Safeguarding disabled children in residential settings: what we know and what we don't know

Research in America, Canada, Australia and Britain has revealed that disabled children are particularly vulnerable to abuse. Their likelihood of attending residential institutions, their dependency on others for personal care and the lack of opportunities for them to alert others to maltreatment or comprehend the nature of abusive acts all increase levels of risk. Over the last decade, there has been increasing public and professional concern about the abuse of children in residential establishments, resulting in a number of inquiries. However, the abuse of disabled children in residential settings has received little attention. Despite residential schools, care homes and respite care being widely used by disabled children, there is a paucity of knowledge regarding the standards of child protection in these establishments. This article explores the research literature revealing the vulnerability of disabled children to abuse when living away from home, what measures can be taken to help protect them and the limitations of available data as a basis for planning child protection measures. Copyright © 2002 John Wiley & Sons, Ltd.     

Separation anxiety,attachment and agoraphobia

Within a framework of attachment, developed by John Bowlby, the anxiety disorder of agoraphobia (fear of leaving familiar surroundings, especially when alone) is conceived as a condition of anxious attachment, related to fear of separation from those with whom one has formed affectional bonds. Bowlby attributes this anxiety to earlier separation or loss experiences or threat of separation. Uncertain about his/her attachment figures, the person is prone to separation anxiety and clinging behavior and lacks confidence for exploring the world and dealing with stressful situations. Psychotherapy offers a temporary attachment relationship, a secure base from which to explore and understand the effects of these experiences in order to develop more self reliance in relationships with others.     

Standards,Regulation and Development of School-age Day Care and ‘Open Door’ Services1

The subject is play and day-care services for school-age children. The paper draws on research carried out by the author and colleagues at Thomas Coram Research Unit (TCRU). It reports a survey of 120 services, randomly sampled, from 20 local authorities in England and Wales. This provides data about the standards to be found in such services when they became subject to registration and inspection under the Children Act 1989, and identifies shortcomings with regard to material resources and practice. The paper then draws on two case studies, and reports and discusses the problems met by local authorities in carrying out their new duties under the Act. These included their inexperience of services for over fives, the lack of resources available to improve services and the transient nature of holiday play schemes. It covers ways in which registration personnel used the Act to raise standards, eg ‘counselling out’, making requirements and conditions, and advising and resourcing service providers. The concluding discussion points to the need for further policy development in this area.     

Reinstituting the Economic Process: (Re)embedding the Economy in Society and Nature

Polanyi argued that the project of creating a fully self-regulating market was utopian, in the sense of impossible. However, movement towards this utopia, the ever greater but never completed process of disembedding the economy from both society and nature, creates growing dislocations and tensions which call forth a counter movement. This double movement may be thought of as successive changes in the way in which the economic process is instituted. The focus of the paper is on the meaning of embeddedness, the ways in which the economy was reinstituted during the Great Transformation and the subsequent counter movements, and alternative approaches to further reinstituting the economy in ways that disembed it further or (re)embed it more firmly in society and nature. It is argued that prior to the creation of the capitalist market the economy was organically embedded in society and nature. However, the creation of separate economic institutions, the institution of the economic process as a distinct system with its own laws of motion, severed these organic links and the economy came to dominate both society and nature. Here, however, the symmetry between society and nature ends. Society has the capacity for conscious, purposeful action; nature does not. For the economy to be reinstituted in ways that create a sustainable organic relationship with nature, it must first be reinstituted in ways that bring it under social control.     

Developing a Core Competency Model and Educational Framework for Primary Maternity Services: a national consensus approach

BackgroundAn appropriately educated and competent workforce is crucial to an effective health care system. The National Health Workforce Taskforce (now Health Workforce Australia) and the Maternity Services Inter-Jurisdictional Committee funded a project to develop Core Competencies and Educational Framework for Primary Maternity Services in Australia. These competencies recognise the interdisciplinary nature of maternity care in Australia where care is provided by general practitioners, obstetricians and midwives as well as other professionals.ParticipantsKey stakeholders from professional organisations and providers of services related to maternity care and consumers of services.MethodsA national consensus approach was undertaken using consultation processes with a Steering Committee, a wider Reference Group and public consultation.FindingsA national Core Competencies and Educational Framework for Primary Maternity Services in Australia was developed through an iterative process with a range of key stakeholders. There are a number of strategies that may assist in the integration of these into primary maternity service provider professional groups’ education and practice.ConclusionsThe Core Competencies and Educational Framework are based on an interprofessional approach to learning and primary maternity service practice. They have sought to value professional expertise and stimulate awareness and respect for the roles of all primary maternity service providers. The competencies and framework described in this paper are now a critical component of Australian maternity services as they are included in actions in the newly released National Maternity Services Plan and thus have relevance for all providers of Australian maternity services.     

Output-sensitive algorithms for Tukey depth and related problems

The Tukey depth (Proceedings of the International Congress of Mathematicians, vol. 2, pp. 523–531, 1975) of a point p with respect to a finite set S of points is the minimum number of elements of S contained in any closed halfspace that contains p. Algorithms for computing the Tukey depth of a point in various dimensions are considered. The running times of these algorithms depend on the value of the output, making them suited to situations, such as outlier removal, where the value of the output is typically small. This research was partly funded by the NSERC Canada.     

Histories of poverty and self-rated health trajectories

This paper investigates the dynamic relationship between poverty histories and self-rated health trajectories. We are interested in patterns of change in individuals' health over time and the ways in which such patterns are structured by continuity and change in poverty experiences. Data, collected for adults aged 25 and older in 1984 (N = 7,258), are from the 1968-1996 annual waves of Panel Study of Income Dynamics (PSID). Individual growth curves allow us to investigate health trajectories as continuous processes, as well as individual and group heterogeneity in these trajectories. We find that, on average, health deteriorates slowly over time, but there is significant variation in health in 1984 and the rate at which health declines. Histories of poverty partly accounted for the sources of individual differences in self-rated health in 1984, but they were not related to health change over time. Although increasing incomes were better for self-rated health than falling incomes, current economic circumstances did not erase the health effects of earlier poverty experiences.     

What is Adult Attachment?

This paper explores the concept of adult attachment. Although attachment theory is now getting a great deal of attention, there is not yet a clear picture of what it means to be attached in adulthood or what the clinical applications of the approach might be. Using Bowlby’s distinctive ethological-evolutionary framework and updating it with findings from neurobiology and attachment research, it is proposed there is an attachment behavioral system that operates throughout the lives of adults and that this changes the way we understand our clients’ distress and carry out psychotherapy.