Case management for child protection services:A multi-level evaluation study

This article presents an evaluation study of a case management method for child protection services, the Delta Method for Family Supervision, in terms of supervision order duration and occurrence and duration of out-of-home placements. Additionally, case and case manager characteristics were examined. Data was collected about 224 cases, 58 case managers and 30 team managers of all 15 offices of the Child and Youth Protection Services in the Netherlands. In all cases the Delta Method was applied. Data were obtained by interviews, questionnaires and case files. Multi-level analysis was performed to study the influence of independent variables on supervision order duration, and the occurrence and duration of out-of-home placements. Case characteristics related to 87% of the differences in the duration of supervision order, case manager characteristics to 13% of the differences. Some case manager characteristics about applying the Delta Method were significantly related to shorter duration of the supervision order and the occurrence and duration of out-of-home placement. Case characteristics also showed strong relations. Together with the more general aspects of case management supported by this study, such as a one family and one worker approach, this contributes to a more effective practice of case management for child protection services

Захист вітчизняного товаровиробника при здійсненні державних закупівель: зарубіжний досвід

Систематизовані знання щодо зарубіжного досвіду здійснення захисту вітчизняного товаровиробника при здійсненні державних закупівель. Проаналізовані основні елементи протекціонізму в США, Великобританії, Швейцарії, Італії, Ізраїлі. Висловлені пропозиції щодо особливостей впровадження їх у вітчизняних реаліях.Систематизированны знания относительно зарубежного опыта реализации защиты отечественного товаропроизводителя при осуществлении государственных закупок. Проанализированы основные элементы протекционизма в США, Великобритании, Швейцарии, Италии, Израиле. Сформулированы предложения относительно особенностей внедрения их в отечественных реалиях.In the articles systematized of knowledge in relation to foreign experience of realization of defence of domestic commodity producer during realization of the public purchasing. An analysis of basic elements of protectionism in the USA, Great Britain, Switzerland, Italy, Israel. Suggestions are expressed in relation to the features of introduction of them in domestic realities are detailed

Evaluation of national surgical practice for lateral lymph nodes in rectal cancer in an untrained setting

Background. Involved lateral lymph nodes (LLNs) have been associated with increased local recurrence (LR) and ipsi-lateral LR (LLR) rates. However, consensus regarding the indication and type of surgical treatment for suspicious LLNs is lacking. This study evaluated the surgical treatment of LLNs in an untrained setting at a national level.Methods. Patients who underwent additional LLN surgery were selected from a national cross-sectional cohort study regarding patients undergoing rectal cancer surgery in 69 Dutch hospitals in 2016. LLN surgery consisted of either 'node-picking' (the removal of an individual LLN) or 'partial regional node dissection' (PRND; an incomplete resection of the LLN area). For all patients with primarily enlarged (=7 mm) LLNs, those undergoing rectal surgery with an additional LLN procedure were compared to those undergoing only rectal resection.Results. Out of 3057 patients, 64 underwent additional LLN surgery, with 4-year LR and LLR rates of 26% and 15%, respectively. Forty-eight patients (75%) had enlarged LLNs, with corresponding recurrence rates of 26% and 19%, respectively. Node-picking (n = 40) resulted in a 20% 4-year LLR, and a 14% LLR after PRND (n = 8; p = 0.677). Multivariable analysis of 158 patients with enlarged LLNs undergoing additional LLN surgery (n = 48) or rectal resection alone (n = 110) showed no significant association of LLN surgery with 4-year LR or LLR, but suggested higher recurrence risks after LLN surgery (LR: hazard ratio [HR] 1.5, 95% confidence interval [CI] 0.7-3.2, p = 0.264; LLR: HR 1.9, 95% CI 0.2-2.5, p = 0.874).Conclusion. Evaluation of Dutch practice in 2016 revealed that approximately one-third of patients with primarily enlarged LLNs underwent surgical treatment, mostly consisting of node-picking. Recurrence rates were not significantly affected by LLN surgery, but did suggest worse outcomes. Outcomes of LLN surgery after adequate training requires further research

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men