles before I took my place on the parish council many years ago and it's something that I think that we should just remind ourselves in this context there are guidelines for showing respect to each other unfortunately the public feel that we're fair game I've been criticised of being useless that's an opinion, that's fair enough but when I get told I'm lining my pockets I'm still waiting for the brown envelope he's lying but then the office of violence in the street for suggesting somebody's parking badly is not acceptable and so I'm very much in sport of this motion, thank you I note both councillor John Williams and councillor Sally Ann Hart but first I've got councillor Mark Howell Thank you chairman it's a very motive subject isn't it on already we're moderating our language we're already doing that people don't, people will say anything and everything and they give the most vile disgusting terms so I've no members here to have letters saying I'm going to reap your ars and that's what they said because of a planning meeting I don't know what helped them in the planning meeting I have no idea but I tell you this now that's the type of thing that they went home to that night and it's absolutely vile I was walking alongside an elected member the other day after they give a talk in a public meeting and as they were walking along there was a guy who was just walking on just shouting abuse and horrible abuse and he agreed with what the person said in a public meeting but because they were a politician they believed that they had the right to abuse them and these are people who let's be honest, we are local people the national politicians of what Diana Abbott has put up with is absolutely disgusting and I think here it gets a bit rumb but it used to be years ago a bit more when you went over it over the top you were to apologise and that was it but now the fact of the matter is you're getting these emails and it could be from anywhere in the world from people who don't even know you they've just picked on you and just having a go and the problem is if it is somebody who has a go at you face to face you know what they look like but when it's an email or a letter it could be anybody you could be walking down the street you could be in the shop and you don't know the only thing we can do is protect each other that's it, it comes down to that we've got to protect each other as much as we possibly can all politics aside, no matter what the issue is whether you agree with the issue or not you have to protect each other and that's the biggest thing we've got to do I wholeheartedly support this and we have been called scum I'm sorry, we are not a scum the people who write this in this vile, disgusting stuff, they are scum I'll say it, 99.9% those who are in people are wonderful they have a bit of fun at your expense they'll say some things that laugh it off but there are some real scum out there and it is nothing we can do but protect each other thank you very much thank you thank you I think the leaders made really quite a good point earlier when she was talking about people having thick skins and I think if 30us people and nice people and sensible people and normal people and people who represent the community are driven out of politics because of a very toxic environment then that is not going to be good for democracy and people are not going to get the leadership that they are asking for there are plenty of narcissistic people psychopathic people who have very thick skins and who don't mind at all being insulted or getting death threats as long as that leads to power and I think if we want to protect our democracy and if we want to have political representation that represents people and that is made up of people who are like us then we have to take us down and we have to make sure that we don't drive and dump like people out of politics thank you thank you very much councillor John Williams thank you chair I can remember 30 years ago when in council chambers it was pretty rowdy and we were pretty rude to each other and then we all went down the pub and had a drink and at the time you thought that's okay we gave it as good as we got what does it matter because we all got thick skins we could all be rude to each other but we all knew that it was a game and at the end of the day you all made this, you all went down in particular in Waltham Forest we all ran Prince of Wales and we made sure the meetings finished at 10 o'clock so we could get there before closing time I'm looking back I think that was not the way to do it and we are now reaping the outcome of that behaviour it still goes on in Parliament you know people cry to shout other people down so they can't be heard and so I think in some ways we brought the supply ourselves because it's different between then and now because in those days the public only saw that if they could be bothered to go to the council meeting nowadays they've got social media we've got Twitter we've got people copying that sort of behaviour now they think it's okay they think it's okay to bully and belittle and insult other politicians because that's the way the politicians behave isn't it I've seen it, I'll tell you I've seen it in Parliament I've heard about it I now see it on social media so in some ways we've only got ourselves to blame I remember this council meeting when I first came to this council there was a certain person who sat at the back making chicken noises bleat it was absolutely a make rude remarks about certain people he was allowed to do it so now we're saying please we don't want it done anymore that's fine it shouldn't be done but we have to remember that it's our behaviour that counts it's our behaviour in this room it's our behaviour elsewhere that you know we've got to be absolutely correct in the way that we treat each other otherwise you can't complain if it comes back at you and unfortunately as I say looking back 30 years to those meetings in Wolfson Forest we've got pretty rowdy sometimes you know we deliberately made meetings go on till 3am in the morning because we knew the toys would have fallen asleep by then I mean it was you know it was it was pretty tough in the 80s in local politics but as I say I support this and I hope that everyone supports this and that we behave the way we want people to behave to us so John Williams we have Councillor Sally Ann Hart and Councillor Bill Handley and I will say something at the end to go ahead thank you, thank you chair it's no coincidence that I'm sitting here with a pen that reminds me that we all have a right to feel safe all the time and you know with that right comes a responsibility to observe other people's right to feel safe I've not been in the council chamber for very long and I think it's got better for me I feel safer I think the challenge is more elegant and I take on board what you say Councillor Hale about looking out for each other and also holding each other to account for me it's you know if somebody is going to apologise for making a mistake we all make mistakes but that's sorry is a feeling people need to feel sorry for mistakes to say I made a mistake I'm mindful that some people