Medicare and Amyloid PET Imaging: The Battle Over Evidence

We examine a recent dispute regarding the Centers for Medicare and Medicaid Services’ (CMS) refusal to unconditionally pay for amyloid positron emission tomography (PET) imaging for Medicare beneficiaries being assessed for Alzheimer’s disease. CMS will only pay for amyloid PET imaging when patients are enrolled in clinical trials that meet certain criteria. The dispute reflects CMS’s willingness in certain circumstances to require effectiveness evidence that differs from the Food and Drug Administration’s standard for pre-market approval of a medical intervention and reveals how stakeholders with differing perspectives about evidentiary standards have played a role in attempting to shape the Medicare program’s coverage policies.     

Restoring Meaning to Supervision Through a Peer Consultation Group in Rural Australia

The establishment of a cross-discipline peer consultation group in regional Australia is described. A research project, which explored the impact of the peer consultation on participants, using pre-group and post-group evaluation surveys along with data from an externally facilitated group evaluation session is discussed. Key findings reveal the value of access to varied modes of supervision; the importance of supervision not feeling like being subjected to surveillance; and the contribution that positive experiences of peer consultation have for our participants' well-being. The potential for improved connection and mutual benefits for practice and academia in sponsorship of professional peer consultation by regional universities also emerges from this research. The effectiveness of contemporary workplace counselling supervision arrangements, and of what, precisely, the enjoyment of engaging in case discussions in peer consultation groups is constituted are areas for more exploration.     

‘Just kids playing sport (in a chair)’: experiences of children,families and stakeholders attending a wheelchair sports club

Children who use wheelchairs have few opportunities to play sport with their able-bodied peers and siblings. This appreciative, qualitative study explored the experiences of children, families and stakeholders at a wheelchair sports club. Participant observation, research activities, focus groups and interviews were used. Sixty-three people participated (37 children, 14 stakeholders, 10 parents, two older siblings). Thematic analysis identified one unifying theme (realising potential) and four main themes: invisibility of disability; ambivalence and attraction of the chair; fun and fellowship; and thrills and skills. The Cheetahs created opportunities for meaningful participation in wheelchair sports for children with and without disabilities.     

Unanticipated ethical issues in a participatory research project with individuals with intellectual disability

The conduct of a participatory research investigation into the everyday literacy of adults with intellectual disability within the context of a PhD thesis highlighted issues related to the ethics of participatory research and the need to revisit and reconsider ethical guidelines around working with individuals with intellectual disability. Tensions were identified between participatory research ideology and the reality of research experiences, with additional issues arising due to disability in the first author.     

“It’s Not My Fault!” Status,Attributions, and Perceptions of Injustice: The Case of Custodians and Teachers

Perceptions of injustice rely upon a sense-making process in which individuals attempt to understand why and how it occurs. We draw from the attribution-of-blame model of justice judgments to examine how two work groups of disparate status make sense of the treatment and outcomes engendered by their interactions. Data from 27 in-depth interviews with custodians and teachers reveal that when custodians perceive disrespect from teachers and teachers perceive that custodians do not fulfill properly their duties, their attributions are shaped by their status position. Although both make internal attributions to each other for their injustice, teachers do not recognize how they perpetrate injustice against custodians and custodians perceive greater injustice by identifying how external factors affect their performance and blame. This unjustified blame fosters counterproductive work behaviors, illustrating how interdependencies fuel a cycle of injustice. We discuss the implications of these findings for the school and justice processes.     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.