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Before coronavirus disease 2019 (COVID-19), few hospitals had fully tested emergency surge plans. Uncertainty in the timing and degree of surge complicates planning efforts, putting hospitals at risk of being overwhelmed. Many lack access to hospital-specific, data-driven projections of future patient demand to guide operational planning. Our hospital experienced one of the largest surges in New England. We developed statistical models to project hospitalizations during the first wave of the pandemic. We describe how we used these models to meet key planning objectives. To build the models successfully, we emphasize the criticality of having a team that combines data scientists with frontline operational and clinical leadership. While modeling was a cornerstone of our response, models currently available to most hospitals are built outside of their institution and are difficult to translate to their environment for operational planning. Creating data-driven, hospital-specific, and operationally relevant surge targets and activation triggers should be a major objective of all health systems.
Demonstratives play a crucial role in the acquisition and use of language. Bringing together a team of leading scholars this detailed study, a first of its kind, explores meaning and use across fifteen typologically and geographically unrelated languages to find out what cross-linguistic comparisons and generalizations can be made, and how this might challenge current theory in linguistics, psychology, anthropology and philosophy. Using a shared experimental task, rounded out with studies of natural language use, specialists in each of the languages undertook extensive fieldwork for this comparative study of semantics and usage. An introduction summarizes the shared patterns and divergences in meaning and use that emerge.
Recent judgments in England and Wales have confirmed and extended the High Court's inherent jurisdiction to make declarations about interventions into the lives of ‘vulnerable’, rather than simply ‘mentally incapacitated’ adults. We argue that this shift is problematic because of the ways that the ‘vulnerable adult’ has been constructed in order to justify such interventions. The accounts of vulnerability drawn upon in the constructive process highlight the person's inherent characteristics and/or the circumstances within which that person might be denied the ability to make a free choice. Such an approach parallels the public policy protection of ‘vulnerable adults’ from abuse in care services and the statutory protection of ‘vulnerable witnesses’ in the criminal justice system, and is built on an external and objective assessment of being ‘at risk’, rather than an understanding of the subjective experience of being vulnerable. We argue that this imbalance might act to disempower the ‘vulnerable adult’ by reducing that person's life to a series of risk factors that fail, first, to place him/her at the heart of the decision to intervene, and, secondly, to engage adequately with the experiences through which that person ascribes meaning to his/her life.
It is widely believed that people can remember the age at which they
first had sexual intercourse. Questions about age at onset are routinely asked
in population sexual behaviour surveys and in clinical history-taking.
However, there are limited test–retest data, especially with regard to
individual differences in unreliable recall. In this study, telephone
interviews and follow-ups an average of 15 months later were conducted with
570 non-virgin subjects aged between 28 and 73 years. Test–retest correlations
for recalled age at first intercourse were 0·85 for females and 0·91 for
males. Consistency was slightly
lower among older people and women with a history of sexual abuse. There were
associations between consistency of recall and measures of personality,
educational background or history of alcohol dependence and depression.
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