who we share our world with don't have the privilege that perhaps we have their experiences of growing up mean that they don't they're not able to respond they don't have that responsibility maybe because of what's happened to them if you've never been empathised with how in else can you empathise so I try my hardest to not have a thick skin to feel safe have people I can talk with that help me and this idea of remaining curious about why somebody might behave in a particular way rather than furious about it because people can change and I think you're spot on in terms of we need to be those role models and to challenge each other if people aren't respecting each other's right to feel safe Thank you very much Thank you Thank you I've seen some pretty bad behaviour at parish council meetings it's not just us it goes right down to the lowest tier it's actually got better for me I think as time has gone on but I do know I've seen it with my own eyes a fellow councillor county councillor getting pretty badly treated by parish councils and I do think that I hope we can sort of persuade them to modify their behaviour as well as far as my experiencers so far the worst is that people thrust their finger in your face and having a pint and you say you're in favour of this bloody congestion charge aren't you mate? As about as far as it's got so far finger in the face a couple of people I thought were friends have stopped talking to me I guess that's part of the course of being a counciller but it's very sad isn't it and I just think that we need to all of us think carefully before we say stuff that we say and particularly on social media Thank you councillor Handley Very quickly Councillor Ellington I'm going to call a halt after Councillor Ellington because I think we run the risk of running out of time Councillor Ellington I'm standing because I do think this is a really really important thing that we're discussing but perhaps my plea is that when I ring the doctor's surgery and it says abuse will not be tolerated it makes me think is that because you're not providing the service that I want or that fellow phone people that phone up are not getting the service they want or is it that there is an increase in people who are abusive over the phone and I just feel that sometimes emotions do overspill and but we have the knowledge as intelligent group of people to know that if we calm the situation if we help somebody see that they're being unreasonable in some way I agree with you that somebody spitting at you is really not something you want to start a conversation with but I do feel that sometimes people do get worked up about things and we shouldn't then charge them with being abusive we need to just cool it okay Councillor Ellington, very quickly please Thank you chair and I just want to say one of the last meetings I went to was Councillor Hart's very good non-violent language presentation and I have to say through you chair that's why when I resigned the Lib Demwit I was so incredibly hurt by the behaviour of former colleagues on social media telling me that I was a labour plant and that I hadn't been sincere in joining the Lib Dems to run to represent the residents of Over and Willingham I have a serious moral issue with the congestion charge and I accept that not everyone sees it in exactly that way it's called policy definition it's central to how we provide solutions to the problems that we face so if I have offended I beg your pardon I hope that other people particularly people who are reported in the newspapers as having bullied council members out of this chamber will also take a moment to take up Councillor Hart's invitation and to say yeah this should be a safer space where we can say yep I got it wrong I got that tone wrong I put that the wrong way and I repeatedly say to you I am sorry if my tone crosses a line however let's not confuse it with the threats of actual physical violence and the actual intimidation that happens even to a member in this chamber today and she got up and did her job while her abuser was in this building and I just want to recognise that as something really special thank you Councillor Lentol I'm not going to take any more comments because I'm going to make one myself and no more I just wanted to say that as chair of this council I absolutely applaud this motion I think it is the core of what we're trying to do here in this council I'm very aware that when when people are passionate about something they're very often inclined to express themselves with that passion and I have no objection to that and obviously the whole purpose my purpose here is to enable debate and so I'm very pleased and I thank you for respecting the mood and tone that I have endeavoured to achieve in this council because I think the best decisions come out of measured, equal, challenge and debate and I thank you for the way that you have responded to me as chair on that so thank you I'm going to call that to a close oh sorry there is one moment Councillor Hansraj if you wanted to say something quickly sorry which is we've got one minute before we have to complete the debate only to say that we also have to be responsible for our personal safety and it isn't on that somebody spits at someone that could be Covid-19 giving I personally feel that putting our addresses in public view is not safe we don't have to put our addresses in public view ok sorry I didn't realise people just told me it's changed so thank you I just wanted to make that point thank you very much so did you want to just come back no we can't right stop we'll go to the vote thank you members if you're in favour of this motion please would you indicate on the green button oh ok by affirmation are we agreed fantastic right members I'm going to carry on because I know no exactly so what I'm proposing is we move back then to item 17 with questions from councillors you'll appreciate those 30 minutes maximum for all of those questions to be asked and answered can I ask that we do this as swiftly and efficiently just referring to the question as written would be helpful any members who put questions but are no longer present I propose that their answers should be given in writing ok Brito so let's make a start then so we're starting our 30 minutes from now so the first question is from councillor Daniel Lentell to the leader of the council thank you thank you for your question I hope councillor Lentell will note that this question has actually been addressed earlier in the agenda with a report on the OCP which will now go to cabinet for formal approval this has never been about one person deciding things councillor Lentell did you have a supplementary I just wonder whether the leader thinks that it might have been better to have had the debate before the decision was taken I'm not quite sure what you mean actually sorry Lentell the decision to participate in Oxcamarch has been taken before we've ever debated it in this chamber we debated it tonight no it hasn't there was a shadow board the decision we took today was to continue to make sure continue to nominate me as a representative on the board proper currently it's just a shadow board so