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Melissa Williams

Publications and source records attributed to Melissa Williams.

3 recordsLinked to original sources

Changes in gait kinematics and posture with the use of a front pack.

The objective of this study was to determine if posture during gait can be affected by position of the load. It was hypothesized that the front pack would result in postural changes in the gait cycle, compared to a similarly loaded backpack. Thirteen healthy adults, free of any injury, volunteered to participate in this study. Two dimensional video data were collected at 50 Hz using a MacReflex video system. A backpack and a front pack were compared using loads of 10 and 15% of body weight. Markers were placed on the ear, acromion, greater trochanter and lateral joint line of the knee, lateral malleolus and fifth metatarsophalangeal joint. Data were collected while the participants walked at 0.75 stride/s. The data were used to calculate joint angles and displacements during each gait cycle. There was a significant difference noted in angles of the hip flexion, with the backpack condition demonstrating a greater flexion in each stride than either the control or front pack. Both backpack and front pack conditions demonstrated a significant change in neck motion compared to the control condition. The results of the position analysis over time also revealed an increase in the forward head position when participants were wearing the backpack compared to either the control or the front pack condition. It was concluded that the use of a front pack results in a more upright posture in gait, when compared to a backpack carrying the same load.

Adult↗

A multi-site study of Medicaid-funded managed care versus fee-for-service plans' effects on mental health service utilization of children with severe emotional disturbance.

Although Medicaid-funded managed care arrangements are commonly used in the delivery of mental health and substance abuse services to low-income children and youth, little is known about the effectiveness of such efforts. This article examines differences in mental health services utilization between children and youth with severe emotional disturbance covered by Medicaid-funded managed care behavioral health plans and those covered by fee-for-service plans. Data are from a federally funded multi-site study. In multivariate analyses controlling for child and caregiver demographic and clinical factors, enrollment in a managed care behavioral health plan was associated with lower inpatient/residential, psychiatric medication, and nontraditional services utilization. No difference was found in outpatient services utilization. Medicaid-funded managed care behavioral health plans appear to reduce use of some types of mental health services, but it is important to address the question of whether low-income children's enrollment in such programs deprives them of needed services.

Adult↗