ABSTRACT
The Scottish Children’s Hearings System makes life-changing decisions regarding the care and protection of children up to 18 years of age referred due to a need for support – because of offending behaviour or a risk to their physical or emotional safety. In March 2020, due to the Covid-19 crisis, Hearings underwent one of the most significant changes since their inception: proceedings shifted to an online conferencing platform (“virtual hearings”), and some procedural modifications were introduced. In June 2020, we used an online survey to gather more than 270 responses from professionals, volunteers, young people, and families who had experience of virtual hearings. These responses highlight that while there are reasonable justifications for the use of virtual hearings, including the duty to ensure orders are appropriately reviewed and renewed, concerns related to children and young people’s right to participation, privacy and representation bring into question the extent to which children’s rights are realised in virtual Children’s Hearings. © Robert B. Porter et al., 2021.
ABSTRACT
BACKGROUND: COVID-19 may result in multiorgan failure and death. Early detection of patients at risk may allow triage and more intense monitoring. The aim of this study was to develop a simple, objective admission score, based on laboratory tests, that identifies patients who are likely going to deteriorate. METHODS: This is a retrospective cohort study of all COVID-19 patients admitted to a tertiary academic medical center in New York City during the COVID-19 crisis in spring 2020. The primary combined endpoint included intubation, stage 3 acute kidney injury (AKI), or death. Laboratory tests available on admission in at least 70% of patients (and age) were included for univariate analysis. Tests that were statistically or clinically significant were then included in a multivariate binary logistic regression model using stepwise exclusion. 70% of all patients were used to train the model, and 30% were used as an internal validation cohort. The aim of this study was to develop and validate a model for COVID-19 severity based on biomarkers. RESULTS: Out of 2545 patients, 833 (32.7%) experienced the primary endpoint. 53 laboratory tests were analyzed, and of these, 47 tests (and age) were significantly different between patients with and without the endpoint. The final multivariate model included age, albumin, creatinine, C-reactive protein, and lactate dehydrogenase. The area under the ROC curve was 0.850 (CI [95%]: 0.813, 0.889), with a sensitivity of 0.800 and specificity of 0.761. The probability of experiencing the primary endpoint can be calculated as p=e (-2.4475+0.02492age - 0.6503albumin+0.81926creat+0.00388CRP+0.00143LDH)/1+e (-2.4475+ 0.02492age - 0.6503albumin+0.81926creat+0.00388CRP+0.00143LDH). CONCLUSIONS: Our study demonstrated that poor outcome in COVID-19 patients can be predicted with good sensitivity and specificity using a few laboratory tests. This is useful for identifying patients at risk during admission.
ABSTRACT
Purpose The study aims to assess the COVID-19 event in three European countries (Germany, Italy and the UK) by investigating the quality of their performance management of it. Design/methodology/approach Pragmatic constructivism (PC) is employed as a lens through which the performance management of each country can be examined and compared over a period encompassing the first wave of COVID-19. Findings Official statistics show that one of the countries has a significantly lower death rate. It developed and operated a more detailed and precise system of performance management. From the perspective of PC, this system supported efforts to build a functioning reality construction integrating facts, possibilities, values and communication. Originality/value The evaluation of different national approaches to the performance management of the COVID-19 reality is novel to the literature on management accounting. PC is used as a diagnostic tool to pinpoint strengths and weaknesses of the performance management of public sector activities in different countries.