Risk reduction: Recontexualizing health as a physical education curriculum

While there is sufficient evidence to suggest that physical activity is inversely related to lifestyle diseases, researchers are far from being certain that this evidence extends to children. Nevertheless, the school physical education curriculum has been targeted as an institutional agency that could have a significant impact on health during childhood and later during adulthood if individuals could be habituated to assume a physically active lifestyle. The purpose of this article is to examine the recontextualization of biomedical knowledge into an ideology of healthism in which health is conceived as a controllable certainty and used as a pedagogical construction to transform school physical education. Using a Foucauldian perspective, we explore how the atomized biomedical model of chemical and physical relationships is constructed, reproduced, and perpetuated to service and empower the discourse and the practices of researchers and scholars. In this process the sociological or cultural aspects of public health are marginalized or ignored. As a result of this examination, alternative approaches are proposed that engage the limitations of the biomedical model and openly consider the insights that are available from the social sciences regarding what participation in physical activity means to individuals.

Public and private psychiatry: Can they work together and is it worth the effort?

Objective: Partnerships in mental health care, particularly between public and private psychiatric services, are being increasingly recognized as important for optimizing patient management and the efficient organization of services. However, public sector mental health services and private psychiatrists do not always work well together and there seem to be a number of barriers to effective collaboration. This study set out to investigate the extent of collaborative 'shared care' arrangements between a public mental health service and private psychiatrists practising nearby. It also examined possible barriers to collaboration and some possible solutions to the identified problems. Method: A questionnaire examining the above factors was sent to all public sector mental health clinicians and all private psychiatrists in the area. Results: One hundred and five of the 154 (68.2%) public sector clinicians and 103 of the 194 (53.1%) private psychiatrists returned surveys. The main barriers to successful collaboration identified by members of both sectors were: 'Difficulty communicating' endorsed by 71.4% of public clinicians and 72% of private psychiatrists, 'Confusion of roles and responsibilities' endorsed by 62.9% and 66%, respectively, and 'Different treatment approach' by 47.6% and 45.6%, respectively. Over 60% of private psychiatrists identified problems with access to the public system as a barrier to successful shared care arrangements. It also emerged, as hypothesized, that the public and private systems tend to manage different patient populations and that public clinicians in particular are not fully aware of the private psychiatrists' range of expertise. This would result in fewer referrals for shared care across the sectors. Conclusions: A number of barriers to public sector clinicians and private psychiatrists collaborating in shared care arrangements were identified. The two groups surveyed identified similar barriers. Some of these can potentially be addressed by changes to service systems. Others require cultural shifts in both sectors. Improved communications including more opportunities for formal and informal meetings between people working in the two sectors would be likely to improve the understanding of the complementary sector's perspective and practice. Further changes would be expected to require careful work between the sectors on training, employment and practice protocols and initiatives, to allow better use of the existing services and resources.

Lessons learned . . . about curriculum: Five years on and half a world away

The knowledge, skills, and attitudes manifested in health and physical education school curricula are an arbitrary selection of that which is known and valued at a particular place and time. Bernstein's (2000) theories of the social construction of knowledge offer a way to better understand the relationship among the production, selection, and reproduction of curricular knowledge. This article overviews contemporary knowledge in the primary field (production) on which curriculum writers in the recontextualizing field might draw. It highlights tensions in the knowledge generated within the primary field and, using a case of the USXs National Standards for Physical Education (NASPE), demonstrates how particular discourses become privileged when translated into curriculum documents in the recontextualizing field

Post-Fordism, the welfare state and the personal social services: A comparison of Australia and Britain

The Post-Fordist welfare state thesis locates contemporary social welfare change within a wider analysis of the transformation of capitalist accumulation regimes. Whilst this analysis is useful in directing attention to macro socio-economic change, it has for the most part contained three shortcomings. First, the Post-Fordist thesis has overemphasized the role of historical 'breaks' in the development of social welfare as it purportedly passes from Fordism to Post-Fordism. Second, the thesis has assumed a degree of convergence between welfare states as a result of global economic forces. In doing so, it has underemphasized the mediating impact of existing institutional arrangements within nations. Third, the thesis has assumed, rather than demonstrated, the specific changes which are alleged to be taking place in various fields of social welfare. As a consequence, aspects of continuity in social welfare have been neglected. These three lacunae are addressed through a comparative analysis of developments in the personal social services in Australia and Britain. Services to older people are employed as the specific context of comparison in relation to three dimensions of measuring transformation along a Post-Fordist trajectory: a shift from a unitary economy to a mixed economy of service provision; changes in the model of service delivery and consumption; and strengthening the governance function of the central state. This comparative analysis suggests the need for refinement of the Post-Fordist welfare state thesis concerning the restructuring of social welfare and its impact on the personal social services.