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.     

Un-imagining the local/future: cinematic engagement with the absence of hope

ABSTRACT

With reference to the 2014 Umbrella Movement and Hong Kong’s uncertain fate come 2047, I ask how one un-imagines the cultural future of inhabiting the locality. As people take prompts from the present predicament to cope with real possibilities about the future, they realize that a strong embodiment of local consciousness permeates the sociocultural space. I discuss how such engagement takes place through cinematic experience, and examine tactics of the spectator’s critique centring around the erosion of hope at the core of everyday, intellectual and affective imagination. I trace the ways in which postcolonial subjects engage with hope and with the shock of hopelessness in a lived social imaginary. Examining in detail three differently representative recent films, namely, The Midnight After (2014. Dir. Fruit Chan, The Midnight After Film and One Ninety Films), Overheard 3 (2014. Dir. Alex Mak and Felix Chong, Sil-Metropole, Bona Film and Pop Movies) and Ten Years (2015. Dir. K. L. Ng (‘Local Egg’, Boon-deh dan), J. Au (‘Dialect’, Fong-yin), K. Chow (‘Self-Immolator’, Jee-fun jeh), F. P. Wong (‘Season of the End’, Dong sim), and Z. Kwok (‘Extras’, Fau gua), Ten Years Studio), I depict the modes in popular imagination that invoke people’s engagement with the ‘local’, albeit in its affective state. Accordingly, in the context of ‘externalized’ social realities, I identify three interlocking modes of cultural engagement, which I characterize as figurative, performative and prefigurative, respectively. In their ‘future’ imaginary, I look for ordinary people’s ways to face the absurdity of the status quo and the performativity of local struggles with the self.     

Comparing the Experiences of Highly Skilled Labor Migrants in Sweden and Japan: Barriers and Doors to Long-term Settlement

As labor markets become increasingly global, competition among industrialized nations to attract highly skilled workers from abroad has intensified. Spurred by concerns over future economic needs caused by the demographic challenges of an aging population, both Japan and Sweden have joined this global competition. This article examines Japanese and Swedish immigration policies for highly skilled migrants and compares the highly skilled migrants’ experiences in the two countries through interviews with these migrants. Despite Japan and Sweden's completely different approaches to immigration itself, both countries’ policies, as well as the experiences of the skilled migrants, are strikingly similar. Highly skilled migrants experience language barriers and prejudice in both countries, making it difficult to build social networks with natives. Career development seems to be perceived as a common problem, although less so in Sweden, where labor markets are more flexible. Overall, these issues reduce both Japan's and Sweden's ability to retain skilled migrants. While they share similarities, Sweden's famed work–life balance and gender equality give it an edge in the competition for skilled migrants, which Japan does not share. This comparison identifies which social conditions facilitate or impede skilled migrant settlement.     

The intersection of nonsuicidal self-injury and suicide-related behavior: Patterns of elevated risk and implications for college mental health

Objective: To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles. Participants: Respondents were 572 undergraduate students at a southwestern public university. Methods: Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure. Results: Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex. Conclusions: College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.     

Foster Parents’ Nutritional Strategies and Children’s Well-Being

Among their many responsibilities, foster parents are tasked with providing healthy food and proper nutrition to children with a variety of physical, psychological, and emotional needs. Using the lens of symbolic interactionism, this exploratory mixed methods study examined how foster parents attend to the nutritional needs of abused and neglected children. Methods used included both quantitative surveys and qualitative follow-up interviews. Surveys were completed by 23 foster parents in a large, Midwest metropolitan area. Parents reported they provided their children balanced meals, although one-third of households reported instances of food insecurity. During qualitative interviews, foster parents (N = 9) described how children arrived at their home with a variety of unhealthy eating habits, some severe in nature. Parents discussed strategies used to modify and improve eating patterns, including offering healthy food choices, having children plan meals, and gathering as a family for daily dinners. In general, parents understood the link between unhealthy eating and past childhood trauma, but also reported being unprepared for more serious eating problems like hoarding. Findings indicate that foster parents need food assistance to increase food security as well as training in assessing and responding a variety of unhealthy child eating behaviors.     

A Systems Approach to Social Entrepreneurship

Currently, disabilities organizations are increasingly being challenged by the requirement for individualized service, expectations to show personal outcomes, and the need to base their services on evidence-based practices. Social entrepreneurship (SE) is being put forward as an innovative approach for dealing with these challenges. This article presents a systems approach to SE based on a program logic model. This model identifies the input factors (a strong social vision, exploiting opportunities, maximizing resources), throughput strategies (entrepreneurial orientation, critical thinking skills, networking, capacity building), and outcome components (improving people’s lives, community-building, improving society) of SE at the micro, meso, and macro level. Also, the importance of planning for contextual changes as a social entrepreneur is discussed. The article concludes with presenting three inspiring practices regarding SE in the field of disabilities organizations.     

NGO Strategies in an Authoritarian Context,and Their Implications for Citizenship: The Case of the People’s Republic of China

This study argues that different cities in China have different resource environments available for NGOs. Organizations react to these resource environments by constructing appropriate resource strategies, which in turn shape the characteristics and structures of the NGOs of that city. It further examines how these characteristics and structures influence the construction and performance of citizenship in an authoritarian environment. Specifically, some types of NGOs encourage Chinese citizens to be passive, while others offer a model for people to actively engage with social issues. This is aptly demonstrated in an analysis of NGOs operating across four cities—Beijing, Shanghai, Kunming, and Nanjing—which reveals three different types of resource environments and behavioral models for NGOs. We subsequently discuss the implications of each model for citizen engagement.     

Disability,personalisation and community arts: exploring the spatial dynamics of children with disabilities participating in inclusive music classes*

This paper uses personalisation and the capabilities approach to explore inclusive music classes for children with disabilities in Scotland. It provides a unique insight into the impact of participation through the voices of the disabled young musicians, their parents and tutors. The study highlights the power of inclusive spaces to transform lives, to build confidence and contest disabled identities. It engages in the spatial dynamic of opening up inclusive spaces, as well as exposing emerging tensions in the liminal space that is created through movement between safe and supported spaces and the antithesis, spaces that disempower and marginalise. The findings suggest good practice around personalisation, when conceived of from a social justice perspective, as a template for working with other marginalised groups and in other professional settings.     

The Children First Program: The Effectiveness of a Parent Education Program for Divorcing Parents

This study evaluated the effectiveness of the 2nd and 3rd editions of the Children First parent education programs for parents experiencing divorce or separation. Participants were 678 parents experiencing separation or divorce in 2 Midwestern counties. Changes from pretest to posttest on participants’ knowledge, attitudes, and likelihood of adaptive coparenting were assessed. Both editions of the program had a significant positive effect on all 3 measures of adaptive coparenting. The effect sizes from pretest to posttest for the 2nd edition were small, whereas the effect sizes for the 3rd edition of the program were nearly twice as large. Superiority of the 3rd edition might be due to an increased focus on explicit training on adaptive coparenting behaviors.