Child Welfare in the South Pacific: Deciding Child Protection Matters Across Pasifika Nations.

The Asia-Pacific region is undergoing rapid change, and family structures and functioning are not exempt from this. Economic growth and urbanisation greatly affect the livelihood of family households across the Pacific Island countries. These changes take place against a backdrop of increasing inequity, rapid growth in technology, changes in traditional employment structures and a changing climate. Key social indicators suggest that violence, abuse and exploitation of children in the Pacific Island nations challenge their most vulnerable and marginalised children (Save the Children, 2019). To make the Pacific safe for every child, a number of nations are developing legal and regulatory frameworks for children's protection, with child and family welfare systems that address behaviour, attitudes and policies related to child protection concerns. This article examines key 'grey' literature drawn from UN, NGO and government documents, to offer an overview of what legal and welfare systems are in place in the Pacific Island nations in regard to child protection needs. It draws on Parton's (Parton, International Journal on Child Maltreatment 3:19-34, 2020, p. 20) suggestion that a range of political, cultural and sociological influences shape child protection policies which vary according to both time and place and family and community values. What the literature uncovers is the challenges Pacific Island nations face implementing such legal and regulatory frameworks for children's protection, what supports are needed to support any changes (UNICEF, 2015a, b), their need to address the United Nations Convention on the Rights of the Child, and to work with local communities, if there is to be effective reform around child wellbeing and safety, and their protection from harm (United Nations Convention on the Rights of the Child (UNCRC), 1989).

A Web-Based, Mobile-Responsive Application to Screen Health Care Workers for COVID-19 Symptoms: Rapid Design, Deployment, and Usage.

BACKGROUND: As of July 17, 2020, the COVID-19 pandemic has affected over 14 million people worldwide, with over 3.68 million cases in the United States. As the number of COVID-19 cases increased in Massachusetts, the Massachusetts Department of Public Health mandated that all health care workers be screened for symptoms daily prior to entering any hospital or health care facility. We rapidly created a digital COVID-19 symptom screening tool to enable this screening for a large, academic, integrated health care delivery system, Partners HealthCare, in Boston, Massachusetts. OBJECTIVE: The aim of this study is to describe the design and development of the COVID Pass COVID-19 symptom screening application and report aggregate usage data from the first three months of its use across the organization. METHODS: Using agile principles, we designed, tested, and implemented a solution over the span of one week using progressively customized development approaches as the requirements and use case become more solidified. We developed the minimum viable product (MVP) of a mobile-responsive, web-based, self-service application using research electronic data capture (REDCap). For employees without access to a computer or mobile device to use the self-service application, we established a manual process where in-person, socially distanced screeners asked employees entering the site if they have symptoms and then manually recorded the responses in an Office 365 Form. A custom .NET Framework application solution was developed as COVID Pass was scaled. We collected log data from the .NET application, REDCap, and Microsoft Office 365 from the first three months of enterprise deployment (March 30 to June 30, 2020). Aggregate descriptive statistics, including overall employee attestations by day and site, employee attestations by application method (COVID Pass automatic screening vs manual screening), employee attestations by time of day, and percentage of employees reporting COVID-19 symptoms, were obtained. RESULTS: We rapidly created the MVP and gradually deployed it across the hospitals in our organization. By the end of the first week, the screening application was being used by over 25,000 employees each weekday. After three months, 2,169,406 attestations were recorded with COVID Pass. Over this period, 1865/160,159 employees (1.2%) reported positive symptoms. 1,976,379 of the 2,169,406 attestations (91.1%) were generated from the self-service screening application. The remainder were generated either from manual attestation processes (174,865/2,169,406, 8.1%) or COVID Pass kiosks (25,133/2,169,406, 1.2%). Hospital staff continued to work 24 hours per day, with staff attestations peaking around shift changes between 7 and 8 AM, 2 and 3 PM, 4 and 6 PM, and 11 PM and midnight. CONCLUSIONS: Using rapid, agile development, we quickly created and deployed a dedicated employee attestation application that gained widespread adoption and use within our health system. Further, we identified 1865 symptomatic employees who otherwise may have come to work, potentially putting others at risk. We share the story of our implementation, lessons learned, and source code (via GitHub) for other institutions who may want to implement similar solutions.

Mental Illness in Children: Childhood Illness and Supporting the Family.

Childhood is a stage of life that is filled with potential for development, and the early years of childhood see immense physical changes in growth; mastery over body functions like movement; the acquisition of language and cognitive development to understand their own and others' thinking and reasoning; and the psychosocial development of trust in the world, comfort in the care they receive from parents and caregivers, and the sense of being secure in themselves that this engenders. [...].

Saving billions of dollars--and physicians' time--by streamlining billing practices.

The U.S. system of billing third parties for health care services is complex, expensive, and inefficient. Physicians end up using nearly 12 percent of their net patient service revenue to cover the costs of excessive administrative complexity. A single transparent set of payment rules for multiple payers, a single claim form, and standard rules of submission, among other innovations, would reduce the burden on the billing offices of physician organizations. On a national scale, our hypothetical modeling of these changes would translate into $7 billion of savings annually for physician and clinical services. Four hours of professional time per physician and five hours of practice support staff time could be saved each week.

Partnership in mental health and child welfare: social work responses to children living with parental mental illness.

Mental illness is an issue for a number of families reported to child protection agencies. Parents with mental health problems are more vulnerable, as are their children, to having parenting and child welfare concerns. A recent study undertaken in the Melbourne Children's Court (Victoria, Australia) found that the children of parents with mental health problems comprised just under thirty percent of all new child protection applications brought to the Court and referred to alternative dispute resolution, during the first half of 1998. This paper reports on the study findings, which are drawn from a descriptive survey of 228 Pre-Hearing Conferences. A data collection schedule was completed for each case, gathering information about the child welfare concerns, the parents' problems, including mental health problems, and the contribution by mental health professionals to resolving child welfare concerns. The study found that the lack of involvement by mental health social workers in the child protection system meant the Children's Court was given little appreciation of either a child's emotional or a parent's mental health functioning. The lack of effective cooperation between the adult mental health and child protection services also meant decisions made about these children were made without full information about the needs and the likely outcomes for these children and their parents. This lack of interagency cooperation between mental health social work and child welfare also emerged in the findings of the Icarus project, a cross-national project, led by Brunel University, in England. This project compared the views and responses of mental health and child welfare social workers to the dependent children of mentally ill parents, when there were child protection concerns. It is proposed that adult mental health social workers involve themselves in the assessment of, and interventions in, child welfare cases when appropriate, and share essential information about their adult, parent clients. Children at risk of abuse and neglect are the responsibility of all members of the community, and relevant professional groups must accept this responsibility.