that decision to pursue that was taken today after proper debate the chief executive would like to speak thank you and through you chair I'm sorry to just make a slight correction the decision the recommendation today was to support cabinet to decide to continue with the OCP it's actually a decision of cabinet and so rather than just go straight into cabinet Councillor Lentell we felt it was right and proper to bring the paper here so that council could have a debate and then it has provided its support to cabinet and a report will now go to cabinet in March for cabinet to formally take that decision to continue with the OCP partnership thank you very much okay the question from Councillor Carla Hoffman can we just confirm on the line but I think she has now no okay so we'll move on and her question will be answered in writing 17C Councillor Sally-Anne Hart as written on the papers so Councillor John bachelor thank you very much for the question as you imagine I've got a very long list here wonders of the housing department and what they have delivered we've already touched on that in earlier debates so I just see a few highlights such as we now have a dedicated team to make sure there's meaningful tenant engagement we recognize the beacon of national good practice in terms of domestic abuse and safeguarding we've got ambitious plans as we heard earlier for climate emergency improvements of our housing we are working hard to prevent homelessness and we continue to deliver new high quality homes but the real thing so the question was believe if I can find the question for you and that's right but it was to feel that you believe that there are any particular risks that the council currently faces in relation to council housing so the real reason for that all those good things simply don't happen by chance the reason we should feel confident in our housing department is because we've got a first class management team and that's backed up by our professional and dedicated workforce so well done them thank you very much was your supplementary question answered yes thank you okay I can't oh yes so 17D from councillor Natalie Warren Green I think part of my question has already been answered earlier in the meeting in terms of the scale the support for South Cambridgeshire for the Ukrainian programme so the key question I've got now is what the council's main focus is at the moment to ensure hosts and guests get the support they need thank you I believe this leader will that go to the lead member for communities councillor Bill Handley it will be me I think thank you for the question as I said right at the beginning South Cambridgeshire has seen the highest number of visas granted by any local authority district in the country almost 800 and of those 500 over 500 are still with us so I can't really overstate the huge amount of work that our officers have had to put in to make the homes for Ukraine scheme work in South Cams with numerous checks what's that some of these bags is chiming it's not a fire alarm at least okay so yeah I can't overstate the huge amount of work that's gone in to make the homes for Ukraine scheme work in South Cams numerous checks, welfare visits payments to be made and actually they've gone further providing community support initiatives such as the free bike scheme which we're running in partnership with Al Bikes Cantrust and Papworth Trust they've done a fantastic job considered exemplary actually by other local authority responses indeed the homes for Ukraine work has become embedded in work programs now and we can think of that as one really of the council's response and the question from councillor on green was what are we doing now or what are we going to do forward so let's think of that as phase two the next steps for the guests and that's to do with thinking how we can help them into more independent living communications is key and we've started with an information pack that has been sent out so that our guests know their options accessing private rented accommodation in our district is just a huge challenge the significant gap between the nationally set local housing allowance and the cost of renting a home in South Cams however with the clever use of available home for Europe funding the council is putting in place mitigation in the form of rent deposit schemes, rent in advance support for essential white goods and furniture, hardship funds and more another creative way to help is to make the families share accommodation or suggest that the families share accommodation really makes rent more affordable makes it more viable hasn't been a particularly straightforward nut to crack but it's taken a lot of officer time and we feel we're there now so it's just a case of watch this space and you'll see what we're what we're proposing we can't imagine what our Ukrainian guests have gone through being away from their homes and loved ones and in some cases their loved ones to the war the council is going to continue to play its part in making life as good as it can possibly be for our Ukrainian guests at this terrible time our homes for Ukraine team climbed a mountain in phase one in the scheme but there's an even bigger one to climb in phase two but there are a dedicated and capable bunch and I'm absolutely confident that this is a great once again rise to the challenge I'd just like to thank them wholeheartedly for what they've done Thank you very much Councillor Henry I'm sure we agree with you I think councillor Susan Van Dr Susan Van Davern has left so so 17f is from councillor Corin Garvey Do you go ahead a real live councillor Corin Garvey in front of me Do you go ahead with your question Thank you chair How might the newly formed Oxford-Cambridge partnership benefit self in return Thank you councillor Garvey so we've already discussed this actually quite some length today so base just to reiterate what I've said before it will allow us to work on a regional scale to deliver environmentally sustainable growth, the benefits, communities across the district I could just give you an example of one of the environmental projects that I'd like to see rolled out further I went up to Oo's Fenn to see the work the RSPB have been doing on a massive aggregate extraction site and as that site is extracting so the RSPB are doing restorative work there to recreate wetlands and there was four species of birds they were aiming to attract there bitons, marsh harriers reed warblers and one other and when I got up there the far side of the site there was massive diggers extracting all this stuff, the bit where they'd done the work was full of these birds and I saw a marsh harrier which I'd never seen before and I wasn't there early enough to hear the bitons but I saw the reed warblers there so that's a fantastic project which could be rolled out arc-wide and particularly if things like east west rail happen there will be more and more of these major extraction sites along there so we could end up with an Oxford to Cambridge wetland project which will do a massive amount so that's the kind of vision that's what it's about, that can't be done on a smaller scale thank you very much yes, sorry