Assessing human movement with accelerometry

The methods for measuring and evaluating human movement have advanced rapidly over the past 2 decades. The use of smaller, lighter, more powerful personal computers, digital video cameras and miniature, portable accelerometers have allowed the health professional, engineer, sports coach and scientist to very precisely record and quantify human movements on the sports field, in the business office, industrial setting and in the home. Most human motion analysis systems have evolved to meet the particular needs of the user. One such system that has developed over the past ten years in the Sport Science Laboratory at Dalhousie University is the Padlog series of accelerometer systems. This paper will discuss the development the Padlog systems at Dalhousie.     

Improving mental health assessments in child protection through audit

Existing agency records, together with questionnaires completed by social services referrers and mental health providers, were used to identify problems in current arrangements for obtaining specialist mental health assessments in child protection cases. Standards were set and implemented through a multi‐agency steering group. The practice of referrers and providers was then reaudited. Sixty‐nine social workers, six mental health specialists and 27 child protection initial case conferences (involving 31 children) were involved in the reaudit over a 4‐month period. Initially, main problems concerned communications, unclear referral and access arrangements, waiting times and disagreements over prioritization. Standards concerned consultation and decision‐making arrangements within the child mental health service, the format of referral and reply letters, the sharing of information and the attendance of mental health professionals at child protection case conferences. There appeared to be improvements in all these areas at reaudit. In conclusion, some shared views of problems, additional support funding and the audit process appear to have helped to improve inter‐agency collaboration and develop more efficient referral and care arrangements. There is a need to maintain and further develop this work, and audit would again be a useful means. Copyright © 1999 John Wiley & Sons, Ltd.     

‘Who do I turn to if something really bad happens?’ Key working and relationship-based practice in residential child care

ABSTRACT

This article explores the psychodynamics of relationship-based practice from the perspective of young people in residential care. This research involved qualitative semi-structured interviews with 10 care leavers, aged 18–24 years, who had been in residential care in Ireland. Drawing selectively from that research, this article reports their views and experiences of key-working and how relationship-based practice acted as a reparative method within their experiences of care and aftercare. Similar to previous research, this study underscores the necessity to ensure that children in care are cared for and supported by a trusted adult. In addition, based on this study, the role of a key worker appears capable of providing this ideal type of supportive relationship. It also highlights the importance of the care system working to provide consistency and support for the young people and confirms the importance of relationships with trusted adults, such as key workers.     

Social process theory of emotion: A dynamic systems approach

In this paper we apply a dynamic systems perspective to infant emotional development. We propose that emotions are not states but self-organizing dynamic processes intimately tied to the flow of an individual's activity in a context. We review data on the relationship between emotional actions and the social context, in particular the development of smiling and laughter. These data are more adequately explained by our perspective than by other theories of emotional development. We provide a model for how emotional processes in early infancy become embedded into sociocultural systems, and suggest new avenues of research on emotional development.     

Procurement process: Decision by exclusion and pairwise comparisons

Two case studies illustrate multicriteria decision making techniques frequently used in procurement practice: least-cost sufficient performance and weighted utility optimization. Both techniques have defects and are rarely robust. Decision by exclusion and pairwise comparisons is proposed as a third approach which eliminates inferior alternatives by generalized forms of minimum performance requirements established under multicriteria framework. It is more robust and maintains high level of accountability.     

Barriers to accessing HIV and sexual health services among gay men in Tasmania,Australia

We examined barriers to accessing HIV and sexual health services among gay and bisexual men (GBM) in Tasmania, Australia, using in-depth interviews. Most participants were satisfied with the care they had received at public sexual health services. Barriers included the limited number of services, concerns about anonymity and privacy in small communities, difficulties accessing services via a general practitioner, and perceived stigma and discrimination. Improving the accessibility and availability of HIV and sexual health services in Tasmania is crucial to promote the engagement of GBM, which could be achieved via combined efforts of government services and community organizations.     

HMO marketing: the Cadillac and the Chevy.

The author's bias and goal is to create an effective group practice model. Managed care will play an important role in this model. This article is designed to examine the role of an HMO in this model and to provide a framework for examining the HMO-group practice relationship. The bottom line question : Are HMOs the most effective group practice vehicle for delivering managed care?