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.     

Tracking weight change,insulin resistance,stress, and aerobic fitness over 4 years of college

Objective: To determine if weight gain is accompanied by development of insulin resistance (IR) during 4 years in college. Participants: Two cohorts of college students were enrolled in fall semesters 2009 and 2010 and tracked for 4 years. Methods: Following a 12-hour fast, subjects reported for measurement of body mass index (BMI), perceived stress (PSS), aerobic fitness, and blood glucose, insulin, and lipids. Results: In the first year, 33% of subjects were overweight or obese, and 20% were hyperinsulinemic. Year 4 had 29 remaining subjects with disproportionate attrition of overweight and obese individuals. Just over half the subjects gained weight (WI), whereas nearly 30% lost considerable amounts (WD). WD showed significant decline in fasting insulin, low-density lipoprotein (LDL) cholesterol, and PSS from year 1. WI was primarily highly fit men who did not demonstrate increased IR. Conclusion: WI was not associated with IR over 4 years of college.     

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.     

Evaluation of <Emphasis Type="Italic">Safer,Smarter Kids:</Emphasis> Child Sexual Abuse Prevention Curriculum for Kindergartners

This study assessed the effectiveness of the Safer, Smarter Kids kindergarten sexual abuse prevention curriculum in meeting its educational objectives of increasing children’s knowledge of safety risks and self-protection strategies. The study utilized a two-phase non-probability convenience sample of public school kindergarten students. The sample consisted of 1169 students in four school districts in Florida. Using an alpha level of .05, a paired-samples t test was calculated to compare the mean pretest scores to the mean posttest scores of the youth participants. The mean difference was significantly greater than zero (p-value ≤.001). The measurement instrument used to assess student gains functioned well in terms of reliability (α = .82). The effect size was large with a Cohen’s d effect size of 1.09. The results indicated that completion of the Safer, Smarter Kids curriculum was followed by a significant increase in students’ knowledge of key prevention concepts with a 77 % increase in scores post intervention.     

Community Informant Explanations for Unusual Neighborhood Rates of Child Maltreatment Reports

This study explored perceptions of community informants on socioenvironmental factors that explain why rates of child maltreatment reporting are different in neighborhoods with similar population characteristics. This study used data from the SoCal Neighborhoods and Child Welfare study, a multiphase, mixed-methods study of neighborhoods in Los Angeles and San Diego counties. Semistructured qualitative interviews with key informants (N = 28) in 22 census tracts explored factors that account for differences in maltreatment rates among sociodemographically similar neighborhoods. Thematic content analysis revealed three themes regarding neighborhood contributors to maltreatment behaviors and reporting: (a) community norms and values, (b) community resources and providers, and (c) housing dynamics and built environment. Findings indicate complexity in forces that affect maltreatment behavior and reporting. Adding to research on neighborhood social dynamics and child maltreatment, findings suggest that composite indicators of maltreatment within neighborhoods are affected by maltreatment behaviors and the definition, recognition, and reporting of maltreatment.     

Online Civic Engagement and the Anti-domestic Violence Movement in China: Shifting Norms and Influencing Law

In the context of China’s new law against domestic violence, proposed by the State Council in November 2014 and passed in July 2015, this article examines online engagement by Chinese citizens leading up to the legislative revision, and examines the Sina Weibo microblog activities of one influential organisation, nǚquán zhī shēng (Feminist Voice). I ask how a Chinese Civil Society Organisation (CSO) uses online media to open public discourse on, and in some cases challenge, formal and informal institutions around a normatively marginalised issue, the case of domestic violence. Drawing on and synthesising literature on domestic violence, civil society and online communications in China, this study provides a timely contribution given the relative limitedness of up-to-date data, after the huge wave of publications following the 1995 Beijing conference. Findings are based on content analysis of the Feminist Voice microblog during 2012. While Chinese CSOs are often dismissed as non-confrontational and therefore ineffective change agents, Feminist Voice does challenge status quo marginalisation of domestic violence in the public sphere and facilitate discussion around formal and informal institutional reform, thereby influencing social attitudes and potentially also policy and law making.     

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.     

Fostering Environmental Integration in Public Aid: Influence of Interactions Between Environmental NGOs and Aid Donors

In order to ensure sustainable development, aid donors need to improve the environmental effectiveness of their whole activity. This improvement seems to be influenced by their interactions with environmental NGOs (ENGOs). Faced with a diversity of interactions between these two kinds of actors, a strategic typology is proposed here to describe this multiplicity and, by doing so, to consider their environmental impact. Four relational postures have been identified: (i) external advocacy and (ii) the cooperation–criticism focus on the antagonistic link that exists between environment and development; (iii) environmental collaboration, and (iv) service provision, which focus on synergies that can exist between environment protection and development issues. Win–win solutions need to be continuously sought and enhanced. However, ENGOs and donors are called to recognize the necessity of maintaining a critical position in actors’ interactions vis-à-vis the implementation of development activities that are detrimental for the environment.