what will you do if government rysins on its promise that the OCP is focused on the economy and the environment and starts to talk about large scale housing developments so that's a very smart question I think the difference now is that when it was the arc it was top down government led this is now firmly locally led and as I said earlier today there's no appetite at all to deliver large scale housing they were talking about the NIC report of 2017 talked about a necklace of new developments the whole way along it so there's no appetite from that certainly at the local level and I don't actually think there is in government anymore but if they suddenly came back and started talking about 1 million homes I'd be first on the line to object to it that we'd pull out of it and refuse to play ball thank you very much so moving on to item 17G a question from councillor Paul Berfock my question is for the lead member of finance and it's Hazred thank you chair well we discussed a lot of this today already but just to recap how we're responding there are five things that we're doing first of all be on top of expenditure and for that we have an extremely good leadership team at this council and it is extremely good at identifying value for money and where we can make savings the second thing is that of course we've introduced a transformation project and we set aside a transformation fund and we are using that to drive forward productivity across the council particularly using automation and artificial intelligence and as I say again that is driving value for money third thing we're doing is we've made some very shrewd investments over the last three or four years that is bringing in very good yields for us that are supporting our more traditional income streams of council tax and business rates the fourth thing is that we need to target and we are targeting our support on those that need it rather than a blunderbust approach we are identifying people for our cost of living crisis identifying people that need our support the food banks and the warm hubs etc and finally the fifth area is that we have through our business support team been making sure that our local businesses are supported and are given every opportunity to grow because it's our businesses that provide the jobs that give our residents the money to be able to spend and support other services in south camps Thank you Councillor Williams Did you have a supplementary? I do yes I'd like to ask the lead member for finance what he thinks the most significant challenges will be over the next three years I think as it becomes clearer what the government is going to do with a fair funding review then obviously the next three years is going to be all about countering the negative impacts of that to make sure that we are able to continue to provide good quality services and to meet the needs of those most in need in our district Thank you very much Councillor Graham Cohn Would you like to go with your question? Just as on the order paper chair Thank you That is directed to the leader Could Councillor Henry Baxter answer please on my behalf Thank you chair The answer I had prepared was quite lengthy I'm going to edit it down for speed So the answer comes in two parts Firstly what we're doing in our own housing stock and two what we're doing in private accommodation as well So in terms of what we're doing with our own housing stock regarding the mould issue we have instructed our repairs contractors to ask every single person who reports a repair of any kind if there are any other issues specifically mould in their properties so regardless of what the repair contractor is in there to do they will also be asking specifically about mould We've also issued guidance to all non-technical staff who may be in people's houses to do other types of work and the guidance revolves around how to identify mould and how to ensure it's properly reported This guidance has also been sent to all of us as councillors too We've also been asked our repairs contractor to ensure that all mould issues are reported correctly as well The big one that we're doing so we're carrying out a stock condition survey this year and we will instruct the surveyors to report any signs or reports of mould back to the council Finally if we identify a property that is high risk of developing mould we will then fit it with sensors to record the environment that may lead to a growth of mould for example high temperatures and humidity This will then help us to inform a tailored solution for each property I will now move on to private sector housing and what we're doing here We have slightly less control over this chair but obviously it's a matter for environmental health which is within my portfolio The steps we're taking here are we're reviewing our website to ensure the private tenants can readily find information on what they should do if they have poor housing conditions A landlord forum will be held in the next few months and a specific section on mould will be and how to identify and treat it will be raised there The private sector stock conditions survey will be completed by September of this year So that is the heavily edited version of my answer Thank you very much for that summary I'm rather hesitating Do you have a supplementary? I don't chair I just wanted to thank the lead member for that answer I know it's something that residents are very concerned about and I'm very reassured by the information that he has given to the council and residents Thank you very much Councillor Tom Bygott Thank you so much So this is to leader I'm going to ask to defer to Councillor Tewin Hawkins but just to say that I did attend Longstanton Parish Council meeting and I'm pleased to see that in their question they say Longstanton residents are pleased that the loss of their groundwater has now been taken seriously by SCDZ because I wasn't quite sure that was the case last night but I'm going to ask Councillor Hawkins to give some more detail which I didn't have at my fingertips last night Thank you Councillor Hawkins Thank you for your question Councillor Bygott I think I should say first of all that this administration has taken the groundwater issue very seriously since May 2018 when it was first brought to our attention by previous councillors John Johnson and Marian and that is why the HR well-informed et cetera process began and of course the meeting you referred to took place on the 26th of January so yeah just over three weeks but in that time we've been focusing on getting the actions that were agreed through and basically as of this week we've now received correspondence from the leg chair with the notes of the meeting secondly officers from the council just to let you know we've not received anything yet from leg on their engagement with HR well-informed is one of the things that was discussed but officers have made contact directly with HR well-informed and hopefully if they respond we can provide an update before the meeting which is scheduled for this Friday and also lastly the planning service we have actually contacted LNQ and Homes England with respect to obtaining the CCTV information in relation