Re-setting special education for justice: An essay on the logics and infrastructure enabling deep change in the COVID-19-era

COVID-19 shocked the education system, disrupting the policies and practices of special education over multiple school years. This essay brings together the institutional logics perspective and racialized organization theory to first examine aspects of special education and then describe how leaders and teachers can improve special education to target inequities. We illustrate features of three logics of special education: compliance, intervention, and equity. We explain how these logics are racialized structures in the special education field. Applying an agentic stance, we portray how leaders and teachers draw on multiple, competing logics of special education. Next, we highlight how infrastructure enables leaders and teachers to enact the equity model of special education. In sum, this essay encourages improving infrastructural elements and confronting racism and ableism to re-envision special education in the face of COVID-disruptions.

'And what did you do about my emotions during Covid-19?' Making sense of negative emotions at work through institutional logics and Critical Systems Heuristics

The literature on Covid-19 has demonstrated that frontline workers use different coping strategies and engage in sense-making to address negative emotions. However, we know little about the underlying process of sense-making. Thus, this paper uses institutional logics to investigate how sense-making of negative emotions is enabled and constrained. This analysis draws on a diary written by a nurse at an Italian hospital, which represents an account of the emotions experienced by medical staff. The analysis identifies a set of enablers and disablers of sense-making, as well as, the patterns that alleviate and intensify frontline workers' emotions. Based on these findings and evidence of the Covid-task force at Papa Giovanni XXIII hospital in Bergamo, Italy, this paper illustrates Critical Systems Heuristics as a means to address the disablers of sense-making through participatory conversations that consider different institutional logics.

What determines the tax compliance intention of individual taxpayers receiving COVID-19-related benefits? Insights from Indonesia

PurposeEven as governments worldwide take extraordinary measures and spend unprecedented amounts of their state budgets to combat COVID-19, tax compliance remains challenging. Therefore, this study employs previously identified predictors to investigate the factors that persuade individual taxpayers to comply with the law.Design/methodology/approachIndividual taxpayers in Indonesia (N = 699) who had experienced COVID-19-related benefits were asked to assess the provided evaluation regarding the tax compliance intention and its determinants. The bootstrapping analysis was employed using smart partial least squares (SmartPLS) to test the hypotheses.FindingsThe results suggest that the perceived fiscal exchange, tax morality, tax fairness, tax complexity and the power of authority are significant determinants of tax compliance intention. This study also supports the indirect effects of numerous factors on tax compliance intention through the perceived fiscal exchange and tax morality. In practice, reminding taxpayers of how tax payments fund public services, improving taxpayer morale, increasing the perceived fairness of the tax system, streamlining the tax code and managing the effectiveness of tax administration could all lead to a greater intention to comply with the law.Originality/valueIn addition to highlighting the dynamics of tax compliance amid the unprecedented pandemic crisis, our findings also provide insight into the importance of perceived fiscal exchange and tax morality for achieving and sustaining planned behavior to comply with tax rules.

Extracting Temporal Relationships in EHR: Application to COVID-19 Patients.

Association rules are one of the most used data mining techniques. The first proposals have considered relations over time in different ways, resulting in the so-called Temporal Association Rules (TAR). Although there are some proposals to extract association rules in OLAP systems, to the best of our knowledge, there is no method proposed to extract temporal association rules over multidimensional models in these kinds of systems. In this paper we study the adaptation of TAR to multidimensional structures, identifying the dimension that establishes the number of transactions and how to find time relative correlations between the other dimensions. A new method called COGtARE is presented as an extension of a previous approach proposed to reduce the complexity of the resulting set of association rules. The method is tested in application to COVID-19 patients data.

An assessment of information needs and workflows for emergency service providers and caregivers of children with medical complexity.

BACKGROUND: The goal of Project Austin, an initiative to improve emergency care for rural children who are medically complex (CMC), is to provide an Emergency Information Form (EIF) to their parents/caregivers, to local Emergency Medical Services, and Emergency Departments. EIFs are standard forms recommended by the American Academy of Pediatrics that provide pre-planned rapid response instructions, including medical conditions, medications, and care recommendations, for emergency providers. Our objective is to describe the workflows and perceived utility of the provided emergency information forms (EIFs) in the acute medical management of CMC. METHODS: We sampled from two key stakeholder groups in the acute management of CMC: four focus groups with emergency medical providers from rural and urban settings and eight key informant interviews with parents/caregivers enrolled in an emergency medical management program for CMC. Transcripts were thematically analyzed in NVivo© by two coders using a content analysis approach. The thematic codes were combined into a codebook and revised the themes present through combining relevant themes and developing of sub-themes until they reached consensus. RESULTS: All parents/caregivers interviewed were enrolled in Project Austin and had an EIF. Emergency medical providers and parents/caregivers supported the usage of EIFs for CMC. Parents/caregivers also felt EIFs made emergency medical providers more prepared for their child. Providers identified that EIFs helped provide individualized care, however they were not confident the data was current and so felt unsure they could rely on the recommendations on the EIF. CONCLUSION: EIFs are an easy way to engage parents, caregivers, and emergency medical providers about the specifics of a care for CMC during an emergency. Timely updates and electronic access to EIFs could improve their value for medical providers.

Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital.

BACKGROUND: Developing and implementing home telehealth (HTH) services for patients with chronic conditions is a challenge. HTH services provide continuous and integrated care to patients, but very often pilot projects face non-adoption and abandonment issues. Change processes in healthcare are often complex and require learning to adapt to non-linear and unpredictable events. Complexity science can thus provide a complementary view to the predominant Quality Improvement (QI) approach in healthcare. In this study of two pilot projects in a Swedish hospital, we explore how a theory-driven approach can be used (a) to support the development of a self-monitoring HTH service in hospital care and (b) to evaluate staff and patients' experiences from early adoption. METHODS: To plan and evaluate the service for the recipients (i.e., patients and healthcare providers), we used the Plan-Do-Study-Act (PDSA) tool in combination with two complexity-informed frameworks: the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework, and the joint Complexity Assessment Tool (CAT). The theory-informed development process led to two pilot projects of an HTH service for patients with heart failure and COVID-19. We collected data from multiple sources (project documents, a survey on readiness for change among staff, and semi-structured interviews with patients and staff) and analyzed the data using descriptive statistics and qualitative content analysis with a deductive approach. RESULTS: Patients and staff perceived the services as valuable as they enabled rapid feedback, and improved communication and collaboration between patients and healthcare providers. Yet, despite the extensive development efforts, there was a perceived gap between how individuals valued the service and the capacity of adopters, the organization, and the wider system to effectively integrate these services into routine care. CONCLUSIONS: The combined use of PDSA, NASSS, and CAT can support the development and evaluation of HTH services that are perceived as valuable by individual patients and staff. For successful adoption, the value for individuals must be supported by organizational efforts to learn how to integrate new routines and tasks into clinical practice and daily life, and how to coordinate multiple providers within and outside the hospital walls.