Health Care innovation and children in poverty: lived experiences of caregivers of children with disabilities in a medicaid-serving ACO

This paper reports the results of a qualitative study of caregivers of children with disabilities enrolled in a Medicaid-serving accountable care organization (ACO). The state of Ohio mandated ACO enrollment for Medicaid-eligible children with disabilities in 34 of 88 counties effective July 2013. Research participants were queried in focus groups and individual interviews about their children’s care experiences and care coordination after enrollment. Most told researchers that they themselves are their children’s care coordinators, and many indicated that resource scarcity is a more pressing problem than fragmented care. Data analysis identified a theme of scarcity and four categories of insufficiency that made caregiver efforts on behalf of their children more difficult: a lack of health services under managed care, resource constraints on other agencies and programs for which families were eligible, a lack of financial support, and a lack of family support. A conceptual framework places ACO care coordination among more upstream factors and identifies ways in which ACOs serving Medicaid populations may wish to address the social determinants of the well-being of children with disabilities. Implications for future research are discussed.     

Theory of mind,gender, gains in friendships versus peer acceptance and anxious solitude from middle childhood through early adolescence

This investigation proposes that theory of mind (ToM) may be related more strongly to change in friendships than peer acceptance in late middle childhood through early adolescence, and examines the relation between ToM and anxious solitude. Fourth grade ToM was tested as a predictor of change in reciprocated friendships, peer acceptance, and anxious solitude from 4th to 7th grade, and, conversely, reciprocated friendships, peer acceptance, and anxious solitude in 3^rd grade were tested as predictors of 4th grade ToM. Gender moderation of these relations was evaluated. Participants were 688 American public-school children (51.5% girls), 193 of whom completed a ToM questionnaire in 4th grade. In 3rd–7th grade children and their peers reported reciprocated friendship, and peers reported peer acceptance and anxious solitude annually. A multi-group (gender split) autoregressive cross-lagged panel analysis modeled relations between ToM and reciprocated friendship, peer acceptance, and anxious solitude over time. Consistent with hypotheses, girls’ more advanced 4th grade ToM predicted incremental gains in their number of friendships two years later, but not their peer acceptance. In contrast, boys’ more advanced 4th grade ToM did not predict change in their number of friendships or peer acceptance over time. Gender differences in the relation between ToM and friendship are discussed in the context of gender-specific peer relations patterns in late middle childhood and early adolescence. Additionally, more advanced 4th grade ToM predicted gains in anxious solitude in middle school for both genders. This somewhat surprising result is discussed in relation to ToM assessment and peer relations in anxious solitary children.     

Preventing child abuse and neglect: a national evaluation of Parents Anonymous groups

This evaluation assessed whether participation in Parents Anonymous mutual support groups was associated with child maltreatment prevention. Parents new to groups across the United States were interviewed at baseline, one month, and six months. Using standardized scales, all parents showed improvements in some child maltreatment outcomes, risk factors, and protective factors. Parents starting out with particularly serious needs showed statistically significant improvement on every scale. Results indicated that Parents Anonymous participation contributes to child maltreatment reduction.     

Warum kann die Wirkung von Maßnahmen eines Unternehmens auf das Vertrauen des Partners kulturabhängig sein?

Several studies give recommendations which actions a company can take to build its partners’ trust in business relationships. Studies report that, for instance, a company’s flexibility and detailed contractual agreements may positively affect the partner’s trust. However, cultural norms may moderate the effects of potential actions on the partner’s trust and this has hardly been considered in relevant literature. The present paper explains why actions a company takes may have different effects on trust in different cultures. Suggestions for future research and the design of empirical studies are proposed.     

Breaking the Silence of Child Sexual Abuse in the Caribbean: A Community-Based Action Research Intervention Model

In Trinidad and Tobago, little data exists on child sexual abuse, although there are many anecdotal reports of high prevalence. The Breaking the Silence Gender and Community Empowerment Model is a multidisciplinary intervention to prevent and respond to child sexual abuse in Trinidad and Tobago. It is an innovative, gender-sensitive intervention that uses a community based action research methodology anchored in a national framework. Preliminary evaluation of the Breaking the Silence model shows increased knowledge of child sexual abuse, increased willingness to discuss child sexual abuse, and an impact that goes beyond the target communities. This model can be replicated in communities to prevent and respond to child sexual abuse and adapted to address other sensitive social issues in the Caribbean.     

How Heterosexism Plagues Practitioners in Services for Lesbians and Their Families

Barriers to services for lesbians and their families have been well documented in the literature (DeCrescenzo, 1984; Harris, Schatz, & O'Hanlan, 1994; Nightengale, & Owen, 1995; Mallon, 1998), especially among medical professionals and social service providers. This study seeks to explore the prevalence of heterosexism and homophobia among mental health practitioners who identify as qualified providers for lesbians and the recipients' perspectives regarding the services they have received. Of the twenty-five practitioners who responded, 48% of them “knew personally of incidences of professional bias against lesbian clients.” Interestingly, only 26% of the 98 families reported heterosexual bias from their providers.     

The Effects of the Political Environment On Public Relations in Bulgaria

The purpose of this article is to examine the relationship between Web characteristics and perceptions toward relational components. A 2 (low interactivity and high interactivity) x 2 (text-oriented and multimedia-oriented) between-group experiment was designed with 197 participants to investigate this question. The outcomes showed that interactivity has significant effects on relationship building. However, the interaction effects between interactivity and medium arrangement suggest that nonessential arrangement of interactivity and multimedia did not enhance positive perceptions of relationships with the organizations. Interactivity, however, showed that the main effect, multimedia orientation, did not. The application of interactivity on the Web was discussed for better relationship building.     

Student Rights in an Age of Austerity? ‘Security’, Freedom of Expression and the Neoliberal University

In this profile, we examine a worrying trend taking place in institutions of higher education around the world: a notable increase in their managerial corporatization and neoliberalization, combined with greater repression of freedom of expression on campuses under the aegis of ‘securitization’. We focus attention specifically on how these twinned trends have impacted student activism in a post-2008 austerity-driven economic environment. Drawing on examples from Canada and elsewhere, we highlight attempts to depoliticize and institutionalize student engagement, as well as evidence of students working to break free of myriad constraints to foment change in their respective communities.