to phase one and the data for the groundwater on phase one and two again as was discussed at that meeting so really what we're doing or what we've been doing in the last three weeks is making sure that all that information that was talked about we can get it and then any action we need to take will follow on from that Thank you very much Did you have a supplementary and if you could keep it for me? Yes, Chair What has the council learnt from the long standard groundwater problem and what steps has it taken to ensure that something similar doesn't happen at Water Beach New Town or any other future New Town council plans? Thank you Thank you Chair Interesting What have we learnt? Things happen that you don't plan to happen then we still don't know why what's happened that's why we're still investigating as to trying to prevent that happening again in the future until we know why it happened I can't give you any assurances of what we can do to prevent it happening I don't know what we're preventing Thank you very much Sue Ellington Thank you, Chair I saw on the paper Thank you very much Sorry, I'll keep passing them on I'll pass it on to Councillor Electricity Milnes here knows all things electricity I look forward to hearing from Councillor Electricity Milnes Useless with Councillor Electricity Okay Thank you for your question Sue referencing our solar farm and micro grid in Water Beach Clearly this was part of an extended programme of decarbonising the refuse fleet which included the proposition to buy several electric refuse vehicles which we're already doing as you're aware including my favourite the rotating one The Archimedes screw Very noisy Very sorry about that So that REN project will create a solar array and a micro grid of electricity that includes battery storage and clearly that is the opportunity for us to generate green power or renewable energy and it will have the capacity of supporting around 20 refuse vehicles Each year you asked I think previously or within there about what the difference between winter and summer usage so there will be a significant difference so in the winter probably about 50 kilowatt hours to be generated whereas in the summer in the mid-summer we're talking about maybe 79 1000 kilowatt production and obviously that will vary the amount of electric vehicles we can support without going back to the grid and then that itself is going to be an issue because the local network provider UKPN have to providers with more electricity than previously was available so that's part of the project is to get them to move ahead with effectively being able to provide more power did you have a supplementary the whole thing goes belly up and we have a really cloudy or snowy period like 63 when we were sort of there for about three months without any sign of sun thank you we've had a conversation briefly about the snow effect and clearly if you get 63 levels of snow which I remember well because I was very excited to not be able to get out of my house because of the snow against the door so clearly those are exceptional circumstances and we'll have to make provision to make sure that we can clear the solar arrays from being blocked by heavy snow normally that wouldn't be a particular problem because as I said there was solar arrays generate some heat so that snow falls it's likely to melt and therefore slip off the solar panels but there's clearly an issue and we clearly won't be able to take on more electric vehicles than we can charge even with using the batteries as a supplemental power source which will allow us to continue operating those more evenly not only through the year but day by day great thank you very much indeed Councillor Mark Howell how's on the order people great thank you the sign of good leaders there was delegates so Councillor Henry Batchelor please thank you chair so very briefly so essentially the items commonly known as POPs or for assistant organic pollutants which more commonly known are things that are essentially upholstered like sofas chairs etc which now have to be disposed of in a very specific way now also have to be collected separately from other bulky items as well meaning that the service has had to essentially hire a separate van and deploy this van on its own round to solely collect these items has meant that service has had to be reduced the service for collecting these items has started up again albeit on a much reduced scale given the fact the separate van issue so the collection method has to have been assessed and it will continue to be assessed if the demand continues to rise the service will look at getting another van thank you very much and Councillor Howell did you have a supplementary? thank you very much so moving swiftly on I just wanted to draw your attention to the chair's engagements and to add to that that I attended the opening of the South Cambridgeshire Christmas Market at Camborn on the 11th of December and also the groundbreaking at Oakington Recreation Ground on the 2nd of February and that brings our formal business to a close but I would just like to say a special thank you to Angie Francis for this his first full council meeting and for keeping the timing so beautifully thank you very much indeed okay, members at 1855 I'll call the meeting to a close


More useful blocks. With the editing turned on, if we click the Add block dropdown, we can see that there are many blocks that can be added to our course, and it's worth exploring these by adding them and seeing what they do and by looking at the Moodle documentation on each block. We'll just look at a few in this video. For example, there is an Activity Results block. Later in the course, we'll learn how to add a quiz and then, if you have the Activity Results block, you can add a competitive element on your course page where the highest score is, or even the lowest score is, can be displayed. You can use this block with other gradable activities too. The Comments block allows your learners to add short little comments to either your course as a whole or to a particular activity. You can also add a Random Glossary Entry block. Later in the course, we'll look at adding a Glossary where learners can contribute items to the Glossary and then the Random Glossary Entry block will allow entries to be displayed on your course page directly. Another block is a Tags block, and this allows your learners to search for other learners with similar interests. If we take a look here, we can see that there's a Tags block, and if we click on any of the links, we can see the users who've put that as their interest. If we click Cats, here are the people who liked Cats. Let's take a look at another course page, and we can see an example of the Comments block. Some people have already made a comment, and you would simply add your comment and save it. As a teacher, you're allowed to delete students' comments if you think they're not appropriate. And individual learners can delete their own comments, but not those of others. If we open this, here's an example of the Random Glossary Entry block. So why not go and take a look at some of the other useful blocks you can add to your course?


Today, we will be talking about how to differentiate between SGA and FGR babies which is a very important topic, the growth disorders in pregnancy. Before you start doing that, you should know that accurate dating and assigning the correct EdD in early pregnancy is very important to determine the growth disorders later in pregnancy. We have seen this in our previous video when the gestational age matches the ultrasound biometric age, we assign the EdD as per LMP. When in early pregnancy scan, the gestational age mismatches the ultrasound biometric age, we assign the EdD as per ultrasound age and once assigned, we do not change the EdD in subsequent reports. So what is the criteria for this mismatch and this was the chart which we have seen in our previous video. So during growth scan, it is very important to always look at the early pregnancy dating scan only then you will be able to correctly diagnose the growth disorders in your subsequent scans. So if you have not really gone through the previous video, I request you to understand the concept of estimation of gestational age and assigning the EdD and then look at this video about the growth disturbances. So first we will define certain terms which are often used in the follow-up or the growth scans. The AGA or the appropriate for gestational age, the AGA fetus is the one whose size is within the normal range for its gestational age and they typically have the individual biometric parameters and or the expected fetal weight between 10th and 19th percentiles. For gestational age fetus is the one whose size is below a predefined normal threshold for its gestational age and so they typically have EFW or AC below the 10th percentile. Here we do not really take into consideration the other biometry that is BPD and FL. Here mainly the EFW and AC, these are the only two parameters which are considered. Either one of the two can be abnormal, it is not necessary to have both these parameters to be abnormal. The LGA is the large for gestational age fetus and it is the one whose size is above a predefined threshold for its gestational age and these fetuses typically have EFW or AC above the 90th percentile. So what is a macrosomia? Macrosomia at term usually refers to a weight above a fixed cutoff usually 4000 grams or some countries or some studies say it is more than 4500 grams. So if you see a fetus who at 32 weeks weighs say something like 3.4 kg which will be at around 95th centile so you will call it as the LGA baby but not really a macrosomic baby. So it is always better to label them as LGA fetuses. So this is the chart which will tell you about the AGA between 10th and 90th centile. Anything which is above 90th centile is large for gestational age and anything below 10th centile is a small for gestational age. So what is a fetal growth restriction? FGR or IUGR fetus is the one that has not achieved its growth potential. So it is a pathological smallness and not a physiological smallness. It is not small because it is meant to be small genetically because the parents are small in height or small in size but it is pathologically small. It has not achieved its growth potential. So there is a difference between the absolute size and the growth. The fetus should steadily grow during pregnancy, should increase in size during pregnancy so that is what is important. So that is why the growth velocities are important. It is important to plot the biometric graphs and it should not be just a single study but from the previous ultrasound studies if the biometrics can be plotted and compared and if this feature is available on your machine that actually helps to define the growth disorders better. Nowadays most of the machines have this feature. You should contact your application specialist and get this feature understood. So any particular studies say I do a study today and I draw this biometry plot graph but what is more important is to see the growth velocity. A fetus which is growing at 10 centile but is steadily growing will do much better than somebody who was growing normally initially and then has started falling back, falling down on the growth centiles. This will be still a worst condition because a fetus at 28 weeks which was almost at around 80th percentile at 32 weeks had come down to around 50th centile and if you see this fetus at 35 weeks it is actually come down to 15th centile. So by definition you will not even call it a small for gestation fetus but if you see it has gone down from growing at the speed of 80th centile to come down to around 50th centile. So this fetus also actually is a growth restricted fetus and that needs to be understood and in fact these are the ones which are at more or they are more susceptible to hypoxia later in pregnancy. So whenever you want to diagnose SGA versus FGR the first step is to define the smallness and we saw that that AC and or EFW less than 10 centile is a smallness. It may be only AC, it may be only EFW or it may be both these parameters may be smaller than 10 centile. So the consensus statement which was published in 2016 they defined the early versus late onset smallness. Then they discussed which parameters will be useful to detect FGR that means to differentiate between SGA and FGR and amongst these parameters which will be solitary parameters versus the contributory parameters to diagnose the growth restricted babies. So first was define early versus late. So before 32 weeks when you detect smallness it is called early onset and after 32 weeks if you detect smallness it is called a late onset. Now we come to which parameters are useful to detect the FGR. So there are biometry parameters and there are certain Doppler parameters which are the biometry parameters, the abdominal circumference and the EFW and the AC crossing centiles or the EFW crossing centiles. This is what we discussed before what we saw that the fetus which was growing say at 80 percentile has suddenly come down to 15 centile or say 12th centile is definitely crossed the centiles that means this is the FGR baby. So that needs to be understood and that is also the criteria to detect the FGR versus SGA babies. And which are the obstetric Doppler parameters, umbilical artery Doppler, the CPR and the uterine artery Doppler. What are the abnormal Doppler parameters we saw in our video on Doppler obstetric Doppler that umbilical artery PI more than 95th centile is considered abnormal, uterine artery PI more than 95th centile is considered abnormal and CPR if it is less than 5th centile then it is considered as abnormal parameter. We also saw in that previous video there are some other Doppler parameters like MCA, DV, aortic is thermos. So are they not important? No they are important in decision making about timing of delivery which will be discussed in a later section but right now we stick to umbilical artery, uterine artery and CPR for defining the FGR versus SGA. So now we saw which are the parameters which are useful to detect FGR and then we come to the solitary versus contributory parameters. Solitary parameter is a single parameter which is sufficient to diagnose FGR even if all other parameters are normal and a contributory parameter is the one which requires another parameter to be present to diagnose the FGR babies we will see this. So now you come to the small babies. Now if you see a smallness which was detected at less than 32 weeks that is early onset we know it is detected by AC or AFW less than 10th centile. Then we look at the centile if it is less than 3rd centile or if the Doppler parameter umbilical artery is absent in diastolic flow then we straight away diagnose it as FGR even though all other parameters may be normal. So this is a solitary parameter to diagnose FGR. Then early onset smallness. If you take the smallness detected which is less than 32 weeks by AC and AFW less than 10th centile but it is between the 3rd and 10th centile. So you cannot really rely on that criteria that less than 3 centile it is definitely FGR because it is between 3rd and 10th centile. So you need a contributory parameters to diagnose FGR. So which are these? One parameter of AC or AFW less than 10th centile combined with one of these Doppler parameters the umbilical artery PI more than 95th centile and or uterine artery PI more than 95th centile any one of the two or both of them. But there has to be one criteria as biometry less than 10th centile and one criteria of the Doppler. So this will be if they are there then it is FGR. If the contributory parameters if you don't see these Doppler parameters then it is SGA baby. So these are to summarize the criteria proposed by an international Delphi consensus in early onset FGR. Now you take an example where the smallness is detected beyond 32 weeks. So that is the late onset again the criteria remains the same for smallness. Again the criteria remains the same for absolute smallness or a severe smallness when it is less than 3rd centile you are definitely going to call it as FGR even though everything else is normal. Even though your Doppler is normal if it is less than 3rd centile it is going to be an FGR baby. So it is a solitary parameter to diagnose FGR. Now if you see that though it was small the AC or AFW is between 3rd and 10th centile. So now you are going to need a contributory parameters to diagnose FGR and what are these contributory parameters 2 out of 3 of the following which are these three AC AFW less than 10th centile of course you know because this is needed to define your smallness and which are the other is the AC AFW crossing centiles what we understood this concept before the crossing centiles or a falling growth velocity. If they fall more than 2 quartiles what is a quartile it is 25 percentile. So if it falls to more than 50th centile then also we will consider this as one of the finding one of the parameter to diagnose the FGR and what are the Doppler parameters CPR less than 5th centile or umbilical artery PIM more than 95th centile. So two of these criteria will tell you if it is the FGR and not his GA baby. So it may be that the Doppler parameter may be abnormal and the crossing centile is detected then also you will call it as the FGR fetus. So if it is there then FGR baby and if it is not there then it is a small for gestational age baby. So these are just to summarize the criteria proposed by an international Delphi consensus to detect the late onset FGR. So this is the absolute parameter or the solitary parameter severe smallness or at least 2 out of 3 of these following criteria which are the contributory parameters. We will just see it with the help of examples so that you understand it better. Now you see the scan at 36 weeks the AC is at 6th centile, AFW is at 8th centile. So smallness is detected it is late onset. Now you have to differentiate it between SGA versus FGR. Is it severely small to say directly that this is FGR no it is not below 3rd centile. So I need the help of contributory parameters and what are these these are the Doppler parameters. What are my Doppler parameters? The umbilical artery Doppler is PI is 1.5 which is 95th centile and more CPR is normal at 12 centile. But I have one parameter which is smallness that AC 6 centile and I have the criteria of umbilical artery Doppler abnormal so I will call it as the FGR fetus. Now if you take this example where it is not very small to call it directly as FGR. So we have done the Doppler and the umbilical artery Doppler is PI 80th centile and CPR is 18th centile both of them are normal. So only one parameter what I have is the smallness less than 10th centile. You do not count AC and AFW you have to call them together as one parameter that is biometry being abnormal. So now with this I call this as a small for gestational age and not the FGR baby because I have only one contributory factor and I do not have two contributory factors to call it as a FGR fetus and of course you should have seen the growth velocity that these centiles have not fallen below two quartiles more than two quartiles. So then I will call it as HGA versus FGR so that needs to be considered. Now if you see this fetus whose AC is 1.7 centile and AFW is at 6 centile umbilical artery Doppler is normal CPR of course also was normal so will it be FGR or SGA it will be straight way FGR irrespective of my Doppler parameters because the AC is at 1.7 centile which is less than third centile and it is a severe smallness. So this is an absolute or solitary criteria which can diagnose FGR. So just to summarize we should remember that all SGA fetuses are not FGR so you need to differentiate between the two but mind you all FGR fetuses may not be small. The weight may be 12 centile but if it is crossed more than two quartiles it is going to be the FGR fetus so that needs to be remembered and that's why the growth velocity and crossing centiles are important especially in the late onset FGR and the correct interpretation of biometry and Doppler helps to differentiate FGR subset from the SGA babies. After this we will then see the staging and management protocols in FGR babies in our next video. Thank you.


Soy Alfredo Gómez y deberíais seguir a Steps2Codio.  Getting better every day, trying to be as soon as possible on the bike again. Do you think you're going to be participating on the bike? Yeah sure, I will make a few races, still I don't know when I will be back, but sure I will be back. And for the people who are going to put in the next You look thinner, 5 kilos. Why? How could you lose weight doing less? Did you find those 5 kilos? 5 kilos? Did you find them, you lost? I lost. I wish, I need some weight. I need more weight. You get some traction here, right? Yeah. He will be saying that soon, so... You need it. So actually it's a question for both. Since you already participated and it's your first time in XLGash, who do you think is going to be one of the contenders for Cool? For Churro Graham, he knows the race very well. And for you, how's the race? Have you ever participated in the course of this slippery? The first bird 2 years ago was pretty slippery, but I don't think. The rivers and everything, I haven't ridden a race like that before. So walking, I crashed twice. I had the worst. In California, they don't have those rivers. I ride in the dust a lot. I put in the desert, so I don't have much water. But, I don't know. Last night was like an eye-opening deal, because it rained a lot, so the first race. I had troubles like the first two laps, and then I figured it out, and then I was good. The rest of the night was fast, but the first two laps was hard. And what's your take on the West? The West? Ah, it's good. What do you think you're going to shine? What kind of shine? I think I could do well, like Enduros. I think I could do... Classic Enduros? Yeah, Classic Enduros. I think I could do well at, like, the dollar, at Cross Country, as well as the beach race. I think I could do well at. I think Romania has to be pretty tough for me, because I haven't spent a long, five days on a bike like that. Yeah, from what I've heard of Navigations, I'm not thinking of the deal anymore. Yeah, I think the extreme races are hard for me, but I think, yeah, just experience. I haven't done enough. But this is your beach, right? No. This is your salad. Oh, riding the streets? These obstacles. All right, Willy boys? What? It's kind of narrow. I think I've never seen a tire so big in my life. That's going to be quite interesting.  Good to see you, man. Thank you so much. So much to you. Thank you so much.


And now on Sports News, a first half Romelu Lukaku strike and Chelsea a 1-0 victory over Saudi Arabia al-Qaeda on Wednesday to seal a spot in the club World Cup final. The European champions will face Brazilian side Palmyra on Saturday in the Mohamed Bin Zayed Stadium in Abu Dhabi after Belgian striker Lukaku fired home from close range in the second minute. Without Coach Thomas Tuchel on the touchline after he tested positive for COVID-19, the Blues looked in control in the first half, fully deserving their lead at the break. However, Asian champions Al-Hilal improved a great deal in the second half with Chelsea goalkeeper Kepa Arizo Balaga pulling off several fine saves to keep them at bay. Hello, hope you enjoyed the news. Please do subscribe to our YouTube channel and don't forget to hit the notification button so you get notified about fresh news updates.


Dhan-e-r-fukar-daman, dhan-ki-bab-e, kon-biz-di-le-balo-habek Shab-jibagan-ki-bab-e, hori-sar-sabak-to-habek Fasha-fashe aro baza-chat-karan-chok-mandi-darana-diye-ta-ki Ma-saib-de-shi-kar-e O-gola-ar-zon-na-mandir-ka-se-ashe-a, bi-u-der-ki-help-puri We connect farmers in real-time to extension services, to market pricing and also connect them to markets. This is an excellent opportunity to scale up the digital village initiative to help address some of the nutrition security issues in the country as well as food security challenges.